Enhancing HCV, HIV and STI Care Through Building an Innovative ECHO Program
When it comes to caring for patients with infectious diseases, Leah Besh has a unique perspective. Leah, who is a Physician Assistant at the Alaska Native Tribal Health Consortium (ANTHC), works with ANTHC’s HIV and hepatitis clinics. Through this work, Leah has seen firsthand the negative impacts of co-morbid infectious diseases. She has also witnessed how integrated care can positively impact patient outcomes. This awareness inspired Leah and her colleagues, including Lisa Townshend-Bulson, a family nurse practitioner, to create an Infectious Disease ECHO Program for Alaska-based providers.
When funding opportunity and need collide
“Once we saw the funding announcement by Indian Country ECHO, we decided to create an ECHO that encompassed diseases that are often seen together: HCV, HIV, and STIs,” Leah explained. The team also decided to leverage their connections with the Mountain West AIDS Education and Training Center, which provides education and training to improve access to care and quality of life for people who are living with or are at-risk for acquiring HIV. Through collaboration, Leah and the team reasoned that they could recruit a wider spectrum of speakers and clinicians interested in presenting and participating in the ECHO.
A quick start up with the help of Indian Country ECHO
In December 2020, the ANTHC team applied for a grant and was awarded the funding one month later. Amazingly, they held their first ECHO only one month after that. According to Leah, this whirlwind timing was, in part, made possible due to the guidance, technical assistance, and support provided by Indian Country ECHO. For instance, Indian Country ECHO helped Leah and her colleagues by discussing ways to advertise. They also provided specialists and case presenters when needed. “We could not have gotten off the ground and had our first ECHO in one month without them,” said Leah.
The ANTHC team decided that their ECHO would take place on the second Tuesday of every month from 12–1pm Alaska Standard Time. They also decided to keep the format similar to other ECHOs- with each online session beginning with a didactic presented by a subject matter expert. Every session would also include one or more case presentation(s) to a team that included hepatologists, infectious disease specialists, a clinical psychologist, and a pharmacist – all of whom would provide the presenter with holistic treatment input.
Forming partnerships within and between disciplines
A diverse group of specialists, including PAs, ANPs, MDs, RNs, pharmacist, and clinical psychologists, staff ANTHC’s Infectious Disease ECHO. According to Leah, the collaboration and sharing of expertise have led to more integrative patient care at ANTHC and for those who join the ECHO. Of this, Leah explained, “When you get into specialty fields there is a lot of siloed care…We were able to break down those silos a bit by sharing roles, responsibilities, and knowledge during ECHO sessions.”
The team’s relationship with the Alaska Department of Health and Social Services (DHSS) was also strengthened through regular collaboration. For the first six months of the ECHO program Alaska DHSS not only helped provide attendees with foundational information on Alaska epidemiology, they also shared important information about screening protocols for common infectious diseases.
Future Directions
Now that Leah and the ANTHC team have shared basic knowledge of infectious disease epidemiology and screening with ECHO participants, she hopes that they will begin delving into the nuances of specific diseases. In addition, Leah hopes that community health aides and other rural providers who work in Alaska will be encouraged to attend ECHO sessions and present cases. “The most important thing to me is that people know that ECHO session topics are decided by clinicians, “Leah concluded, “It’s a way we can all learn from each other.”
To enhance your ability to screen, treat and manage patients, join one of ANTHC’s Infectious Disease virtual ECHO sessions. If this time doesn’t work, consider joining one of Indian Country ECHO’s Infectious Disease ECHO sessions. At both, you will participate in didactic and case presentations, receive recommendations from peers and a multidisciplinary team of specialists, and join a learning community of dedicated providers committed to growing clinical capacity so every patient across Indian Country receives the care they deserve.
Image Source: ANTHC Facebook