Replicating the Program

As the Army seeks to improve pain management for wounded warriors by establishing a more uniform approach, ECHO could be a good model, said Galloway.

“You can have a huge conference and bring in 800 people and really impact them for four days, and then they go back,” he said. “What this allows us to do is reach out from our specialty centers on an ongoing continual basis to start influencing the care and understanding and create what we called in the Army Pain Management Campaign, ‘pain champions’.’’

In addition, the ECHO model would allow the military to address the problems of supply and demand of specialty care for pain in remote areas.

“For us to build confidence and competence in our primary-care centers to be more effective in keeping things at the proper level if they can be handled effectively at the primary-care level, that is good. It decreases the backlog of specialty waiting currently. That queue for specialty care, even in our system, is tough,” Galloway said.

ECHO also can be a way for DoD to synchronize pain care with the VA, which has developed its Specialty Care Access Network (SCAN) program based on the UNMHSC model.

“We are working as part of the pain campaign to synchronize pain care across DoD and VA,” said Galloway. “So as they create for their ECHO didactic content, we are partnering with them, so it is the same stuff.”

Joanna Katzman, MD, associate professor of neurology at the UNM School of Medicine and the medical director of the chronic pain Tele ECHO Project, said the UNM program is working with Army pain experts to help them replicate the program.

“We are sharing our didactic information, our model, and they are coming on a weekly basis to us,” she said. “We are also working with them in developing outcomes, in developing the most appropriate research tool that can also be used clinically to measure how effective this model is in the military.”

In addition to the Army and VA, the ECHO model is being implemented at other sites. The University of Washington in Seattle received a grant from the Robert Wood Foundation to replicate the model to treat conditions including diabetes, substance-abuse and mental-health problems, asthma, rheumatology, chronic pain and high-risk pregnancy.

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