Project ECHO® (Extension for Community Healthcare Outcomes) is a teleconsulting and telementoring partnership between MD Anderson specialists and providers in rural and underserved communities.
Build capacity among community based clinicians via case-based learning and co-management of patients by using videoconferencing technology integrated with clinical management tools to connect primary care providers in rural and underserved areas with specialty consultants.
Overview and Proof of Concept
Project ECHO was developed in 2003 by Dr. Sanjeev Arora of the University of New Mexico (UNM) in response to a high prevalence of untreated Hepatitis C (HCV) in the state. Dr. Arora conducted weekly videoconferences with primary care providers in 16 community clinics and 5 prisons in New Mexico. Patient cases were presented, and a multidisciplinary team at the UNM provided clinical mentoring, evidence-based advice on patient management and regular didactic education sessions. At the end of the three year period, the outcomes of patients treated by primary care providers who participated in Project ECHO were no different than patients treated by specialists at UNM. The results of this study were published in 2011 in the New England Journal of Medicine and concluded that the ECHO model is safe and effective in helping to manage patients with HCV in underserved communities.
The Project ECHO model has since expanded to manage over 100 complex conditions including infectious diseases, rheumatologic diseases, chronic pain, addiction, HIV, diabetes, complex multisystem disease, cancer prevention and hospice care. Currently over 320 academic centers around the U.S. and globally serve as ECHO hubs.
The University of Texas MD Anderson Cancer Center today announced the expansion of its global oncology efforts in Mozambique and Brazil, including a new four-year agreement to broaden existing cancer prevention and treatment efforts with the Ministry of Health in Mozambique and a $5.1 million grant from the National Institutes of Health (NIH) focused on cervical cancer prevention and treatment among women living with the human immunodeficiency virus (HIV).
"As an institution committed to advancing cancer care globally, MD Anderson recognizes the urgent need to address the cancer burden in Mozambique and Brazil. Through these collaborations, we strive to empower communities, to improve access to quality care and to enhance research efforts,” said Peter WT Pisters, M.D., president of MD Anderson. “Together, we can make a profound impact on reducing the effects of cancer in these nations, bringing us all closer to Making Cancer History®.”
MD Anderson and colleagues in Brazil began collaborating with Mozambique’s Ministry of Health in 2014 to increase cervical cancer screening and treatment. Together, they are working to further increase cervical cancer screening, to perform research, and to train additional medical providers with hands-on experiences and through the Project ECHO® telementoring model.
Every year, more than 600,000 new cervical cancer cases are diagnosed and more than 340,000 related deaths occur worldwide. In Mozambique, cervical cancer represents about 32% of the country’s new diagnoses and is the leading cause of cancer-related deaths among Mozambican women.
Collaboration in Mozambique expands to include breast and prostate cancer
Building on nearly 10 years of success, MD Anderson has signed a new agreement expanding its collaboration in Mozambique to continue offering high-quality cancer care to Mozambican women and to increase the country’s medical capacity by training nurses and doctors. The collaboration, initially focused on cervical cancer, will broaden to include breast and prostate cancer.
In addition to increased screening and treatment, the initiative aims to grow the nation’s participation in research studies. More than 10,000 Mozambican women combined participated in the first two cervical cancer research studies jointly performed by MD Anderson and the Mozambique Ministry of Health.
Consortium will advance technologies to better prevent and diagnose cervical cancer
MD Anderson, along with Rice University and partners in Mozambique and Brazil, was awarded a $5.1 million U54 grant from the NIH to develop novel, low-cost technologies for cervical cancer screening, diagnosis and treatment in women living with HIV, a significant risk factor for cervical cancer.
The collaborative team will conduct research studies in Brazil and Mozambique, which are both primarily Portuguese-speaking nations. Performing these studies in Mozambique as well as Brazil will allow for important comparisons between countries and will provide results that may be applicable to other low- and middle-income countries, as well as underserved regions of high-income countries. The grant also will support research training and exchanges between investigators in the U.S., Brazil and Mozambique, furthering global collaborations.
“Both HIV/AIDS and cervical cancer are significant public health issues in Mozambique and Brazil,” said principal investigator Kathleen Schmeler, M.D., executive director of Global Oncology and professor of Gynecologic Oncology & Reproductive Medicine. “We look forward to working together with our colleagues in Mozambique and Brazil to improve cervical cancer screening, diagnosis and treatment for women living with HIV globally.”
MD Anderson Cancer Network® advances the institution’s mission to eliminate cancer by collaborating with local hospitals and health systems to improve the quality and accessibility of cancer care and research. As part of its Global Oncology program, a collective approach to ending cancer in low- and middle-income countries, the institution collaborates with governments and mission-aligned organizations to advance cancer education, training, public policy and research initiatives.
MD Anderson and the World Health Organization (WHO) previously announced an international collaboration to reduce the global burden of women’s cancers, including breast and cervical cancers, and an agreement with Indonesia’s Ministry of Health to establish a cooperative relationship to advance cancer care/services, cancer education/training and cancer research.
Train to become an ECHO hub for oncology.
Becoming an ECHO Partner for MD Anderson programs
Follow these steps to become a member:
- Find a program you would like to participate in
- Contact the program manager or Melissa Lopez Varon to receive the meeting invitations and information about the ECHO clinics
- Set up the free videoconferencing software (Zoom) and any required hardware that is needed for participation
- Connect to your first ECHO clinic
Videoconferencing (Zoom) Instructions
Follow these steps to connect to a clinic:
What are the benefits to clinicians?
- Evidence-based, best practice guidance from specialists
- Case-based "learning-loop"
- Clinical updates and presentations from specialists
- No cost CME, CEU, CNE for participation
- Live Q&A
- Opportunity to translate new knowledge into practice to improve outcomes for patients in their community.
What is the cost?
All of our sessions are free, but require a commitment to actively engage in the peer learning community by sharing their experience and presenting cases.
What equipment is needed?
ECHO MD Anderson uses an internet-based video technology called Zoom. Participants can connect to the video sessions through their phone, tablet, laptop, or a computer with a webcam. Technical support is provided.
Is this only for physicians?
Any health care professional interested in engaging around a topic, sharing their experience, and learning from their peers can attend ECHO sessions. We welcome physicians, nurses, psychologists, counselors, social workers, healthcare administrators, certified tobacco treatment specialists, patient navigators, pharmacists, and public health practitioners.
How can I be sure that the case presentation I share in a session remains confidential?
Only non-identifiable information is shared during the sessions. Our sessions are HIPAA safe and a secure place to share information.
Can I get CME, CNE or CEUs for attending?
All non-international sessions include continuing education credit for attending.
How do patients make an appointment at ECHO?
Patients do not attend and are not seen during Project ECHO sessions. Instead, these sessions facilitate a way in which community providers connect to specialists who help co-manage patients. Participants can present cases to a specialist or simply join others in the spirit of learning.