Facilitating Healthcare Providers to Use Project Echo for Rural Healthcare

POSTER

FACILITATING HEALTHCARE PROVIDERS TO USE PROJECT ECHO FOR RURAL HEALTH CARE Deven Willardson, BSN,RN, DNP Student & Jia-Wen Guo, PhD, RN Key Findings: • Despite and overall positive perception of Project ECHO, it continues to be a lack of provider engagement. • The main barriers of implementing Project ECHO included lack of time or the perception of lack of time, lack of clinic/employer support for the service, and lack of motivation to use the service Background • Individuals living in rural areas have higher mortality rates when compared to those living in metropolitan areas. • Supporting primary care providers in rural areas to better manage common complex medical conditions could be a solution to address this important problem. • Project ECHO model uses teleconferencing technology to connect an interdisciplinary team of experts (the “hub”) to educate and enable rural primary care providers with the ability to manage common complex diseases. • Project ECHO is now nationwide and includes a hub in Utah; however, the Project ECHO model has not been fully implemented in Utah rural areas. Purpose Purpose: To discover the barriers and potential solution(s) implementing and eliciting provider engagement in Project ECHO Methods • Framework: E-Facilitation Model: • Developer: M. Dzinotyiweyi • Components: preparation, engagement and ensuring value must exist for meaningful online engagement/learning to occur (Figure 1) •Location: A clinic in rural Cache Valley Utah •Implementation: • An interactive online learning module: Introduce Project ECHO, how to register and log in for a session • Project ECHO • Data Collection: • Timing: Pre and post implementation • Approach: A semi-structured interview with questions generated from the E-Facilitation Model • Data Analysis: A combination of direct and indirect content analysis. Results • Participants: Figure 1: E-Facilitation Model • 4 providers of 8 (2 PAs, 1 DNP, 1 Physician) participated. • One had known/used Project ECHO • Pre-implementation: Figure 2 • Facilitators: All report access to computer/internet, comfortable with technology, overall positive perception of telehealth technology, and feel collaboration with specialists is important. • Barriers: Time was cited as the biggest barrier/perceived barrier, some expressed previous challenges of telecommunication systems, concerns about the format of Project ECHO, and negative experiences collaborating with specialists. • Other findings: Motivation for underserved patient population was a key factor for the provider who previously used Project ECHO. Introducing Project ECHO early could improve the user engagement. • Implementation: • All four providers successfully completed the online learning module introducing them to Project ECHO • None of the providers logged in to a Project ECHO session. Figure 2: Concept Map of Pre-implementation Interview Results • Reasons of unsuccessful implementation: • Time barriers • Lack of sufficient clinic supports Previous Knowledge/use of Project ECHO Access to reliable computer/internet connection Precursor to Positive perception of Telecommunication systems Precursor to Strongly Correlated Project ECHO Engagement Perception of or Actual Time Barriers Reinforces Strongly Inhibited by Motivated by Patient Population Influenced by Influenced by May be inhibited by Negative or Neutral Perception of Telemedicine and or Telecommunication Comfortable using Technology Lack Knowledge of Project ECHO Positive Perception of Project ECHO Influenced by Reinforced by Uncomfortable with format of meeting/discussion Lack of Content Expert present at each session Negative or neutral Live online seminar experience Concept Map Legend Main Objective/desired outcome Strongest correlating Factors Underlying factors Conclusions • Lack of engagement persist despite overall positive perception of Project ECHO Clinical Application: Possible solutions to increase engagement: • Increase clinic/employers support for the service • Introduce Project ECHO to new graduates/students • Motivation seems to be a key factor but more research is needed to fully understand how it impacts engagement with Project ECHO Acknowledgement: Contact Experts: Christina Choate (Project ECHO Program Coordinator) Sue-Chase Cantarini (DNP, RN, CHSE) Rebecca Wilson (PhD, RN) Relationship between each concept Connects correlating concepts COLLEGE OF NURSING