With the constant media coverage of medical research these days, it's easy to assume that the big advances in health care will depend on a gleaming future of painless cures and breakthrough discoveries in the laboratory. But any big picture of health in this country reveals a very large obverse of the coin: the millions of people who don't have access to the medical care that's already out there—particularly care in the medical specialties.
Patients in these underserved communities risk unnecessary illness, suffering and loss of life, while medical costs associated with care for sicker people rise.
The GE Foundation, the charitable arm of the global company, is throwing its support behind a program that's been using a technological fix to connect frontline community physicians and health providers with specialists in cutting-edge research centers. The foundation recently announced a $14 million grant to the University of New Mexico to expand Project ECHO (Extension for Community Healthcare Outcomes.)
ECHO uses basic videoconferencing to link community providers with specialist care teams at far-off academic medical centers. At weekly teleconferenced clinics, primary care providers from multiple sites present patient cases and work with multidisciplinary teams of experts to determine treatment.
The goal is to enable primary care doctors, nurses, and other clinicians to provide specialty care to patients right in their own communities. Long trips or delays once associated with specialty care can be reduced or eliminated—as can a substantial portion of the costs.
"For millions of Americans, access to specialty care for common, complex health conditions like rheumatoid arthritis or chronic pain is extremely challenging," said GE. "Many patients must travel hours in order to see a specialist, while others forgo the specialty care they need."
We've reported on similar grantmaking before. Last year, for example, the Duke Endowment gave big to expand access to psychiatric services in North Carolina using online technology—so-called "telepsychiatry."
The three-year GE grant will be used to increase the number of federally qualified health care centers that can participate in ECHO.
ECHO enables the specialist teams to mentor community providers in the treatment of conditions that were previously outside their expertise. You may have heard of telemedicine, in which a single patient connects with a doctor in a remote location. Project ECHO can help many more patients by increasing the ability of local providers to manage a greater variety of medical problems.
ECHO resembles other innovative forms of community-based health initiatives that are demonstrating significant benefits for people facing barriers to medical care and information. In California, for example, extensive research is underway on the effectiveness of the promotora model in communities with large immigrant and non-English-speaking populations. Promotoras are laypeople who receive special training in subjects like heart health and diabetes; the promotoras then help educate others in their communities, or possibly help them get medical care. Unlike ECHO, promotoras come at the problem from the patient's side of the equation, but one element is the same: better access to care and information that can mean the difference between health and illness.