"Chronic disease management is a team sport." So said Dr Sanjeev Arora at this week's Transform conference, hosted by the Mayo Clinic in Rochester, Minnesota. Arora is an liver specialist by training, though a sideline in community healthcare has now become more than a day job. In 2002, he founded Project ECHO [Extension for Community Healthcare Outcomes] in an attempt to handle the very real problems suffered by those diagnosed with hepatitis C in New Mexico. Frustrated that he wasn't able to do enough within his own clinic (there was an eight month waiting list while many of those with the disease were unable to travel for the many visits necessary for treatment, Arora started ECHO as an attempt to mobilize a network around a disease.
The video above gives the gist of how the program works. At Transform, Arora outlined the importance of collaboration to the new practice. Every Wednesday afternoon, a team of specialists, including doctors, nurses, nurse practitioners and the like call in from wherever they're located to take part in a video conference. Together, they'll co-manage the care of up to 15 patients in the course of the call. In his talk, Arora spoke the language of business, of the need to standardize best practices and channel the processes of the most streamlined organizations. Yet, he added, expert clinicians need to implement a quality that's not necessarily a factor on Toyota's production line: wisdom. "What makes this different from manufacturing is that every patient is different," he said.
As Arora mentions in the video, there are now ECHO projects for diseases other than hepatitis C, though he's also aware of the complex issues that surround trying to scale the program too aggressively. "Don't start ECHOs for 200 diseases," he said at Transform. "Just a few diseases account for morbidity and mortality. Do it for those."