Health IT Knocks Out Hep C

Telehealth played a key role in significantly increasing hepatitis C cure rates in a New Mexico medical trial, according to an article published online Wednesday by the New England Journal of Medicine.

Treatment of hepatitis C, a chronic infectious disease of the liver that can be fatal, requires 12 to 18 visits to a specialist in a year. According to the study, there aren't enough specialists to provide timely treatment to the 30,000 New Mexicans who are infected with the hepatitis C virus.

The Project ECHO (Extension for Community Healthcare Outcomes) study teamed primary-care clinicians with specialists at academic medical centers for videoconference training on hepatitis C treatment. The clinicians were organized into "knowledge networks" that meet weekly to present and consult on patient cases using Web-based disease-management tools and shared best practices.

Armed with specialist-level knowledge, the health-care providers -- physicians, nurses, physician assistants and community health workers -- are able to effectively treat hepatitis C patients in their own communities. The cure rate for patients treated under Project ECHO was virtually identical to that of those treated at the University of New Mexico Medical Health Sciences Center in Albuquerque, and significantly higher than those in previous community-based treatment programs. Additionally, the program reduced racial and ethnic disparities in treatment outcomes by providing specialty services to minority communities.

The university medical center conducted the project, which was funded in part by a three-year, $5 million grant from the nonprofit Robert Wood Johnson Foundation.

"Project ECHO has the potential to transform health care as we know it," Dr. Risa Lavizzo-Mourey, president of the foundation, said in a news release. "What began as a truly disruptive innovation in New Mexico for treatment of hepatitis C has the capacity to re-engineer health care delivery and training across the health-care system."

Since the Project ECHO hepatitis C clinic launched in 2003, it has expanded to include videoconferencing clinics in asthma, mental illness, chronic pain, diabetes and cardiovascular risk reduction, high-risk pregnancy, HIV/AIDS, pediatric obesity, rheumatology and substance abuse. More than 1,000 New Mexico clinicians have participated.

The Robert Wood Johnson Foundation is applying the Project ECHO model nationwide, with programs already under way in Washington state and Chicago.