Cancer centers across the U.S. are continually developing innovative solutions to address growing cancer care gaps. These solutions often include increasing access to valuable cancer trials or highly targeted screening initiatives.
Project ECHO at Houston-based University of Texas MD Anderson Cancer Center offers another solution, through the use of virtual consulting and mentorship.
Originally developed in 2003 by Sanjeev Arora, MD, at Albuquerque-based University of New Mexico to address the untreated hepatitis C in the state, Project ECHO has expanded to more than 320 academic centers across the U.S. The program model allows care providers in underserved communities to present cases to experts and receive guidance on patient management.
Kathleen Schmeler, MD, oncologist and associate vice president of global oncology, spoke with Becker's about how the program functions at MD Anderson.
Editor's note: Responses have been lightly edited for clarity and length.
Question: How would you describe cancer care deserts?
Dr. Kathleen Schmeler: Cancer deserts are not what we always think of as rural, it's more just underserved populations. Especially in a state like Texas, we're not a Medicaid expansion state, so we have all kinds of disparities in care. Care deserts to me are social in many ways, not necessarily just geographical.
Q: How does Project ECHO help address those care disparities?
KS: Dr. Arora approached us at MD Anderson and said, "You guys should really use this [model] for cancer," we thought cancer was too complicated. Then I started the program with an OB/GYN in the Rio Grande Valley of Texas who needed help and support. Ten years later, and we still do it every two weeks.
Through Zoom, community providers will present deidentified patient cases and then volunteers from MD Anderson and other specialists have a discussion about the patient and how we would treat them. There's no legal issues, no money exchanged. They take care of the patient, but they have our advice and support.
Project ECHO is a great solution to some of these care deserts, and we couple it with hands-on training courses, but it's a partial solution. It's a piece of the puzzle, but it's been really helpful.
Q: So you're empowering local providers with knowledge and insight to care for their patients as opposed to MD Anderson physicians treating patients directly?
KS: Oh yes, and that's how we learn. As young doctors we learned by seeing patients and reviewing cases with our attending physician. We're kind of doing the same thing [with Project ECHO], except they're not formally our trainees.
One of the big things to come out of Project ECHO is patient satisfaction. They don't have to travel. They're much more comfortable in their clinic compared to coming to a big hospital in another city.
Q: And the program has been going for 10 years?
KS: Yes, in January, it will be 11 years. We do the meetings at 7:30 a.m. on Friday mornings. It makes me so happy every time I log on and there are still so many people that we're providing something of value to. It's voluntary for everybody. We give them continuing medical education credits, but essentially, it's voluntary. People really want to join and ask questions about what to do and how to care for their patients.