Lessons learned implementing an innovative extension for community healthcare outcomes (ECHO) program

As the United States faces mounting challenges to improving health outcomes, new strategies are needed to address root drivers of health and engage community partners to change the community conditions that impact health and health disparities. Project ECHO (Extension for Community Healthcare Outcomes) is a telementoring model developed in 2003 at the University of New Mexico to disseminate knowledge, share evidence-based care practices, and create communities of learning. The ECHO model has been shown to improve clinical outcomes by training primary care care clinicians to provde care often delegated to specialists. This paper describes modifications to ECHO programming to improve population health through engagement of diverse, community audiences in order to impact non-clinical contributors to health. During these community-facing ECHO courses, participants learn from short didactic sessions, share best practices through case-based presentations, and increase connections between sectors of the community and the health system. Implementation of this novel ECHO program is described using the RE-AIM and CFIR frameworks. Adapting the ECHO model to support collaborative learning to impact upstream drivers of health may be an important innovation for improving population health.