This is an archived article that was published on sltrib.com in 2016, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
What good is high-quality, cutting-edge health care if it is difficult or impossible to access?
Access to affordable health care is limited by the capacity of our health systems to see patients. Only about 10 percent of doctors practice in rural areas of the United States, despite nearly a quarter of the population living in these areas. Recruiting and retaining health care providers in rural and frontier Utah and the Mountain West is difficult. Providers are too often overwhelmed by limited resources, geographical isolation and exponentially increasing medical knowledge. As a result, patients are left to travel long distances — sometimes hundreds of miles — to be seen by specialists in urban centers.
To make matters worse, sometimes there are not enough specialists to see patients, leading to clinic wait times of weeks or even months. Even patients living in urban areas — especially those who are un- or under-insured — can experience challenges in accessing specialty care for critical conditions, such as cancer, mental health disorders or even pregnancy.
So what can we do? It's imperative that we begin to innovate new ways to deliver health care.
University of Utah Health Care and its partners are working to address this problem through a transformative model of medical knowledge-sharing and collaborative practice called Project ECHO (Extension for Community Healthcare Outcomes). Multi-disciplinary specialist teams use low-cost, multi-point videoconferencing (similar to Skype or FaceTime) to conduct weekly "teleECHO clinics" with community providers in rural and underserved areas around Utah and the Mountain West. During the teleECHO clinics, community providers present patient cases and work with specialists to determine treatment. Specialists serve as mentors, training community providers to deliver care in clinical areas that were previously outside their expertise. Patients who otherwise would've been referred out are able to receive high-quality care in their communities, from providers they trust.
Recently, we were privileged to advise Sen. Orrin Hatch, R-Utah, and Sen. Brian Shatz, D-Hawaii, on the development of the ECHO Act. The ECHO (Expanding Capacity for Health Outcomes) Act brings national attention to the issue of high-quality health care access. The act's aim is to better integrate the Project ECHO model into health systems across the country. The bill requires our federal health care leaders to prioritize analysis of the model and to conduct research that examines how the model can be adopted and funded.
The ECHO Act supports University of Utah Health Care in expanding critical access to patients in rural and underserved areas. Telehealth-based programs like Project ECHO increase our capacity to provide high quality care in the right place at the right time to the right people, in a way that keeps costs down for both the patient and the health system.
Whether you're part of an urban, suburban, rural, or frontier population, the exciting progress we're making in medicine should be available to you. We are thrilled to have the support of Hatch in this significant step forward to relieve provider shortages, build capacity, and bring cost-effective, high-quality health care to every corner of our state and country.
Terry Box, M.D., is medical director of Project ECHO and an assistant professor at the University of Utah School of Medicine.