J. Harrison, United States of AmericaKENNEDY KRIEGER INSTITUTE Psychiatry
Moderator Of 1 Session
The shortage of child and adolescent psychiatrists is a global crisis. Much attention has been given to solutions to the unmet need for child mental health services. One of the four priorities for the next decade of child psychiatry outlined in 2019 by a workgroup of psychiatric leaders of international groups is to expand the workforce beyond the direct training of child psychiatrists to other healthcare professionals. (Skokauskas 2019). Project ECHO (Extension for Community Health Care Outcomes) has been a promising model of workforce expansion. It uses the approaches of high quality CME and integration by combining collaborative cased based consultation with didactic instruction delivered virtually. The initial success of this model has led to its global expansion.(VanCleave 2017) This workshop will demonstrate the efficacy of ECHO as a workforce multiplier by describing its use to address child psychiatry shortages in four different countries. An opportunity for general questions and discussion of developing ECHO programs will follow brief presentations. Dr. Pajer will describe Project ECHO Ontario(CYMH) which has trained 500 primary care and mental health providers. Dr. Leppert will discuss KKI-NECT(US) which addresses early childhood mental health and development. Dr. Newcomb will describe ECHOs targeting general practitioners and non-medical staff in Queensland Australia. Dr. Dharmadhikari will discuss using ECHO to train general psychiatrists in rural India. Dr. Gardner’s presentation of operational outcomes will open the discussion about developing of ECHO programs (funding, operationalization, evaluation). All of the presenters will describe adaptations to their programs to address COVID-19 related concerns.
Presenter Of 1 Presentation
W0029 - Introduction to Project ECHO(Extension for Community Heathcare Outcomes)
Introduction: Nationally and internationally, there is a gap between the need and availability of child mental health services. This gap stems from a lack of trained specialists, workforce misdistribution, variations in insurance and financing, and family concerns about the benefits of existing services. Of the possible solutions to these problems, expansion of the child mental health capacity of primary care providers (PCPs) has been proposed as a feasible and scalable approach.
The Extension for Community Healthcare Outcomes (ECHO) model was originally conceived and executed by Dr. Sanjeev Arora at the University of New Mexico for Hepatitis C. It serves to de-monopolize medical expertise by extending knowledge from specialists to PCPs
Objectives: After attendance at this session, the learner will be able to: 1. describe the history and expansion of the ECHO model worldwide, 2.name the components and structure of ECHO sessions, 3. discuss ECHO as a force multiplier.
Methods Dr. Harrison will briefly present the history and expansion of ECHO. She will then describe the program, which consists of a “hub and spokes” model with “tele-clinics” consisting of a “hub” of specialists and “spokes” of clinicians in rural, underserved areas who present cases for discussion, generating treatment recommendations.
Results: The ECHO model has been replicated in a variety of disciplines across the United States and internationally. Its success has been well documented. There are currently 920 active ECHO programs worldwide.
Conclusions: Project ECHO is a viable model to address the workforce shortage of child psychiatrists worldwide.