Project ECHO (Extension for Community Healthcare Outcomes) is an organization that provides training, expertise, and mentoring via video conference in a variety of fields but primarily focuses on medicine. Project ECHO began in New Mexico to provide medical expertise to health care professionals in underserved areas and has expanded to all 50 states and at least 25 countries around the world. Project ECHO still mainly focuses on healthcare but has expanded to include education and civics programs. The program continues to grow especially because of the Covid pandemic. It is funded mainly through private donations but recently has received money from government.

History

Project ECHO was founded in 2003 as a program that sought to expand healthcare to rural and underserved areas of New Mexico. ¹ Founded by Sanjeev Arora, Project ECHO began by sending out hepatitis C treatment guidelines to doctors around the state and evolved into recruiting health care professionals throughout the state to form a virtual community to learn from experts and each other. ²

Project ECHO launched in 2004 as TeleECHO Clinic with support from the University of New Mexico, the New Mexico legislature, and Agency for Healthcare Research and Quality at the U.S. Department of Health and Human Services. ³ Project ECHO uses a video-mentoring hub and spoke model. ⁴ Weekly, experts in fields of medicine host online discussions and cite examples to teach others in their expertise to provide knowledge to underserved areas or those seeking more knowledge. ⁵ Project ECHO currently serves people in every state in the United States and over 25 countries around the world. ⁶

Programs

Project ECHO was founded as a telehealth operation and has greatly expanded with advanced technology in videoconferencing. It began as a healthcare platform for healthcare professionals but has evolved to include health, education, and civics programs. ⁷

Healthcare continues to be the primary focus of Project ECHO. ⁸ Each area of expertise in Project ECHO is called a hub and the organization has hubs on more than 750 topics. ⁹ Additionally, Project ECHO has super-hubs which are usually run by medical schools or associations like the American Academy of Pediatrics. ¹⁰ These super-hubs provide more content and training, archived presentations, and online information on demand. ¹¹ During the COVID-19 pandemic, Project ECHO became a focal point for health care professionals to share information. ¹²

Project Echo introduced an education portal. ¹³ The education portal was designed for teachers to communicate on best practices or discuss situations that arise in education. ¹⁴ Another component of the education portal is training and educational resources for inmates in prison. ¹⁵ The education portal saw an increase in users beginning with students staying home in 2020 during COVID-19. ¹⁶

The third program is a civics component. ¹⁷ Project ECHO has been used by the Albuquerque Police Department to train officers on crisis intervention and other continuing education. ¹⁸ It also includes areas such as mentoring of incarcerated individuals, journalism training and networking, and connecting government leaders. ¹⁹ More recently, Project ECHO has expanded and is now engaged in the global warming debate. ²⁰

Funding

Project ECHO’s funding largely relies on donations from organizations and nonprofits including the Robert Wood Johnson Foundation, the Leona M. and Harry B. Helmsley Charitable Trust, Con Alma Foundation, McCune Foundation, and the GE Foundation. ²¹ Among government support, in 2012 the U.S. Department of Health and Human Services awarded Project ECHO an $8.5 million grant to expand programming on chronic health conditions. ²² In 2021, Project ECHO was one of six finalists competing to receive a $100 million grant from the MacArthur Foundation. ²³ In 2022, Project ECHO received an unspecified grant from MacKenzie Scott. ²⁴

Several states including California, Colorado, New Mexico, and Oregon have used Medicaid funds to support Project ECHO. ²⁵ Use of such a funding mechanism would require a state to seek a waiver or permission from the Centers for Medicare and Medicaid Services to direct funding to the program. ²⁶

Leadership

Sanjeev Arora is the director and founder of Project ECHO. ²⁷ Dr. Arora is a professor of medicine at the University of New Mexico’s Health Sciences Center and has served as executive vice chair of the Department of Internal Medicine and president of the medical staff. ²⁸ He has also served as president of the University Physicians Association. ²⁹ Born in India, Arora moved to the United States in 1980 to study medicine and became a gastroenterologist. ³⁰ Arora has given to multiple political candidates from both parties since 1997 while slightly giving more to Democrats than Republicans. ³¹

Elizabeth Clewett is chief of staff at Project ECHO. ³² Clewett has a PhD in comparative politics from George Washington University and oversees policy, development, sustainability, partnerships, and programs at Project ECHO. ³³ Previously she was the director of development at Global Links, a Pittsburgh-based medical aid organization that collected unused supplies from U.S. hospitals and provided them to hospitals and clinics in Latin America. ³⁴ Clewett has politically donated to Democratic candidates since 2008, including former President Barack Obama. ³⁵

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