Guest posting by Sanjana Puri
“Could a system be built to ‘demonopolize’ health care knowledge? To move it out of the heads of specialists into networks of primary care providers in remote places so they could manage complex illnesses in their local settings? And could rural clinicians provide care that was on a par with specialists?”
These were the questions Dr. Sanjeev Arora sought to answer through Project Echo (short for Extension for Community Healthcare Outcomes), a project that began as an attempt to demonopolize specialized hepatitis C knowledge and spread the information to rural areas in New Mexico. Today, the solution is transforming the world’s access to health care.
Dr. Arora brought together a team of specialists and developed a model that combined video conferencing technology to facilitate weekly case-based training (similar to the teaching approach in medical schools) with collaborative care and careful patient tracking. He then used these trainings to teach hepatitis C information to recruited local providers. Here’s an image from Project Echo’s website, depicting how it works:
Photo credits: http://echo.unm.edu/
I wondered if this same practice could work in rural areas of Texas, where there are also large gaps in healthcare:
“In rural Texas, sixty-three Texas counties have no hospital. Routine medical care is often more than 60 miles away — and specialty care is almost unheard of. Most of Texas’ 177 rural counties, home to more than 3 million people, are considered medically underserved.”
The need for Project Echo in Texas is clear. I researched and found that Project Echo has a site at Baylor St. Luke’s Medical Center in Houston, another urban area. Still, some of the most underserved areas are in West Texas and the Panhandle, where I realized medical care simply does not exist.
Texas is unique, with giant voids of healthcare scattered throughout the state. Major steps have been taken to address this problem: rural lawmakers have fought for recruitment programs, scholarships, and loan repayment for young doctors who go into rural medicine.
Yet these incentives don’t seem to be enough: 27 counties don’t have a single primary care physician. Before Texas can begin to address the specialized knowledge divide, Texas must address its lack of primary care physicians in rural areas. Incentives must be persuasive; until the last legislative session, the loan repayment programs hardly made a dent in the average medical student’s debt.
Perhaps it’s time to make a push for even greater incentives for young physicians to work in rural Texas, beginning as early as high school. To ECHO, Texas must have community health professionals to extend health care knowledge.
Texas should be like a bat and ECHOlocate more physicians for rural areas.