Veterans, Rural Physicians Reap Benefits of Virtual Technology

VA's SCAN-ECHO Program Extends Subspecialists' Reach, Expands Patient Care

July 17, 2012 06:15 pm Matt Brown

The United States Department of Veterans Affairs (VA) announced(www.va.gov) July 10 that it is using videoconferencing equipment to expand specialty care access to veterans living in rural and medically underserved areas.

[Stock Photo-Docs watching video conference]

According to VA Undersecretary for Health Robert Petzel, M.D., the Specialty Care Access Network-Extension of Community Health Outcomes (SCAN-ECHO) initiative allows primary and specialty care physicians to combine their efforts.

"Despite the reach and high quality of our health care services … one of our biggest challenges is that many millions of our patients live in rural and highly rural areas," Petzel said during a press conference. "It's difficult to bring specialty care, and best practices in specialty care, into these rural areas.

"SCAN-ECHO uses video communication technologies to create virtual clinics. In these clinics, primary care and specialty care physicians collaborate to manage patient cases, provide up-to-date information on patient medical problems and deal with real patient problems."

story highlights

  • The United States Department of Veterans Affairs (VA) announced it is using videoconferencing equipment to expand specialty care access to veterans living in rural and medically underserved areas.
  • Via the Specialty Care Access Network-Extension of Community Health Outcomes (SCAN-ECHO) program, primary care physicians present patient cases to a multidisciplinary care team during a 90-minute virtual SCAN-ECHO clinic, after which the team recommends a treatment plan.
  • Eleven VA medical facilities currently serve as SCAN-ECHO centers.

The VA has already begun piloting a version of SCAN-ECHO in 11 of its medical centers. Subspecialists are providing input on care for patients with diabetes, pain management, and hepatitis C via videoconferencing equipment that connects them with the patient's local primary care provider and patient-aligned care teams.

Sanjeev Arora, M.D., of the University of New Mexico in Albuquerque and author of the original project on which the SCAN-ECHO program is based, explained that primary care physicians present patient cases to a multidisciplinary care team during a 90-minute virtual SCAN-ECHO clinic, after which the team recommends a treatment plan.

Arora said the SCAN-ECHO program is a logarithmic methodology designed to expand capacity to match the increasing shortage of highly-specialized expertise worldwide.

"The heart of ECHO is case-based learning," he said. "The problem is that if you're going to take a primary care physician in a rural area and convert him into a junior rheumatology specialist or hepatitis C expert, how are they going to do that? Just listening to lectures is not enough, so we are going to teach them the same way we learned in the specialty -- we will learn by doing."

Arora said that, although it is neither necessary nor practical for primary care physicians to be experts on every disease known to exist, ECHO allows physicians to extend their practices to meet the needs of the patient population and get care to those who need it.

"Every primary care physician should choose an area of special interest," he said. "In rural or underserved areas, these primary care physicians can create self-sustaining networks to support each other, so that patients can get care where they live."

According to the VA, 35 teams in 14 different specialties had been formed as of May 2012, with 150 sessions held and a total of 690 consults completed.


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