Using Technology to Address Workforce Shortage: Impact of ECHO Rheumatology on Primary Care Providers

Rheumatic diseases are a major burden on individuals and health care systems. Shortages of health care providers, limited capacity at academic medical centers, and geographic and socioeconomic challenges contribute to this burden. The Extension for Community Healthcare Outcomes (ECHO) enables community-based primary care providers (PCPs) to partner with academic medical center-based specialists to deliver best practice care to underserved communities. This study evaluated the reach and impact of the ECHO Colorado Rheumatology program on PCPs who work in underserved areas in Colorado.

Participation, self-reported demographic, and self-efficacy data of participants who attended the series between 2020 and 2023 were assessed. Changes in self-efficacy before and after the series were analyzed using a Wilcoxon signed rank test. A retrospective secondary analysis assessed whether participation increased the proportion of participants rating their ability as "competent or higher" changed after participation in the series using McNemar's test.

A total of 211 providers participated in the program, and 93% resided in Colorado. Self-efficacy ratings improved across all learning objectives, with a statistically significant improvement in 9 of 10. The proportion of participants reporting a level of "competence or higher" also significantly improved in 8 of 10 learning objectives.

Most self-efficacy scores in the learning objectives identified in this study improved after participation in the ECHO Colorado Rheumatology series, demonstrating improved PCP self-reported competence in identifying, evaluating, and diagnosing rheumatologic conditions. Additionally, by reaching providers who work with medically underserved populations, ECHO Colorado hopes to improve patient access to rheumatologic care.