What is Is Project ECHO?

Project ECHO (Extension for Community Healthcare Outcomes) is an information exchange that uses tele-mentoring to share knowledge between specialists (the hub) and outlying PCPs (the spokes) with the goals of supporting PCPs in their administration of high-quality, leading-edge care to their patients and improving health outcomes for underserved patients. Currently, the ECHO movement has been scaled to more than 70 specialties and 400 global hubs, with more than 245 hubs in the United States alone.

The ECHO Movement

At its heart, Project ECHO is a grassroots movement with the motto “Moving knowledge, not people.” Project ECHO has rapidly expanded across the United States and the globe since 2015. It is now in 48 states and 40 countries. Established hubs are growing the ECHO movement by becoming superhubs. Superhubs serve as training centers for those wanting to replicate the ECHO model.

Project ECHO brings best practices in health care to underserved patients via their primary care providers (PCPs)—improving care in rural areas and supporting PCPs everywhere. Thanks to telemedicine, knowledge between specialists and PCPs can be shared via regular training sessions that discuss best practices and new technologies and provide feedback on case studies.

Today, there are Project ECHO knowledge exchanges on several complex chronic conditions, including hepatitis C, HIV, chronic pain, opioid addiction, mental illness, diabetes, and cancer. Stanford Medicine was the first hub to offer Project ECHO strictly for type 1 diabetes (T1D), thanks to a pilot study with the University of Florida. Now, ECHO Diabetes supports primary care providers in providing both T1D and T2D care to adults and children.

History of Project ECHO

Project ECHO is the brainchild of Sanjeev Arora, MD, a liver disease specialist at the University of New Mexico Health Sciences Center in Albuquerque. Project ECHO dates back to 2003. Legislation supports the ECHO movement. The Echo Act of 2016 requires the U.S. Department of Health and Human Services (HHS) to report on collaborative learning between specialists and PCPs via telemedicine, with the aim to disseminate best practices and evaluate outcomes. 

Project ECHO at Stanford Medicine

ECHO Diabetes is directed by Nicolas Cuttriss, MD, MPH, assistant clinical professor of endocrinology and diabetes at Stanford Medicine. Dr. Cuttriss was a part of Endo ECHO at the University of New Mexico and joined Stanford Medicine in 2018 to help develop Project ECHO here. He and the Stanford ECHO Diabetes team are working with colleagues at the University of Florida and the University of New Mexico to create a scalable version of ECHO Diabetes that can be replicated across the globe.

The ECHO Diabetes hub is composed of a multidisciplinary team of experts: