MS ECHO: Innovative Pilot to Improve the Capacity of Providers in Underserved Areas to Treat MS

Background: MS Project ECHO (Extension for Community Healthcare Outcomes) is a collaborative effort between the University of Washington (UW) and the National MS Society (Society) to improve MS care in underserved communities.  The model catalyzes a mentor-based learning community where a multidisciplinary specialty MS care team, primary care providers and community neurologists engage through weekly videoconferencing and case based learning with CME credits. The Project ECHO® model has demonstrated improved healthcare outcomes in pain management, Hepatitis C, HIV, and other diseases.  The pilot goal is to develop a Project ECHO® for MS care and to establish feasibility and replicability. A unique characteristic of this ECHO is the collaboration between an academic center and a voluntary health organization. A grant to the Society from the Medtronic Foundation, Patient-Link Program provided funds for this pilot.

Objectives: a) develop an MS-focused curriculum, b) identify recruitment strategies and assess retention among participants c) obtain meaningful feedback on satisfaction with the program and, d) identify preliminary information to determine impact on clinical care.

Methods: A team consisting of representatives from the Society and the UW developed a curriculum, and supporting resources to be tested during a 12-week series of one-hour videoconference sessions with community neurologists and primary care providers from Alaska, Idaho, Montana, and Washington.  Each session included a brief didactic presentation and case presentations as well as introduction to resources available through the Society to support care delivery. Semi-structured interviews and surveys were utilized to assess satisfaction. After the first 12 week series, the program was assessed and modifications made for a second 12 week series.  Recruitment strategies targeted health care providers from the Society’s resource database, the UW network, and the Health Resources and Services Administration (HRSA)’s list of rural providers

Results: Outcomes included developing a unique MS-focused curriculum and piloting the ECHO methodology in two 12-week series with >18 participants. Feedback from the first 12-week series led to an increased emphasis on case-based education in the second 12-week series. Recruitment was most successful among community neurologists, although primary care providers who participated valued the case consultation, learning about resources, and addressing complex MS care issues through a comprehensive model. 

Conclusions: MS Project ECHO was successfully delivered to enhance the knowledge of community providers treating individuals with MS. Replication of this model and long-term follow-up are needed to determine whether this model can be applied more broadly to improve the quality of MS care and outcomes for underserved MS populations.