AHRQ Innovations Exchange | Specialists Train and Support Rural and Prison-Based Primary Care Clinicians, Enhancing Access to Hepatitis C Care

Innovation Profile:

Specialists Train and Support Rural and Prison-Based Primary Care Clinicians, Enhancing Access to Hepatitis C Care


Snapshot
Summary
As part of Project Extension for Community Healthcare Outcomes (Project ECHO), specialists at the Albuquerque-based University of New Mexico Health Sciences Center train community- and prison-based primary care clinicians on appropriate care of chronic hepatitis C, and also host weekly, 2-hour, case-based discussions via teleconference during which they provide guided feedback on how best to manage patients over the course of treatment. During these sessions, community-based providers also share advice and expertise and generally support each other, and specialists give short, didactic presentations on specific issues related to hepatitis C care. A separate part of Project ECHO trains prisoners to become “peer educators,” allowing them to teach fellow inmates about hepatitis C. The program significantly enhanced community-based providers’ knowledge, skills, and abilities related to hepatitis C, leading to enhanced access to care for patients. Based on this success, similar programs have been developed to assist community-based primary care physicians in treating many other chronic conditions.

Evidence Rating
Moderate: The evidence consists of pre- and post-implementation comparisons of various measures of primary care clinician knowledge, skills, and satisfaction related to hepatitis C care, along with post-implementation statistics on program usage.


Developing Organizations
University of New Mexico Health Sciences Center
Project ECHO represents a collaboration between the University of New Mexico Health Sciences Center and 5 prison sites within the New Mexico Corrections Department, Indian Health Service facilities, 10 Federally Qualified Health Centers (FQHCs), and private practice physicians serving low-income communities. At present, 21 different treatment sites participate.

Date First Implemented
2003

The program began as a small-scale, volunteer pilot in 2003 focused on chronic hepatitis C; it later expanded to serve other participating sites. Over time, the same approach has been used with other conditions/diseases.

Patient Population
The program serves community-based patients and prisoners with hepatitis C. Because so many hepatitis C patients have co-occurring substance abuse disorders, prisoners must complete a prison-based drug rehabilitation program before becoming eligible to participate in the HCV program.Race and Ethnicity > American Indian or Alaska native; Vulnerable Populations > Impoverished; Prisoners; Rural populations; Substance abusersend pp


full-text:
AHRQ Innovations Exchange | Specialists Train and Support Rural and Prison-Based Primary Care Clinicians, Enhancing Access to Hepatitis C Care