ECHO-CMU for ATTC 25th Anniversary: SEA-HATTC’s expansion of new learning strategies

Behavioral health is a major problem while ongoing health workforce shortage is global issue. SEA-HATTC signed MOU with Missouri Telehealth Network, University of Missouri for utilization of ECHO® model and software to conduct virtual clinics via multi-point videoconferencing also extend behavioral healthcare knowledge and tele-consultation to primary care and community hospitals in the upper northern Thailand.

To promote the expansion of new learning strategies, SEA-HATTC mapped out an implementation of behavioral health ECHO® (Extension for Community Healthcare Outcomes) model as a guided practice strategy for transforming medical education and increasing workforce capacity to teach best-practice specialty care.Having been endorsed as a highly innovative strategy that produces improvements in the quality and efficiency of integrated care, ECHO is a low-cost yet high-impact intervention linking expert inter-disciplinary teams of practitioners through tele-education.

A regular monthly 60-minute tele medical education on ‘behavioral health’ under ECHO-CMU Project has been launched for doctors, nurses, psychologists and nutritionists.The goal is to manage and control of chronic disease through behavioral health interventions. ECHO-CMU has 4 sites in Chiang Mai, Chiang Rai, Lamphun and Lampang Provinces all are the provincial hospitals located in the upper northern region of Thailand. Hub is located at SEA-HATTC Office, Department of FamilyMedicine at Chiang Mai University. Spokes are residents of Family Medicine in in-service training program.

To date, there are 75 health professionals (excluding Hub team) participating. Sessions under behavioral health theme included ‘care for patients with EMCO stroke’; ‘multidisciplinary approach for self-management support’; ‘approach and management for delated development at child’; ‘MI and counseling’; ‘health behaviors and behavior change’; ‘caring past stroke patients’;‘depression’; ‘deconditioning’; ‘nutrition for patient with NCD’; ‘dealing with alcohol and smoking in chronic disease patient’; ‘ updating guideline for NCD’; ‘diet for DM’; ‘exercise for elderly with chronic disease’, and etc., as the model shown below.

The clinics are supported by basic, widely available teleconferencing technology. During teleECHO clinics, primary care clinicians from multiple sites present patient cases to the specialist teams and to each other, discuss new developments relating to their patients, and determine treatment. Specialists from Faculty of Medicine, Chiang Mai University and Mahidol University serve as mentors and colleagues, sharing their medical knowledge and expertise with primary care clinicians. Essentially, ECHO® creates ongoing learning communities where primary care clinicians receive support and develop the skills they need to treat a particular condition. As a result, they can provide comprehensive, best-practice care to patients with complex health conditions, right where they live.

Besides the behavioral health theme of the pilot ECHO-CMU, the upcoming theme will be provided on ‘Caregiver of NCDs Geriatric Patient’ targeted to primary care practitioners, co-health workers, village leaders and health volunteers.

Given the limited project budget and the vast geographic spread of the target countries, SEA-HATTC introduced ECHO model to the regional advisory board members as an effective multi-point videoconferencing platform in extending HIV/addiction technology transfer and tele-consultation to health and social workers in Tier 1 countries including Cambodia, Lao PDR, Myanmar plus India and Indonesia for workforce development within the Southeast Asia region.

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