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Published on January 28, 2019

rural scene

Project ECHO Goes the Distance

Distance is a tremendous challenge for rural health care. Experts and the patients may be too far apart to allow for services to come to the aid of those who need them most.

A new program that Avera Behavioral Health professionals are launching could bridge this gap. Project ECHO is a distance-based learning platform that can help primary-care providers partner with distant specialists. It’s a program that began in New Mexico, but has spread across the globe, with Avera being the first South Dakota Project ECHO hub launched.

“The potential for a program like this is huge, and we’re hopeful that this initial development, which is focused on substance abuse patients, will in time allow for variations of the Project ECHO hub in our region,” said Malia Holbeck, LCSW, LAC, outpatient manager with Avera’s Addiction Recovery Program. “This program will focus on eastern South Dakota, where we have patients who need assessment, counseling and treatment but who do not have facilities in their communities to provide these services.”

Building the Spokes, Sharing Knowledge

A federal Health Resources & Services Administration grant has allowed Avera Behavioral Health professionals like Holbeck to extend chemical dependency therapy services to rural communities. Project ECHO has similarities, but is more focused on giving tools and expertise to caregivers instead of directly to patients. The substance abuse program underway will focus on a number of communities, starting with Aberdeen and Flandreau, S.D.

“We envision Sioux Falls as the hub for the project, and that our substance abuse counseling teams can share insights and expertise with providers in the ‘spoke’ communities who need it,” said Holbeck. “The original Project ECHO began with patients who were facing hepatitis, but who were hundreds of miles away from the facilities and doctors who could help them. Specialists in hepatitis treatment there began hosting sessions to train local health care providers who could aid patients more directly.”

Improving Technology's Reach

In a typical Project ECHO session, a group would meet virtually via video conference using computers with webcams.

“The panel of experts at the hub would consider particular cases, but we would remove patient information and maintain their privacy,” said Cathy Niklason, Avera eCARE Account Executive, and co-director of the project. “The panel would spend about 15-20 minutes in a didactic lecture format, and then the session would be opened to the group for interactive questions and answers. This allows providers in locations away from the central setting to share information confidentially.”

The entire group could gain insight from the feedback the experts at the hub would offer to each participant. Those who take part in sessions would not only be doctors or care-providers, but the multidisciplinary teams that make up holistic care, including nurses, social workers and others. The clinicians would also be able to obtain CME & CNE credits for having participated in these sessions.

Project ECHO efforts will initially concentrate on chemical dependency including Medication Assisted Treatment (MAT), but expansion of scope and geographic range is likely, including all parts of the Avera footprint.

“It’s a great way to pool resources and save money,” said Niklason. “We also hope to provide better possible outcomes for those who need specialized care.”

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