@article{ba49ef140d51459dbddf4a009cee1762,
title = "A telementoring intervention leads to improvements in self-reported measures of health care access and quality among patients with complex diabetes",
abstract = "Individuals living with complex diabetes experience limited access to endocrine care due to a nationwide shortage of endocrinologists. Project ECHO (Extension for Community Healthcare Outcomes) is an innovative, scalable model of health care that extends specialty care to medically underserved areas through ongoing telementorship of community primary care providers. We evaluated the effects of an endocrine-focused ECHO program (Endo ECHO) on patients with type 1 and complex type 2 diabetes, and report here on changes in patient-reported measures of health care access and quality from baseline to one year after program enrollment. Patients were eligible for Endo ECHO if they were 18 years or older with complex diabetes. After participating in Endo ECHO, access to health care and diabetes-related quality of care improved dramatically. Our results suggest that Endo ECHO may be a suitable intervention for extending best practices in diabetes care to medically underserved patients.",
keywords = "Diabetes mellitus, Medically, Rural health, Rural health services, Rural population, Medically Underserved Area, Diabetes Mellitus, Type 2/therapy, Health Services Accessibility, Humans, Self Report, Community Health Services",
author = "Paul, {Margaret M.} and Saad, {Andrea Davila} and John Billings and Saul Blecker and Bouchonville, {Matthew F.} and Cindy Chavez and Hager, {Brant W.} and Sanjeev Arora and Berry, {Carolyn A.}",
note = "Funding Information: Findings from this study are potentially limited in several ways. First, the data were self-reported and could be subject to desirable response bias.24 Our team limited the chance of this type of bias by administering the post-surveys independent of Endo ECHO program staff, and by assuring patients of the confidentiality of their individual responses. Another limitation of our study is that we did not collect survey data on a comparison group of patients who were similar to the patients enrolled in Endo ECHO and therefore we do not know how the sample of enrolled patients differed from the general population of eligible patients. Finally, the version of Endo ECHO that we evaluated was funded by the Helmsley Charitable Trust to cover 20% of a PCP and 100% of a CHW throughout the study period. While these grants allowed sites to fully participate in our study by, for example, providing protected time to participate in weekly teleECHO clinics, it is unlikely that many, if any, “naturally occurring” implementations of Endo ECHO will include funding for such a large amount of PCP time and a dedicated CHW; therefore the generalizability of our study is limited. Moreover, this program structure precluded us from being able to disentangle provider vs. CHW effects on patient outcomes. Publisher Copyright: {\textcopyright} Meharry Medical College Journal of Health Care for the Poor and Underserved.",
year = "2020",
month = aug,
doi = "10.1353/hpu.2020.0085",
language = "English (US)",
volume = "31",
pages = "1124--1133",
journal = "Journal of health care for the poor and underserved",
issn = "1049-2089",
publisher = "Johns Hopkins University Press",
number = "3",
}