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The Promising Success of Project ECHO Diabetes: Case Series
Lauren Figg;
Ananta Addala;
Ishaan Jain;
Claudia Anez-Zabala;
Paul Midney;
Cathy Brockman;
Corin De Chirico;
Kelly Hunt;
Colleen Symanski;
Brian C Fitzgerald;
Kristi Colbert;
Terry Raymer;
Candy Stockton;
Elizabeth Murphy;
Leah Collins;
Cyd Bernstein;
Melanie Hechavarria;
Eleni P. Sheehan;
Angelina Bernier;
Sarah C. Westen;
Korey K. Hood;
Dessi P. Zaharieva;
Marina Basina;
Nicolas Cuttriss;
Stephanie L. Filipp;
Matthew J. Gurka;
Ashby F. Walker;
David M. Maahs;
Michael J. Haller;
Rayhan A. Lal
ABSTRACT
Background:
In the U.S., there are over 37 million people with diabetes (PwD), but only 8,000 endocrinologists. Therefore, many PwD receive care exclusively from primary care providers (PCPs). To democratize knowledge regarding insulin-requiring diabetes through tele-education, Stanford University and the University of Florida developed Project Extension for Community Healthcare Outcomes (ECHO) Diabetes.
Objective:
ECHO Diabetes uses a Hub and Spoke model connecting specialists (the “Hub”) with PCPs (the “Spokes”). One-hour, weekly sessions include Hub diabetes didactic presentations and Spoke de-identified case presentations. Lessons learned during these sessions target provider knowledge and confidence surrounding diabetes management and patient care.
Methods:
Spokes were asked to provide short descriptions of PwD whose diabetes management improved directly or indirectly from their providers’ participation and/or their involvement with a Diabetes Support Coach (DSC). We provide a case series to describe individuals and outcomes. Because this study was not a randomized controlled trial and was a prospective observation of patients with the intervention delivered to providers, the trial is not registered in a public trials registry.
Results:
A case series of 11 PwD was compiled from 10 PCPs and one DSC from California and Florida between 2021 and 2022. The principal impact of ECHO Diabetes is the education amplified from PCPs and DSCs to PwD. In all cases, PwD reported increased engagement and improved diabetes management. Several cases reflected increased access to diabetes technology, improvement in glycemic outcomes, and positive trends in mental health measures.
Conclusions:
This case series elucidates the potential value of the ECHO Diabetes program to PwD who receive their diabetes care from PCPs. Those matched with a DSC saw clinically significant improvements in HbA1c and mental health outcomes.
Citation
Please cite as:
Figg L, Addala A, Jain I, Anez-Zabala C, Midney P, Brockman C, De Chirico C, Hunt K, Symanski C, Fitzgerald BC, Colbert K, Raymer T, Stockton C, Murphy E, Collins L, Bernstein C, Hechavarria M, Sheehan EP, Bernier A, Westen SC, Hood KK, Zaharieva DP, Basina M, Cuttriss N, Filipp SL, Gurka MJ, Walker AF, Maahs DM, Haller MJ, Lal RA
The Promising Success of Project Extension for Community Healthcare Outcomes (ECHO) Diabetes: Case Series