OPINION: ECHO’s no-cost model can broaden knowledge of health care providers

In my small-town clinic, about a quarter of my patients have diabetes. More broadly, there’s more than 200,000 New Mexicans diagnosed with diabetes and another 53,000 who have diabetes, but don’t know it, according to the American Diabetes Association.

From Las Vegas, the closest endocrinologist — a diabetes specialist — is an hour away in Santa Fe and their wait lists are long. I’m a family nurse practitioner, not a specialist; thanks to Project ECHO (Extension for Community Healthcare Outcomes, a virtual, human-powered mentorship and learning network), I learned how to treat these patients, right where they live.

Today, we have better technology and treatments for diabetes than ever before; but they’re also more complicated. Many primary care providers now rely on specialist referrals instead of treating patients themselves.

But, through ECHO’s no-cost learning model, providers all over the state can broaden their knowledge and skills and be mentored by a specialist. So, the next time they see a diabetic patient, they feel more confident in what they know, and have a mentor to talk through any questions that might come up.

Being from Las Vegas myself, I’m an integral member of the community. My patients see me as an advocate for their well-being, not a stranger who stops in for 10 minutes with lectures about their lifestyle. So, when I ask them to make changes — smaller meals, adding in more vegetables, going for short walks after eating — they’re willing to make the effort.

And, when medication adjustments are needed, I ensure my patients know why the change is recommended and what the goals of that change are — helping promote health literacy, which is an integral part of the ECHO model.

This is one important reason why a local provider may be a better option for patients than a specialist, and an answer to the critical endocrinology care shortage.

A recent study published in the Journal of General Internal Medicine demonstrated that rural providers trained in best practice diabetes care through the ECHO model achieved similar, or better, patient outcomes to specialists at the University of New Mexico.

When providers participate in ECHO, receiving continual education and guidance, it helps overcome “clinician inertia” — the term used when a health care provider fails to take the necessary action to adequately manage a patient’s condition. A study, “Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review,” published in the National Library of Medicine, revealed that up to 50% of type 2 diabetes patients experienced less-than-ideal blood sugar levels for years due to these “inertia” failings.

Diabetes is a chronic condition that has severe, and life-threatening, implications if left untreated, including eye, heart and kidney damage. But when local primary care providers can treat patients close to where they live just as well as a specialist, we can prevent some of the most severe consequences of diabetes and make a huge difference for our patients.

Together, we can make sure that all New Mexicans are receiving best-practice diabetes care when they need it.

I encourage other primary care providers across New Mexico to join our ECHO program and learn today’s latest treatments and guidance in the New Mexico Endocrinology ECHO program at no cost. Register on iECHO.org.

Flavio Salazar is a family nurse practitioner at El Centro Family Health in Las Vegas. The New Mexico Endocrinology ECHO program (Endo ECHO) is a telementoring program that provides diabetes care to underserved and rural communities in New Mexico. It’s part of Project ECHO.