Improving rural health

The Extension for Community Health Outcomes project will bring top-ranked specialists into rural communities by way of teleconferencing and other electronic health care technologies. The program is will be run from the University of Colorado Anschutz Medical Campus with a grant for $3.3 million from the Colorado Health Foundation. (Courtesy photo)

The disparity between rural health care and larger urban areas continues to be an issue in Colorado and across the nation. A two year, $3.3 million grant hopes to improve this situation for underserved areas in the state.

The University of Colorado Anschutz Medical hopes to narrow that gap, bringing big town medical expertise to small town Colorado. The Extension for Community Health Outcomes program was conceived by Dr. Sanjeev Arora of the Department of Internal Medicine at the University of New Mexico Health Sciences Center.

The grant from the Colorado Health Foundation will help rural medical facilities connect to a video teleconferencing network. The network will enable rural health care workers to connect with top-ranked specialists which will improve the level of care in outlying districts.

“ECHO Colorado’s primary goal is to provide the same level of care in rural areas that is available in Denver,” said Dr. John Thomas, codirector of ECHO Colorado at the University of Colorado.

The program allows practitioners to open case studies and submit them to electronic queues, different queues for various medical subjects.

Then a group of cases will be reviewed by specialists, along with the practitioners, during scheduled video conferences.

This will not only give practitioners an opportunity to learn from the specialists, participants in the conference will learn from each other.

The project will cover both primary health care and public health programs.

“ECHO is an effective way to use modern communications and modern learning principles to improve both primary health care and public health,” said Tim Byers, MD, MPH, director of ECHO Colorado and of the Center for Public Health Practice at the Colorado School of Public Health at CU Anschutz.

“We look forward not only to replicating the many successes of this strong learning model shown in New Mexico and other states, but also to adapting the ECHO model based on the principles of peer learning, case-based learning and practical skills advancement in a time-efficient system.”

According to the Rural Assistance Center there are 43 specialists available to every 100,000 rural patients. In contrast there are 134 specialists for the same number of patients in urban areas.

When ECHO is in place, it will enable clinics that see patients with complex chronic conditions like autism, hepatitis, diabetes or epilepsy, to have access to professionals that specialize in these conditions.

ECHO will also support public health efforts in treating obesity, tobacco control and infectious disease control.

“As new rural clinical partners join ECHO Colorado,” said Thomas. “They will receive training in care management, the teleconferencing tools, data collection and reporting and how to engage with other practices like their own in a learning network.”

“From that point on they will be able to join separate disease-specific clinics for case presentations and discussion – all while earning continuing education credits.”

Currently the only options for residents of Park County who need to see specialists is to drive to Leadville, Breckenridge, Salida, Conifer, Buena Vista, Divide or the Denver area. This can be a larger burden for patients who are elderly or at a financial disadvantage.

Telehealth technologies include the use of videoconferencing, Internet, store-and-forward imaging, streaming media and terrestrial and wireless communications.

“We certainly look forward to working with your nurse practitioners to expand their capacities and provide improved health access for the folks in Park County,” said Thomas.

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