Spring/Summer 2018
Project ECHO expands rural and urban clinics in Nevada

synapse: University of Nevada, Reno School of Medicine

Teleconferencing delivers cost-effective, quality care for underserved Nevadans

Story by Julie Ardito, APR

Thousands of Nevadans have limited access to specialty health care, including nearly 300,000 living in rural areas and many others living in urban centers who have no health insurance or Medicaid coverage. To help remedy this issue, the University of Nevada, Reno School of Medicine Office of Statewide Initiatives has expanded Project ECHO (Extension for Community Healthcare Outcomes) with new clinics in cardiology, pediatric endocrinology, medication assisted therapy for substance use disorder, as well as a unique school-based behavioral health program.

Project ECHO uses teleconferencing technology to connect specialists at UNR Med with primary care clinicians in rural and urban under-served communities.

"It's difficult for patients to travel hundreds of miles to seek treatment from a specialist," said Evan Klass, M.D, executive director for the Office of Statewide Initiatives. "But, they can see a primary care clinician in their community on a regular basis and get the benefit of specialty knowledge if their clinician is connected to specialists through Project ECHO."

Each telehealth clinic attracts anywhere from 10 to 40 healthcare providers for a didactic presentation followed by a group discussion focused on approximately six patient management cases at a time. These virtual clinics give primary care physicians, advanced practice registered nurses, physician assistants and other professionals the tools and resources to deliver high quality care in their communities.

"The impact is enormous," Dr. Klass said. "If sub-specialists share what they know as mentors, primary care clinicians get better at what they do. They are able to take better care of their patients, referring fewer to specialists because Project ECHO gives them a community of knowledgeable healthcare professionals to support them on more complex cases. Plus, with fewer referrals, specialists are afforded the bandwidth to provide better care to the patients who need them."

"The work that Dr. Klass and the Office of Statewide Initiatives have done has been transformative in providing critical rural outreach and health care to patients who otherwise would be without. Their work is changing the face of rural health care in the state of Nevada and is a model for delivering access to health care in efficient and affordable ways," said UNR Med Dean Thomas L. Schwenk, M.D.

The ECHO effect

The impact of expanded Project ECHO clinics can be felt across Nevada's entire healthcare network. UNR Med and the Office of Statewide Initiatives now host a total of 14 monthly clinics to help community clinicians throughout the state, including the four new clinics.

The Pediatric Endocrinology clinic connects clinicians with Dr. Kathy Eckert, UNR Med faculty member and the only pediatric endocrinologist between Sacramento and Salt Lake City, and her team. The clinic meets from 8-9 a.m. on the first Friday of every month.

The Cardiology clinic, led by Dr. Ivan Anderson of Renown Health, addresses management of complex patients with coronary heart disease, heart failure and valvular heart disease. The clinic meets from 8-9 a.m. the second Thursday of each month.

The School-Based Behavioral Health clinic connects a hub team at UNR Med-consisting of a child and adolescent psychiatrist and developmental pediatrician-with school-based nurses, social workers and teachers. The clinic is held the second and fourth Wednesday of each month from 12-1 p.m.

The Medication Assisted Therapy clinic, a partnership between UNR Med and Northern Nevada HOPES, connects a team of psychiatrists, pharmacists, physician assistants, social workers and medical assistants to primary care providers engaged in treating opioid addicted patients across the state. The clinic is funded by a federal grant to address the opioid crisis and held the second and fourth Wednesday of each month from 8-9:30 a.m.

All clinics are free to attend and use Zoom, a free video conferencing software. To comply with HIPAA regulations, all patient identifying information is redacted during all Project ECHO telehealth video conferences.

For more information or to register for a clinic, visit med.unr.edu/echo/clinics.