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VA Using Web To Train Rural Providers

ALBUQUERQUE, N.M. — VA hospitals struggling to provide specialized care for rural patients with chronic illnesses such as diabetes and heart disease are turning to a treatment model developed by the University of New Mexico that trains and supports doctors and nurses in remote areas.

The New Mexico VA Health Care System and 10 other large VA centers said this week they are developing a pilot program that uses web-based teleconferencing to train rural providers so they can deliver complex treatments with support from specialists.

The VA program is modeled on Project ECHO, launched by the University of New Mexico in 2003 to expand care for hepatitis C patients throughout the state.

“I think it will improve access for specialty care, because in the VA they have long waits for specialty appointments,” said Dr. Sanjeev Arora, a UNM physician who directs Project ECHO. “It will improve the quality of care and allow best practices to be delivered in rural areas.”

Each of the 11 VA medical systems, including New Mexico’s, received a two-year $1.5 million grant last year from the Department of Veterans Affairs to build the programs.

Project ECHO allows doctors, nurses and physician assistants in outlying areas to develop an expertise in hard-to-treat illnesses such as HIV/AIDS and hepatitis C under the guidance of specialists, Arora said.

In UNM’s program, health care providers at clinics around the state hold weekly teleconferences with a team of specialists in Albuquerque to discuss difficult cases and develop treatment strategies.

The New Mexico VA Medical Center began setting up the program last year and now works with 19 community-based outpatient clinics in New Mexico and West Texas, said program director Dr. Gerald Charlton, a cardiologist at the Raymond G. Murphy VA Medical Center in Albuquerque.

The New Mexico VA now offers telemedicine clinics in three areas: diabetes; heart failure and cardiology; and chronic pain and opioid addiction.

“I think it has already improved the care of patients in the remote areas,” Charlton said.

A key goal of the program is to reduce the crushing demand for specialists in Albuquerque by improving routine care for patients in their local areas, Charlton said.

“All the specialty clinics are a limited resource,” he said. “If we can care for patients where they live, that will open up the specialty clinics for people who most need to come to Albuquerque.”

— This article appeared on page C1 of the Albuquerque Journal