To determine if a teleconferencing didactic and case presentation model could build the capacity of clinicians to diagnose and treat PD and its complications

The ECHO framework is an educational tele-mentoring intervention designed to transfer specialized knowledge from expert centers to outlying clinicians, thereby increasing access to care. This ‘hub-and-spoke’ approach aims to reduce health disparities in under-served areas. 

We recruited 28 primary care providers and other allied health professionals through the Oregon Rural Practice-based Research Network (ORPRN) under an IRB-exempt protocol, with 33% coming from rural or frontier communities. We developed a 10-week program; each session consisted of a 20-minute expert-led didactic followed by a real-life case presented by a participant. They were broadcast via teleconferencing software to promote discussion among all attendees. Participants were surveyed following each session as a measure of quality control. Each participant also completed a pre- and post-curriculum survey to assess program effectiveness.

We averaged 18 unique participants per session with 12 weekly post-session survey responses.  We had 18 participants complete the pre-course evaluation. Of those, 12 completed the post-course evaluation. With respect to weekly questions about meeting objectives, pace, organization, relevance, and opportunity to ask questions, there were consistently high scores with no outliers (5.5 out of 6). Overall, there was an increase in confidence in diagnosis and treatment and a report in direct change in care. Three participants led a didactic on PD in their community and two enacted policy changes to better care for PD patients at their institution.

Improving access to specialist care for PwP is a priority and we demonstrate that Parkinson ECHO can deliver the content effectively to rural and frontier clinicians who practice in counties without access to neurology care. Future work is needed to evaluate the long-term knowledge retention of clinicians and patient-level outcomes.