AHRQ Views: Blog posts from AHRQ leaders
Moving Evidence Into Practice by Innovating Care Delivery
AHRQ is steadfastly committed to finding innovative approaches that accelerate the spread of clinical best practices that deliver the best and most timely care. It has been estimated that it takes about 17 years for a health care discovery to be translated into everyday practice. This is an unacceptable delay, which harms patients who could benefit from discoveries and which can contribute to health care disparities.
To learn more about AHRQ’s efforts in this area, I recently traveled to New Mexico to see the work of AHRQ grantee Sanjeev Arora, M.D., and his team of implementation pioneers, whose achievements have helped speed the implementation of evidence-based practices in rural, primary care settings.
In 2004, AHRQ awarded Dr. Arora a grant to evaluate the Extension for Community Healthcare Outcomes initiative (Project ECHO), which opened the lines of communication between disease experts at an urban academic medical center and rural primary care physicians. Using a tele-consultation network, Project ECHO helps practitioners effectively treat patients with chronic, complex diseases in their own communities.
The results of this work, which were published in the New England Journal of Medicine, demonstrated that with the support of the ECHO model, primary care physicians in rural communities across New Mexico were able to provide care that resulted in health outcomes equal to or better than care provided at the academic center, significantly improving treatment for patients with hepatitis C in these communities.
As described in AHRQ’s recently published profile of Dr. Arora, utilization of the Project ECHO model has expanded to 89 hubs in 30 States and 15 countries outside the United States. It’s used by entities such as the Department of Defense’s Defense Health Agency and Veterans Health Administration health care systems, as well as several agencies in the Department of Health and Human Services.
The ECHO model essentially serves as a force multiplier. When sub-specialist physicians and primary care physicians, nurses, and physician assistants work together to identify best practices in treating complex conditions, a valuable increase occurs in the number of patients who receive the most up-to-date, research-based care.
Building on the success and growth of Project ECHO, AHRQ has undertaken a new initiative focused on medication-assisted treatment of opioid-addicted patients. A frustrating aspect of the opioid epidemic is the lack of treatment options for millions of Americans living in rural communities. This summer, AHRQ launched four grants to study how to expand primary care treatment for patients battling opioid dependence in rural communities. All four teams have chosen to use the ECHO model as part of the solutions they are testing, and one of the projects includes Dr. Aurora and his team directly. By using the Project ECHO model, we believe our grantees will be able to significantly broaden the reach of medication-assisted treatment, an effective, evidence-based therapy that uses both medications and behavioral support to empower people to manage their addiction.
AHRQ Director Andy Bindman, M.D., center, with Sanjeev Arora, M.D., and the Project ECHO team
It is exciting to think about the impact that this potentially life-saving treatment will have when it reaches more patients struggling with addiction in rural primary care practices. Doctors, nurses, and other professionals in these settings are trusted sources of care, and they need the best possible information and tools to provide effective, evidence-based treatment.
Such efforts, of course, must be ongoing. We understand that delivering evidence-based care to underserved areas requires a continued commitment to both patients and health care providers. We’re also thrilled that AHRQ’s ECHO model has emerged as one example of what’s possible—how innovation and a passion for helping patients can shrink the gap between patients and the best possible treatments.