On Tuesday, the House approved the ECHO Act by voice vote, following the Senate's unanimous vote in favor of the bill on Nov. 29. If the president signs the bill into law, the ECHO Act would expand the University of New Mexico's Project ECHO as a national model. This legislation signals telehealth's broad appeal as a uniquely bipartisan solution in an increasingly divided policy landscape. But does this mean telehealth has finally reached its "tipping point?" Our experts weigh in:
What is Project ECHO and how does it fit within the broader context of telehealth?
Project ECHO is a hub-and-spoke telementoring network that connects regional practitioners to AMC specialists via teleconferencing. The program originally launched in 2003, with experts educating local primary care providers and nurses to provide high-quality specialty care and treatment for patients in rural or underserved locations. The "hubs" deliver education, mentoring, and feedback to the "spokes," and local clinicians and remote specialists collaborate to manage cases.
Empirical studies in NEJM, Health Affairs, and Academic Medicine have chronicled the program's clinical efficacy. For example, a study of 21 rural Project ECHO sites determined that Hepatitis C treatment response at the spokes paralleled that achieved at the hub. Participating clinicians also reported significant improvements in knowledge, self-efficacy, and professional satisfaction. Today, Project ECHO operates more than 90 hubs for over 45 diseases and conditions both in and outside the United States.
How does the ECHO Act promote telehealth expansion?
The ECHO Act mandates that the Department of Health and Human Services (HHS) study Project ECHO's impact on patient care and clinician development. The bill has two central components:
- The Secretary of HHS must study Project ECHO's hub-and-spoke infrastructure and examine its effects on four key areas:
- Mental and substance use disorders, chronic conditions, maternal and pediatric health, and palliative care
- Health care workforce issues (e.g. specialty care shortages)
- Public health programs (e.g. disease prevention)
- Delivery of health care in rural and frontier areas as well as Health Professional Shortage Areas
- No more than two years after the enactment of the ECHO Act, the Government Accountability Office and HHS must deliver a report to Congress on the ease of integration of the ECHO model and any barriers to its use. The report must also include recommendations for overcoming those challenges.
What does this mean for the future of telehealth?
Congress's overwhelming support of the ECHO Act brings health care delivery in rural settings and provider shortage issues into the national spotlight. We can expect continued discussion of regional access to high-quality medical care and further emergence of telehealth solutions that harness technology for care improvement. It's not clear yet if this is a tipping point, but it's certainly leaning that way.