Rationale and design of an endocrinology education program for primary care in Maine: initiation of MaineHealth Endo ECHO Maine

Introduction: Population health and quality of care initiatives for the management of common endocrine disorders often include algorithmic and protocol-driven workflows in primary care practices. Endo ECHO is a division of Project ECHO at University of New Mexico that engages primary care clinicians in didactic presentations and case discussions to augment conceptual (experiential, nuanced) rather than algorithmic (rote) learning. Research Design and Methods: MaineHealth Endo ECHO was designed using the Project ECHO model. Project ECHO® is an interactive learning opportunity that uses video conferencing to connect specialty and primary care to share best practices for delivering care. Using a hub and spoke model, providers connect for an hour each month. During each session there is a short didactic component and then 45 minutes of case presentation and discussion. MMP Endocrinology and Diabetes Center serves as a subspecialty “hub” that has engaged 8 “spoke” sites at 8 hospitals in Maine and New Hampshire. In video-networked clinics, a didactic presentation providing state-of-the-art information on management of endocrine disorders precedes discussion of complex patients presented by primary care clinicians from spoke sites. Indispensable resources for executing MaineHealth Endo ECHO included video networking support, program management, an administrator at the hub site, and a physician facilitator to moderate sessions. Results: Feedback from surveys of clinicians at spoke sites have been used to modify the curriculum for subsequent years of the program. Self-efficacy for disease management and appropriate referral improved. Conclusions: Endo ECHO has been successfully introduced in Maine, improves physician confidence, and may be replicated for other specialties