Academic Health Center management of chronic diseases through knowledge networks: Project ECHO
Academic Health Center management of chronic diseases through knowledge networks: Project ECHO
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DOI：
10.1097/acm.0b013e31802d8f68
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发表时间：
2007-02-01
影响因子：
7.4
通讯作者：
Scaletti, Joseph V.
中科院分区：
文献类型：
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作者：
Arora, Sanjeev;Geppert, Cynthia M. A.;Scaletti, Joseph V.
作者描述了一个创新的学术卫生中心(AHC)领导的卫生保健提供和临床教育计划，以丙型肝炎病毒(丙型肝炎病毒)为模型，在服务不足的地区管理复杂、常见和慢性疾病。该项目以新墨西哥大学医学院为基础，代表着AHC三重使命的思维和资金范式的转变，从传统的服务收费模式转向知识网络的公共卫生资金。该项目名为社区卫生保健成果扩展项目(ECHO)，涉及学术医学、公共卫生办公室、惩戒部门和农村社区诊所的合作伙伴关系，致力于在农村地区提供最佳实践和以协议为导向的卫生保健。远程医疗和互联网连接使项目中的专家能够使用基于病例的知识网络和学习循环来治疗患有复杂疾病的患者。Echo项目合作伙伴(护士、初级保健医生、医生助理和药剂师)在每周两小时的远程医疗诊所中使用标准化的基于病例的形式展示丙型肝炎病毒阳性患者，其中包括对病史、体检、测试结果、治疗并发症以及精神、医疗和药物滥用问题的讨论。在这些以病例为基础的学习诊所中，合作伙伴在与大学肝病、传染病、精神病学和药物滥用方面的专家合作管理他们的患者时，可以迅速获得深厚的丙型肝炎病毒领域专业知识。对治疗结果的系统监测是该项目的一个组成部分。作者认为，这种方法将推广到各种服务不足地区的其他复杂和慢性疾病，以改善疾病结局，并为AHC提供了一个机会，以加强和扩大他们的传统使命，教学，病人护理。和研究。
The authors describe an innovative academic health center (AHC)-led program of health care delivery and clinical education for the management of complex, common, and chronic diseases in underserved areas, using hepatitis C virus (HCV) as a model. The program, based at the University of New Mexico School of Medicine, represents a paradigm shift in thinking and funding for the threefold mission of AHCs, moving from traditional fee-for-service models to public health funding of knowledge networks. This program, Project Extension for Community Health care Outcomes (ECHO), involves a partnership of academic medicine, public health offices, corrections departments, and rural community clinics dedicated to providing best practices and protocol-driven health care in rural areas Telemedicine and Internet connections enable specialists in the program to comanage patients with complex diseases, using case-based knowledge networks and learning loops. Project ECHO partners (nurse practitioners, primary care physicians, physician assistants, and pharmacists) present HCV-positive patients during weekly two-hour telemedicine clinics using a standardized, case-based format that includes discussion of history, physical examination, test results, treatment complications, and psychiatric, medical, and substance abuse issues. In these case-based learning clinics, partners rapidly gain deep domain expertise in HCV as they collaborate with university specialists in hepatology, infectious disease, psychiatry, and substance abuse in comanaging their patients. Systematic monitoring of treatment outcomes is an integral aspect of the project. The authors believe this methodology will be generalizable to other complex and chronic conditions in a wide variety of underserved areas to improve disease outcomes, and it offers an opportunity for AHCs to enhance and expand their traditional mission of teaching, patient care. and research.