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Project ECHO® Case Report: El Centro Family Health

Chris Ruge is a nurse practitioner working in Las Vegas, NM. He first learned of Project ECHO when he was doing phone and e-mail interviews with El Centro from Mexico. Intrigued by an initial visit to the Project ECHO website, Chris visited the Albuquerque offices of the ECHO Institute to observe firsthand the HCV teleECHO clinic and was impressed by the professionalism, the relaxed and welcoming atmosphere, and the effectiveness of the clinics. Over 10 years later, Chris has never been disappointed while working and collaborating with the project.

In his practice, Chris uses Project ECHO as a means of establishing both a working and personal relationship with the specialist hub in Albuquerque. The HCV teleECHO clinic sessions provide him with nearly unlimited access to the HCV specialists with whom he can discuss urgent issues in the care of his patients. Without this support and structure, his work with complicated patient cases involving numerous simultaneous or concurrent chronic illnesses would be much more difficult, and would likely necessitate numerous referrals to specialists located 60-100 miles away—too far for his patients with very limited resources. Additionally, participation in the HCV teleECHO clinic sessions has made it possible for him to treat patients with both HCV and HIV, patients whom he would not have otherwise felt competent or comfortable to treat/treating on his own.

The clinic where Chris works has several clinicians who are each engaged in different teleECHO clinics. By participating in Project ECHO, all the clinicians feel connected to peers facing similar struggles with their own patients and in other rural areas. As Chris explained, the ECHO clinic helps him to feel less isolated while living and working in a town of 14,000 people, 60 miles from the nearest “big city” of Santa Fe.

For Chris and his colleagues in Las Vegas, working with Project ECHO allows rural primary care clinicians to provide more evidence-based primary care, and to participate in more focused and specialized care such as the treatment of patients with HCV or with poorly controlled psychological conditions or endocrine-related issues. He and his colleagues feel that they are continuously learning from their collaborations with the specialists in the Project ECHO hub, helping them to grow as clinicians while receiving some 80-100 CME credits annually.

For patients, the participation of their primary care clinicians in teleECHO clinics make it possible to receive excellent primary care in their home community while having their particular health issues examined closely by some of the most knowledgeable specialists in the state. Patients save the time and expense of travelling all day for a fifteen-minute visit with a specialist who may know very little about them and who may not circle back to connect with the referring clinician. Patients can have more confidence that their PCP or other health care professional knows what is going on with them and that their care team is meeting with specialists who are helping to guide their medical decisions.

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