The ECHO Tele-Mentoring Model: How Social Workers Can Extend Best Practices in Health during the Coronavirus Pandemic

Background and Purpose: Social work researchers and educators can play critical roles in reducing health inequities by de-monopolizing knowledge in order to provide quality health care. During the COVID-19 pandemic, health care providers, especially those located in rural regions, were challenged by learning best practices as they emerged. Project ECHO® which stands for Extension of Community Health Outcomes, was developed to train multi-disciplinary healthcare teams in underserved areas how to deliver care to treat a myriad of health issues (e.g., Hepatitis C, opioid addiction, autism, cancer). ECHO® uses a “hub and spoke” model whereby a multi-disciplinary team of experts in the hub and community health care providers in community clinics (spokes) participate in tele-mentoring sessions. The goal is to promote quality and culturally-relevant practice through expert didactics, case-based learning and interaction through the convenience of video-conferencing.

The purpose of this study was to test whether an ECHO® tele-mentoring project could address the critical care needs of cancer patients within the context of the COVID-19 pandemic. Specific aims of the program were to: 1) increase clinical knowledge, comfort and competence in managing cancer care during the pandemic; 2) determine the feasibility and acceptability of using the ECHO® program during a major health crisis. The study took place in Kentucky, a primarily rural state with some of the highest rates of cancer in the nation.

Method: This study is a program evaluation. Participants are providers (physicians, nurses, social workers, administrators) who worked in cancer programs across the state. They were recruited through emails, e-newsletters, and e-fliers. The program consists of a series of six weekly one-hour Zoom sessions that include a didactic, Q&A, and a case presentation. The topics include maintaining critical cancer care, practicing telehealth, ethical considerations, clinical care of older adults, and provider self-care. Following each session, we collect data with a brief survey. After the final session, we will distribute a questionnaire evaluating the program.[1] Knowledge, self-efficacy, and satisfaction with the technology are measured after each session. The final questionnaire includes items on professional isolation, changes in knowledge and practice, and overall satisfaction.

Results: 95 participants registered for the Program and represented a variety of professions: physicians, nurses, social workers, psychologists, administrators, and educators. They work in both urban and rural areas of Kentucky. Analysis of preliminary data collected after the first three session revealed that 88% - 100% of the participants strongly agreed to an increase in knowledge and feeling better prepared to provide quality cancer care.

Conclusion and Implications: These preliminary findings support the feasibility and acceptability of an ECHO® model in building the capacity of multi-disciplinary teams in responding to the COVID-19 pandemic. By using technology to reach health care workers in remote places (at home or in rural clinics), best practices as they emerge can be shared between experts and community providers and community providers with each other.

[1] At the time of this abstract, data analysis has been completed on the first three sessions; the program is still continuing;last session is May 28th.