Providing Epilepsy Care to Patients in Need: Project ECHO

Approximately 1% of children in the U.S. suffer from epilepsy, and a third have refractory seizures that are unaffected by various treatment options. A large number of children with epilepsy also have comorbidities, such as psychiatric disorders.

Despite the need for high-quality coordinated care, many patients and their caregivers have limited access to specialists, especially those with low income and living in underserved areas. Primary care providers who see these patients often struggle in caring for them due to the complexities of treatment and the comorbidities that can accompany epilepsy.

In New Mexico, there are a limited number of specialists available, with the majority of them located in Albuquerque. In fact, there is only one pediatric neurologist specializing in epilepsy in the entire state. Additionally, much of the population of New Mexico lives below the poverty level, making the trip to Albuquerque to see a specialist nearly impossible in some cases.   

What is Project ECHO?

Project ECHO® (Extension for Community Healthcare Outcomes) links expert interdisciplinary specialists with primary care providers around the state through teleECHO™ clinics.

Project ECHO is a lifelong learning and guided practice model that revolutionizes medical education and exponentially increases workforce capacity to provide best-practice specialty care and reduce health disparities. The heart of the ECHO model™ is its hub-and-spoke knowledge-sharing networks, led by expert teams who use multi-point videoconferencing to conduct virtual clinics with community providers. In this way, primary care doctors, nurses, and other clinicians learn to provide a level of specialty care to patients in their own communities.

The Child and Youth (CYE) TeleECHO Clinic team is located at the University of New Mexico Health Sciences Center. During weekly teleECHO clinics, experts co-manage cases and share their expertise via telementoring (guidance, feedback, and didactic education). Facilitators  include a pediatric epileptologist, psychologist, pharmacist, nurse, a coordinator, and a technical assistant.

Since launching in June, 2014, 31 physicians, one physician assistant, one nurse practitioner, 15 nurses, two case workers, and several students (nursing and pharmacy) have participated in CYE ECHO regularly during which 22 pediatric cases have been discussed and over 4,000 CME hours have been offered.

CYE ECHO is supported by a grant from the American Academy of Pediatrics. New Mexico Pediatric Society and the Coordinating Center on Epilepsy are partners of CYE ECHO.

A Typical TeleECHO Session

The CYE TeleECHO Clinic is held every Tuesday for an hour and a half and features a didactic lecture, question and answer session, and case reviews.

A robust curriculum was developed to touch on aspects of pediatric seizure evaluation and management most important to primary care. The curriculum covers recognizing and diagnosing seizures, evaluation and diagnostic procedures, treatments (pharmacological and nonpharmacological), complications, and comorbidities of epilepsy.

Participants are encouraged to present cases from their practice following a specific template designed by the specialists. Participants engage in a guided discussion regarding diagnosis, evaluation, management of seizures using pharmacotherapy and non-pharmacotherapy treatments, cognitive and behavioral management, assessment and management of other comorbidities, and discussion of safety issues. Formalized recommendations are thereafter provided to the presenter.

Why CYE ECHO?

CYE ECHO brings benefits to both providers and patients. Providers are able to gain expertise in a sub-specialty, improve access for patients, improve patient satisfaction, engage in quality improvement, achieve professional satisfaction, and join a multidisciplinary collaborative practice. In turn, patients are able to have access to local specialty care through an ECHO-trained provider which reduces the need to travel outside their community.

How can you join CYE ECHO?

Any healthcare provider can join using a webcam, phone, or in-person at the Project ECHO facility located in Albuquerque. For further information on ECHO, please visit http://echo.unm.edu/. No cost continuing medical education (CME) credits are provided for participation.

Email Leena Matlib, the Distance Education Coordinator, with questions about how to get involved or call 505-272-6326.