Reducing Disparities in MS Care: An International Videoconference-Based Provider Education and Case Consultation Program
As the international community gains access to newer DMT agents that are associated with greater risks of toxicity, there is an increased need for medical education. The international MS community would benefit from providers experienced with the use of newer agents spreading knowledge to providers in countries where these same treatments are just emerging.
To explore the feasibility of an international videoconference-based provider education program for specialty multiple sclerosis (MS) care.
In collaboration with the National MS Society we developed an MS-specific adaptation of Project ECHO (Extension for Community Health Outcomes), a videoconference-based program aimed at reducing disparities in care of chronic conditions in the U.S. Participants in MS Project ECHO receive didactic education and co-manage patients with specialists to improve their delivery of MS specialty care. In the fall of 2015, we piloted international delivery with the University Clinic for Neurology, Skopje, Macedonia, where providers recently gained access to higher potency DMT agents that have been commonly used in the U.S. for many years. Providers were seeking guidance on incorporating those DMTs into their practice, including clinical decision-making and safety monitoring.
Despite differences in time zone, primary language, and technology available for MRI imaging transfer, the videoconference-based model allowed for the review of multiple cases demonstrating real-life examples of optimal decision-making and generating patient-specific safety monitoring plans. The program improved the knowledge of these local MS experts, allowing them to enhance their role as consulting experts within their home country. In follow-up interviews, the participating providers indicated the experience prompted a number of changes in their clinical practice. Videoconferencing was highly cost-effective relative to hosting visiting experts or attending conferences.
MS Project ECHO can effectively and efficiently distribute knowledge internationally for specialty MS care. In contrast to seminars, the case-based learning in our model results in greater engagement and accelerates learning. Further exploration of this program is warranted.