Strategies Used by Interprofessional Teams to Counter Healthcare Marginalization and Engage Complex Patients.

Low-income U.S. patients with co-occurring behavioral and physical health conditions often struggle to obtain high-quality health care.

A Novel Intervention for High-Need, High-Cost Medicaid Patients: a Study of ECHO Care.

Background: A small number of high-need patients account for a disproportionate amount of Medicaid spending, yet typically engage little in outpatient care and have poor outcomes.

Objective: To address this issue, we developed ECHO (Extension for Community Health Outcomes) Care™, a complex care intervention in which outpatient intensivist teams (OITs) provided care to high-need high-cost (HNHC) Medicaid patients. Teams were supported using the ECHO model™, a continuing medical education approach that connects specialists with primary care providers for case-based mentoring to treat complex diseases.

ECHO Care: Providing Multidisciplinary Specialty Expertise to Support the Care of Complex Patients.

Background: Programs for high-need, high-cost (HNHC) patients can improve care and reduce costs. However, it may be challenging to implement these programs in rural and underserved areas, in part due to limited access to specialty consultation.

Aim: Evaluate the feasibility of using the Extension for Community Health Outcomes (ECHO) model to provide specialist input to outpatient intensivist teams (OITs) dedicated to caring for HNHC patients.

Extension for Community Healthcare Outcomes (ECHO): a new model for community health worker training and support.

More than 50,000 community health workers (CHWs) are employed in the United States (US), a country with no national accreditation or certification program. In the US, CHWs are trained, formally and/or on-the-job, and rarely is long-term mentoring included. We developed a CHW training program using the Extension for Community Healthcare Outcomes (ECHO) model™, distance education using video teleconferencing to support case-based learning, and mentoring of healthcare providers from medically underserved communities.

Contingent engagement: What we learn from patients with complex health problems and low socioeconomic status.

Objective: Elicit patients' perceptions of factors that facilitate their engagement in care METHODS: In-depth interviews with 20 adult Medicaid patients who had complex health problems, frequent hospitalizations/emergency department use, and who were enrolled in an intensive, team-based care program designed to address medical, behavioral, and social needs.

Results: Prior to engaging in the program, participants described weak relationships with primary care providers, frequent hospitalizations and emergency visits, poor adherence to medications and severe social barriers to care. After participating in the program, participants identified key factors that enabled them to develop trust and engage with care including: availability for extended intensive interactions, a non-judgmental approach, addressing patients' material needs, and providing social contact for isolated patients.

Project ECHO Brings Innovation to Community Health Worker Training and Support.

ECHO is a movement to build capacity to provide best practice care for rural and underserved people all over the world. Community health workers are an integral part of this movement. Using videoconferencing technology to augment in-person training, ECHO creates a community of practice for case-based learning and ongoing support.

Building capacity to reduce disparities in diabetes: training community health workers using an integrated distance learning model.

Purpose: The purpose of this study is to determine whether an innovative interactive distance training program is an effective modality to train community health workers (CHWs) to become members of the diabetes health care team. The University of New Mexico Health Sciences Center has developed a rigorous diabetes training program for CHWs involving both distance and hands-on learning as part of Project ECHO™ (Extension for Community Healthcare Outcomes).

Methods: Twenty-three diverse CHW participants from across New Mexico were enrolled in the first training session.