ECHO: A Truly Interactive Web-Based Method to Access Frontline Experience and Stimulate Cross–Consultation among State Public Health Programs

Background:

Participants in traditional webinars often become passive recipients of information presented by subject matter experts (SMEs), with limited time for questions and answers. Reduced participation by attendees means content cannot be shaped during the session to meet needs elicited by the discussion. ECHO (Extension for Community Healthcare Outcomes) is a model web-based interactive program developed by the University of New Mexico School of Medicine for discussing patient-centered clinical issues. CDC is assessing its use in a community-based public health service environment. The clinical ECHO program has been in use nationwide for several years and comprises multiple discussion groups. The goal of CDC’s application of the ECHO model is to assure that frontline staff are directly involved in creating content and developing sessions that address key public health issues.

Program background:

CDC’s Early Hearing Detection and Intervention (EHDI) program is using the ECHO video teleconferencing model to bring together state EHDI program partners and SMEs in a new type of technical assistance. During an ECHO video teleconference session, a previously identified state EHDI program presents a “case” or challenge pertaining to EHDI, sharing their attempted solutions with other programs participating in the session. Each “case” is chosen based on challenges that state programs identify as areas of improvement for tracking and surveillance capacity. An SME in the topic area is identified and asked to lead the ECHO session on this topic. During the session, the SME asks clarifying questions about the nature of the challenge and offers suggestions for addressing those issues. Participating programs also share their experiences, including solutions that have worked for them. The session closes with a short didactic presentation by the SME.

Evaluation Methods and Results:

Process and outcome evaluations are conducted to assess each ECHO session. The process evaluation provides information about session implementation, including whether the technology worked properly, total number of participants, relevance of the discussion to the identified need, and the number of participants indicating they learned new practices. The outcome evaluation collects information from participants who stated they are interested in replicating new practices within their state EHDI program as a result of what was learned during the session. These findings are used to measure the effect of changes on achieving specific goals.

Conclusions:

Evaluation findings indicate that ECHO web-based sessions can attract and engage state public health program staff by providing relevant information participants find useful in their service environments. The use of case presentations by peers and commentary by appropriate experts combined with discussion by participants generates a rich source of practical information.

Implications for research and/or practice:

Public health programs looking to improve service impact or efficiency in the face of ongoing barriers may benefit from the mutual support of frontline staff elicited by web-based case sessions. This is especially true if staff are scattered geographically but share common challenges that require more in-depth discussion and problem-solving strategies.