The Promising Success of Project Extension for Community Healthcare Outcomes (ECHO) Diabetes: Case Series.
The Promising Success of Project Extension for Community Healthcare Outcomes (ECHO) Diabetes: Case Series.
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在美国，有超过3700万糖尿病患者，但只有8000名内分泌学家。因此，许多糖尿病患者只接受初级保健提供者（PCP）的护理。为了通过远程教育普及有关需要胰岛素的糖尿病的知识，斯坦福大学和佛罗里达大学开发了社区医疗保健成果项目扩展（ECHO）糖尿病。ECHO Diabetes使用中心辐射模型将专家（“中心”）与PCP（“辐射”）连接起来。每周一小时的会议包括Hub糖尿病教学介绍和Spoke去识别病例介绍。在这些会议中吸取的经验教训的目标提供者的知识和信心周围的糖尿病管理和病人护理。发言者被要求提供简短的描述糖尿病患者的糖尿病管理改善直接或间接从他们的供应商的参与或他们参与糖尿病支持教练（DSC）。我们提供了一个病例系列来描述个人和结果。由于这项研究不是一项随机对照试验，而是对提供者提供干预的患者进行前瞻性观察，因此该试验未在公共试验登记处注册。从2021年至2022年期间来自加州和佛罗里达的10名PCP和1名DSC中汇编了11名糖尿病患者的病例系列。ECHO糖尿病的主要影响是从PCP和DSC扩大到糖尿病患者的教育。在所有情况下，糖尿病患者报告参与度增加，糖尿病管理得到改善。一些病例反映了糖尿病技术的普及、血糖结果的改善以及心理健康措施的积极趋势。该病例系列阐明了ECHO糖尿病计划对接受PCP糖尿病护理的糖尿病患者的潜在价值。那些与DSC匹配的人在血红蛋白A1c和心理健康结果方面有临床显着改善。
In the United States, there are over 37 million people with diabetes but only 8000 endocrinologists. Therefore, many people with diabetes 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. 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 deidentified case presentations. Lessons learned during these sessions target provider knowledge and confidence surrounding diabetes management and patient care. Spokes were asked to provide short descriptions of people with diabetes whose diabetes management improved directly or indirectly from their providers’ participation 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. A case series of 11 people with diabetes was compiled from 10 PCPs and 1 DSC from California and Florida between 2021 and 2022. The principal impact of ECHO Diabetes is the education amplified from PCPs and DSCs to people with diabetes. In all cases, people with diabetes 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. This case series elucidates the potential value of the ECHO Diabetes program to people with diabetes who receive their diabetes care from PCPs. Those matched with a DSC saw clinically significant improvements in hemoglobin A1c and mental health outcomes.