Project ECHO | Brandeis Opioid Resource Connector

A distance education system for physicians, first developed in New Mexico, which enhances a state's capacity to treat opioid use disorder

Project ECHO (Extension for Community Care Outcomes) is a world-wide program designed to develop capacity for safe and effective treatment of chronic, common, and complex conditions, while monitoring outcomes to ensure quality of care.

Started in 2005, the teleECHO clinic based at the University of New Mexico Health Sciences Center focuses on treatment of substance use disorders (SUDs) and behavioral health disorders, with an emphasis on increasing buprenorphine capacity and initiation.

Participants join via video and see case presentations on behavioral health and addiction, interact with instructors, and are encouraged to register to obtain CMEs free of charge. Major functions of teleECHO include the rapid dissemination of SUD-related expertise and the recruitment of physicians for training to obtain waivers for buprenorphine prescribing.

The program was critical in helping to increase the per capita number of waivered physicians in New Mexico to the fourth highest in the nation in 2016. It has been replicated nationwide as a model to increase capacity to address opioid use disorder (OUD).

More information on the program can be found in these presentations here and here. Detailed information of the success of Project ECHO, in general, can be found here. A report on how project ECHO is applied to complex medical conditions, including OUD, can be found here.

A an adaption of the Project ECHO model was implemented in Oregon's substance use disorder continuum of care to respond to the COVID-19 pandemic, as reported here. Another adaption of Project ECHO has been tailored to first responders.

New Mexico has had one of highest number of waivered physicians per capita after implementation of the program...waivered physicians who practice in underserved areas have increased more rapidly in NM than in the US overall.

Continuum of Care

Treatment

Type of Evidence

Peer-reviewed

Replicated

Response Approach

COVID / Coronavirus related

Educational

Medications for Opioid Use Disorder

Peer-reviewed Article

Project ECHO (Extension for Community Healthcare Outcomes): A new model for educating primary care providers about treatment of substance use disorders

Project ECHO connects specialists with on-the-ground practitioners to bridge health gaps in rural communities

Barriers and perceived usefulness of an ECHO intervention for office-based buprenorphine treatment for opioid use disorder in North Carolina: A qualitative study

Feasibility and acceptability of an online ECHO intervention to expand access to medications for treatment of opioid use disorder, psychosocial treatments and supports

Opioid Use Disorder ECHO: A Program Evaluation of a Project That Provides Knowledge and Builds Capacity for Community Health Workers in Medically Underserved Areas of South Texas

The impact of project ECHO on physician preparedness to treat opioid use disorder: a systematic review

Provider engagement in Indiana’s opioid use disorder ECHO programme: there is a will but not always a way

Use of Project ECHO to promote evidence based care for justice involved adults with opioid use disorder

Collaboration in a time of crisis: Adapting a telementoring ECHO for addiction leaders during COVID-19

Promoting best practices for managing opioid overdoses in the field: A novel project Extension for Community Healthcare Outcomes program for first responders

Building a community of experts in medication-assisted treatment (MAT) using the Project ECHO© model

Evidence of Program Effectiveness

From a peer-reviewed article: "The ECHO model has allowed for rapid dissemination of new research findings and epidemiologic trends...Since 2006, when only 36 NM physicians were listed as buprenorphine-waivered in the federal database, more than 375 NM physicians have participated in DATA-2000 buprenorphine waiver trainings offered by Project ECHO IAP program...New Mexico now [in 2016] has more buprenorphine-waivered physicians per capita than all but 3 other US states (Figure 1); the states of Vermont, Maine, Massachusetts, and New Mexico were the top-ranked states in number of waivers per capita as of 2014. Prior to the start of the ECHO IAP program in 2005, NM ranked 13th nationally in waivered physicians per capita (data not shown). In addition, the number of waivered physicians per capita who practice in underserved areas has increased more rapidly in NM than in the US overall since 2005." (Komaromy et al., 2016)

"One proven model of training physicians and cross-disciplinary teams in treating a variety of disorders is exemplified by Project ECHO (Extension for Community Healthcare Outcomes), a collaborative tele-mentoring program in which specialists train health-care workers to treat medical conditions, especially those that affect underserved populations. This systematic review found that Project ECHO has the potential to effectively extend current services to patients suffering from OUD, but that there is also a gap in knowledge regarding this type of training. The articles that we reviewed all presented evidence that Project ECHO improves healthcare provider preparedness to treat OUD, especially in regard to improving knowledge and self-efficacy." (Puckett et al., 2021)