Spring 2012
Project ECHO: Improving rural care

synapse: University of Nevada, Reno School of Medicine

Evan Klass, M.D.

Endocrinologist Evan Klass, M.D., heads up the Project ECHO telemedicine consultation program to rural-based primary care providers. Photo by John Byrne

Using telemedicine to extend medical school expertise to rural providers.

By Anne Pershing

Project ECHO is coming to rural Nevada and no one is happier about this new program than Evan Klass, M.D., of the internal medicine department in Reno.

"The goal of this program is to address the shortage of medical manpower in rural Nevada communities so we can deliver special services to them, and we're incredibly excited about this," said Klass, who is overseeing the program for the University of Nevada School of Medicine.

This program will connect, via video conference, rural primary care physicians with medical specialty experts at the school so they can manage chronic diseases in their patients, he said.

ECHO is a new model of health care education that will bring "health care without walls" to rural and underserved communities. The Nevada program is modeled after the successful program created at the University of New Mexico in Albuquerque, explained Klass.

He was part of a School of Medicine team that included Melissa Piasecki, M.D., senior associate dean of academic affairs and Melissa O'Brien, director of continuing education, who went to New Mexico to look over the program and came away impressed with its outcomes.

According to the University of New Mexico's report "Project ECHO: Bringing Health Care without Walls to Rural and Underserved Communities," some 65 million Americans live in remote, rural communities where there are not enough doctors for everyone to get the care that they need.

"While we can't help rural areas nationwide, there are so many we can help in our own state in places like Battle Mountain, Ely, Winnemucca, Pahrump, Mesquite, Elko, Yerington and Caliente. Fortunately, Fallon and Fernley are closer and have quicker access to specialists in Reno and Sparks," said Klass, who is an internist and endocrinologist.

"We're moving ahead on this so those who can't get help from a specialist now will soon be able to, and this applies to people of all ages. Dr. Thomas Schwenk, the dean of our medical school, wants us to help our rural communities throughout the state, and that is what we're striving for."

Klass added that Project ECHO will improve the health status of rural Nevadans and will assist those rural medical providers who feel isolated.

"Providers will have support from ECHO and the patient will also have more support."

Jason Bleak, administrator and chief executive officer of the Grover C. Dils Medical Center in Caliente, agreed that the project will improve rural health care.

"On behalf of myself and our medical providers, we are extremely grateful for this new program," Bleak said.

"It will allow us to help keep our patients home. It will also help rural Nevada, as some of us are in such remote areas that we feel like we're on an island. This is a great opportunity for our patients to be treated by specialists.

"It's just fantastic that doctors with the University of Nevada School of Medicine will be there for us. ECHO will be connecting our rural facilities with a wide network of physicians and specialists who will also be training our medical providers at the medical center in Caliente."

Klass pointed out: "As specialists, we're donating our time and there will be no cost to the patients. We're depending on grants, charitable contributions and governmental support to come through for us. We're going where health care is ultimately needed and we're moving to the future."

The team of specialists will include an endocrinologist, registered dietician, nurses, mental health professionals and others.

Don McKenzie, chief executive officer of the Native American Southern Bands Health Center in Elko, said he is pleased to know that the project is moving ahead.

"This is a great opportunity for patients to receive specialty care in their rural communities. Otherwise, some may have to travel miles away, but more alarming, some may not have the funds to travel at all," McKenzie said.

"Another benefit of this project is that it will increase training for our medical staff, resulting in continuing medical education credits that will enhance our ability to treat our patients. It's a win-win for our patients and our staff."

According to Klass, one of the first chronic diseases the ECHO specialists will tackle is diabetes, with the first diabetes-cardiovascular risk reduction clinics scheduled this spring.

"Our care team will be set up in the video conference room and will link to providers in the rural communities," he said.

This year, New Mexico published the outcome of their treatment for Hepatitis C through Project ECHO and discovered that patients being treated through the model program did just as well as patients treated at the University Medical Center in Albuquerque, said Klass, adding he is very eager to get Project ECHO started.