Schatz, Hatch Health Tele-Training Bill Passes Unanimously in the Senate

WASHINGTON U.S. Senators Brian Schatz (D-Hawai‘i) and Orrin Hatch (R-Utah) issued the following statements after the Expanding Capacity for Health Outcomes (ECHO) Act, legislation they introduced, passed in the Senate by a vote of 97-0. This legislation will increase access to high-quality health care in hard-to-reach regions.

“We’re now one step closer to supporting new ways to train health providers and deliver health care,” said Senator Schatz, a member of the Senate Appropriations Subcommittee on Labor, Health and Human Services, and Education. “Technology is changing the way medical professionals connect with each other and their patients.  Our bill capitalizes on this technology to give health professionals in hard-to-reach areas the specialized training they need and help them reach more patients.”

“On a recent visit to southern Utah, I had the opportunity to visit a rural health center and speak to some of the families that rely on services included in the ECHO Act,” Senator Hatch said. “Some of these individuals had health conditions that required specialized care or could be managed much closer to home by health professionals they know and trust. By using technology to connect patients and providers, this bill will benefit Utah’s families by helping them receive the care they need, when they need it.  I’m grateful for the valuable input Utah’s health leaders have provided in crafting this proposal.” 

Statements of Support

Kelley Withy, MD, PhD, Director of the Hawai‘i/Pacific Basin Area Health Education Center, John A. Burns School of Medicine, University of Hawaii
“ECHO has been helping dozens of providers a month better understand behavioral health situations, geriatric cases, dementia sequelae and endocrine implications. It will be really helpful to the State to expand the offerings, and even to include mainland and Pacific groups as well.”

Dr. Barbara McAneny, Immediate Past Chair of the American Medical Association:
“Project ECHO is bridging geographic divides to connect physicians and experts with patients in underserved, rural areas. An exemplary model of using new technologies to improve patient care, Project ECHO has potential to bolster access to specialists, reduce incidence of chronic disease, and rein in costs through reduced travel and fewer ER visits. The AMA believes the ECHO Act would provide policymakers with critical information to expand such models to improve clinical practice.”

Dan Hawkins, Senior VP, Public Policy and Research, National Association of Community Health Centers:
“The Expanding Connectivity for Health Outcomes (ECHO) Act is a bipartisan and innovative response to the need to connect primary care providers to specialists in rural and underserved areas.  Because health centers are all located in medically underserved urban and rural areas or serve medically underserved populations, they regularly become the medical home for patients with complex needs and chronic conditions.  This need is often amplified in rural areas which may have higher rates of chronic diseases and less access to specialty providers. By connecting specialists with primary care providers, the Project ECHO model allows for patients to access quality care close to home and creates opportunities for primary care physicians to manage complex needs in their own health centers. We applaud the efforts of Senator Hatch and Senator Schatz to examine the use of, and opportunities to use, technology-enabled collaborative learning and capacity building models, such as Project ECHO, to improve patient care and provider education.”

Dr. Sanjeev Arora, M.D., Founder and Director, Project ECHO, University of New Mexico School of Medicine:
“Medical knowledge is exploding, but it’s often not traveling the last mile to ensure that patients get the right care in the right place at the right time. If we can leverage technology to spread best practices through case-based learning and mentoring of providers, we can move knowledge – instead of patients – to get better care to rural and underserved communities across the country.”  


Rural Health Challenges

  • Only about 10 percent of physicians practice in rural areas of the United States despite nearly one-fourth of the population living in these areas. 
  • Rural areas have higher rates of some chronic diseases and face many challenges, including transportation, connectivity, and isolation.
  • It is difficult to recruit health care providers to work in rural and underserved areas, and opportunities for professional development and support in such areas can be difficult.

Project ECHO Model

  • Project Extension for Community Health Outcomes (ECHO) is an innovative continuing medical education model that uses interactive videoconferencing to link specialist teams (“hubs”) with primary care providers (“spokes”) in rural and underserved areas. Together, they participate in weekly teleECHO clinics that combine didactic teaching with mentoring and case-based learning.
  • Demonstrated uses of Project ECHO have been numerous and include:
    • Addressing disease conditions and topic areas, including hepatitis C, integrated addictions and psychiatry, chronic pain/headache management, and diabetes;
    • A complex care program offering support to multidisciplinary teams providing primary and behavioral health care to high-need, high-cost patients; and
    • Public health interventions, including addressing H1N1, HIV, and tuberculosis as well as improving health and wellness within Native American populations.

Benefits of Project ECHO model for:

  • Patients: Improved access to quality and accessible care, with high-patient satisfaction
  • Providers: Increased knowledge for providers in rural/underserved areas, with ability to serve as a local resource; improved provider network; enhanced professional satisfaction and reduced isolation; more access to specialists.
  • Health care system: Higher retention of providers in rural/underserved areas; better care delivered in the right place at the right time by the right person; decreased costs (less travel for specialty visits, less hospitalizations and ER visits, better quality of care close to home, and treatment of chronic diseases earlier before complications arise).
  • Current health care challenges: Project ECHO has successfully been used to increase the number of physicians able to prescribe buprenorphine for opioid abuse, to quickly educate health providers on public health crises such as H1N1, and to train providers to address complex mental health disorders.

The Enhancing Capacity for Health Outcomes (ECHO) Act:

  • The ECHO Act aims to better integrate the Project ECHO model—referred to as a “technology-enabled collaborative learning and capacity-building model”—into health systems across the country.  The bill does the following:
    • Requires the Secretary of the U.S. Department of Health and Human Services (HHS), in collaboration with the Health Resources & Services Administration (HRSA), to prioritize analysis of the model, its impacts on provider capacity and workforce issues, and evidence of its effects on quality of patient care.
    • Requests a GAO report regarding opportunities for increased adoption of such models, efficiencies and potential cost savings from such models, ways to improve health care through such models, and field recommendations to advance the use of such models.
    • Requires the HHS Secretary to submit a report to Congress on the findings of the GAO report and the HHS report, including ways such models have been funded by HHS and how to integrate these models into current funding streams and innovative grant proposals.