She helped launch Project ECHO. Now it reaches the farthest corners of the world.

It doesn’t seem that revolutionary: experts teleconferencing with frontline workers around the globe regularly to tackle pressing medical and societal problems. 

But this simple model of spreading knowledge that was developed 23 years ago at the University of New Mexico is now replicated in 1,600 sharing “hubs” for such purposes as advancing emergency medicine in Sudan, preventing disease in New Mexico prisons and managing diabetes cases in Brazil.

Called the Project ECHO system, it is basically a formatted way of sharing knowledge of all kinds with rural or underserved places that don’t have the expertise needed to make people’s lives better, says Karla Thornton, who has been with the program since it first started and was named executive director in August. 

“I feel passionate about ECHO in general, but related to health care, it shouldn't matter where you live — you should be able to get excellent care,” says Thornton, a doctor and authority on hepatitis C. “You should have access to the knowledge that somebody needs so that they can take care of you.”

In a typical ECHO (Extension for Community Healthcare Outcomes) session, a panel of experts opens with information about a topic, after which those out in the field talk about particular cases and problems for which they need mentoring. 

The sessions are held as often as once a week, giving the remote learners support and medical advice so they can become “experts themselves over time,” Thornton says.

Thornton started the first ECHO hub to deal with hepatitis C, a bloodborne virus that can lead to liver issues or cancer but for which there is no cure. That hub is still going, with Thornton and other experts mentoring primary care doctors on treatment options.

And the targeted underserved populations are not just in rural areas or foreign countries. Prisons also lack medical expertise and are incubators for infectious diseases, so Thornton started the New Mexico Peer Education Project. The program trains groups of prisoners to educate their incarcerated peers about disease treatment and prevention. 

Such ECHO-style hubs are now operating in every New Mexico prison. And more hubs have been added, including one that focuses on financial literacy skills and another that teaches former prisoners to help others who have been released.

The program has trained nearly 1,200 peer educators, and they, in turn, have educated more than 40,000 incarcerated people.

“These are places where so much needs to be done to help people,” says Thornton, who has served on a World Health Organization panel that advises on hepatitis C. “I am a believer that people who are incarcerated should have good health care.”

Are you affected by changing federal vaccine guidance and the cuts to global health funding? 

It’s very unsettling. We can not fill those gaps, but there are some things that we can actually help with, like the whole issue with vaccines, and the recommendations that are absent or changing. We can put together experts from all over the world to … share information about vaccines. We’re not losing the expertise. It’s just the expertise isn’t where it always has been. It’s not centralized. So we’re getting people together who have that kind of expertise, so they can share their knowledge with communities all over the world.

What’s an important project in which Project ECHO is involved right now?

One of the most important ones for us is in Nairobi, Kenya. We have an ECHO Africa director there, and they’re doing amazing work. One of the big things is emergency preparedness and response, and so we recently launched a network for collaborative disease surveillance in seven countries in Africa, just sort of helping people connect. Part of that emergency work is in Sudan … really helping people who are suffering from all of the ill effects of war, whether that’s battlefield injuries or the spread of disease.”

How did you get involved with Project ECHO?

I was the first person who started to work with Sanjeev Arora, the founder. The reason I went to medical school is because during the ‘80s, when I was in Austin, the HIV epidemic started. I had some dear friends … who didn’t survive, and it really impacted me. I came here (UNM) for residency in 1992, still wanting to just be an HIV doctor. So I did an internal medicine residency, and then an infectious diseases fellowship, and then I was the HIV medical director of the HIV clinic here in New Mexico. And that’s when I was asked to be part of the first ECHO. I was treating hepatitis C and HIV infected patients, so I had this very specialized knowledge that (Arora) wanted on the hub team.

Tell me about the New Mexico Peer Education Project.

I started the program in 2009. I just was thinking, “There’s so many people in prison that have hepatitis C,” which is still true. We train for 40 hours a group of people, usually, 12 to 15 at a time, who are inmates. We teach them about public speaking. And they became amazing educators. They also have become really crucial in the treatment side. (They teach) about what treatments are like, and the importance of it and things like that. And it’s not just hepatitis C, it’s other infectious diseases like HIV and sexually transmitted infections. And now they’ve expanded into all sorts of things like financial literacy.

What inspires you?

People who believe that we should have a just society and that people should be treated with respect and dignity.

What do you think has made Project ECHO so successful?

I think it fills a huge need for not just dissemination of knowledge, but to get people together to solve problems. It’s really hard for one person to figure out what to do, but when you get people who are in the community and people who are involved in the issues together and have them talk about it once a week — it makes a huge difference. When you develop these relationships, and you meet with the people … for a really long time, you can come up with solutions to problems that are really complex.

Ellen Marks, a former Journal editor, writes One-on-One profiles and Scam Watch. You can reach her at emarks@abqjournal.com.