Dr Sanjeev Arora Explains the Origins of Project ECHO and Improving Access to Care

Project ECHO, which helps specialists disseminate knowledge to primary care providers, was created on the idea that patients should not be dying from curable diseases because they don’t have access to the right providers, said Sanjeev Arora, MD, FACG, MACP, director and founder of Project ECHO and a professor of medicine at University of New Mexico.

Transcript

As the founder of Project ECHO, can you explain when this program was started, what population it serves, and what inspired you to create it?

I’m a hepatitis C specialist and I was treating hepatitis C at the University of New Mexico in my clinic, and I recall a patient who she was a 43-year-old woman and she came to see me and there was an 8-month wait to see me in my clinic, and people were driving hundreds of miles to see me. Two hundred miles each way. And would have to make 12 to 18 trips to get treatment, because treatment involved weekly injections with interferon and another medicine that caused anemia, called ribavirin. When she saw me, she had 2 children—1 was a son, 14 years old, she had a daughter who was 9—and she wanted treatment for hepatitis C. She had been diagnosed with hepatitis C many years ago. Her husband had passed away in a car accident 5 years earlier, so she was a single mother.

And when I saw her, she had cancer of the liver already, which was the size of a baseball. And she really wanted to live because she had 2 children, but there was nothing we could do, and she died of a disease that is actually quite curable, because there were no doctors in her area that had the ability or knowledge to treat hepatitis C.

And over the years, I’ve had more than a hundred patients like that, who died of hepatitis C-related liver cancer when this was totally preventable, and because of the 8-month wait and the long drives, poor people couldn’t access me, and I thought I had to do something else to bring access to care to everyone in New Mexico who had this disease, so more people didn’t die of liver failure and liver cancers. And that’s how I started Project ECHO, to bring access to care for hepatitis C treatment to everyone, and then I knew if I could do that, I would have a model for complex diseases and rural locations and other countries.