Connected Care for COVID-19

As part of the AAMC’s collaboration with the Centers for Disease Control and Prevention (CDC), the AAMC has led Connected Care for COVID-19, a project focused on achieving two major goals:

1. Collaborating with AMCs to spread innovative efforts that directly address digital health equity and its impact on promoting more equitable access to COVID-19 vaccines, vaccine information, and associated resources
2. Supporting the trusted role of primary care providers in serving patients and communities by providing efficient tools to address questions and provide clinical guidance on COVID-19 prevention and management

This project has focused mainly on solutions that are highly applicable to the evolving needs of individuals and clinicians during COVID-19 pandemic, and highly adaptable for future pandemic preparedness. The AAMC has since made significant strides toward the major goals of the project. This page features several of these AAMC-led efforts as well as further broadcasts innovations and tools from member institutions and other organizations. 

eConsults and Other Clinical Innovations for Supporting Providers in COVID-19 Management

eConsults are electronic consultations between a primary care provider (PCP) and a specialist. eConsults are designed for use in place of a referral or a curbside and in lieu of an in-person evaluation by the specialist. As part of this supplemental grant with the CDC, the AAMC team gathered knowledge and materials from members of the AAMC’s Project CORE (Coordinating Optimal Referral Experiences) Network that explored the use case for eConsults for COVID-19. 

Members of the AAMC’s Project CORE Network have found eConsults to be useful tools for providers (particularly PCPs) in treating and managing COVID-19-related vaccine questions and problems. CORE participants have also utilized enhanced referrals, e-visits, and Project ECHO to promote management and treatment of COVID-19. The AAMC has collected materials and resources (e.g., condition-specific eConsult templates) to demonstrate the various ways organizations have leveraged and optimized these tools during the pandemic. The AAMC has summarized these approaches, additional details, and resources in one resource, Connected Care: eConsults and Other Clinical Innovations Promoting Primary Care Management and Treatment of COVID-19.

VIEW THE CONNECTED CARE RESOURCE

The AAMC has curated many examples of COVID-19-related eConsults from member AMCs and primary care practices that show the utility of this tool for COVID-19 vaccine, treatment and management questions.

View COVID-19 eConsult Library

Advancing Health Equity Through Telehealth Learning Series

Through this learning series, the AAMC highlighted the role of academic medicine in promoting and advancing health equity through telehealth. Key elements of the series focused on understanding the impact of telehealth on equity and access to care, the role data can play in improving telehealth access, and evolving best practices that are being used by health systems to improve digital health literacy and narrow the digital divide.

View learning series

Promoting Equitable Specialty Access: Clinical Innovations & Tools from the Field

Health systems have deployed many strategies and tools to promote equitable access to specialty care. Through the AAMC’s Project CORE, over 40 AMCs and children’s hospitals have focused on improving access to specialty care through enhancements to the referral process and use of eConsults. eConsults have been shown to enable timely access to specialty input, improve communication and coordination between providers, garner positive patient experience, and reduce costs of care. Learn more here about AMCs' experience with eConsults during the COVID-19 pandemic.

Project ECHO has also served as an important tool for promoting increased primary care-specialty care collaboration and has leveraged technology to remove some of the traditional barriers to specialty access including geography, travel, and costs. During this webinar, speakers from Children’s Wisconsin and Oregon Health & Science University (OHSU), respectively, presented how tools like eConsults and Project ECHO can enable health care equity, and shared opportunities for assessing and improving equity within these programs. 

Watch video

Project ECHO Programming

Project ECHO (Extensions for Community Healthcare Outcomes) is a model that uses technology to connect providers over video and teleconference to engage in case-based learning and the sharing of best practices for various subject areas. Several members of the Project CORE Network as well as others have utilized the ECHO model for education around COVID-19 management:

• Project ECHO at the University of New Mexico
  Project ECHO was founded by Dr. Sanjeev Arora in 2003 at the University of New Mexico. View the ECHO webpage to learn more about ECHO’s history, success stories, partnerships, and programming. 
• Long COVID ECHO for Oregon Clinicians
  OHSU is hosting an ECHO series from September to December 2022 focused on Long COVID, prioritizing participation for providers serving older adults, Latino populations, and those working in under-resourced and marginalized communities. Topics may span neurocognitive effects of Long COVID, care coordination for Long COVID patients, physical therapy protocols, mental health and long COVID, and more.
• Long COVID and Fatiguing Illness Recovery Program
  Through a CDC-funded collaboration between Family Health Centers of San Diego, the ECHO Institute, University of Washington, and University of Colorado, this program offered a monthly ECHO-style webinar series through 2022 as well as quarterly self-paced short courses.

Relevant Publications

A selection of publications related to the use of eConsults or Project ECHO during the COVID-19 pandemic:

1. Trends in Utilization of Electronic Consultations Associated with Patient Payer and Language Among US Academic Medical Centers During the COVID-19 Pandemic
   Study by a group of AAMC Project CORE collaborators demonstrates that eConsults are increasingly used to obtain specialist guidance. During the COVID-19 pandemic, when in-person care was limited, eConsults may have helped clinicians obtain specialist input to guide patient care.
2. Rapid Deployment of a Statewide COVID-19 ECHO Program for Frontline Clinicians: Early Results and Lessons Learned
   This article from OHSU discusses lessons learned from their rapid deployment of a COVID-19 ECHO program early in the COVID-19 pandemic.
3. Clinicians’ Core Needs in a Pandemic: Qualitative Findings from the Chat Box in a Statewide COVID-19 ECHO Program
   This article from OHSU discusses findings from OHSU’s analysis of the chat box during its rapid deployment COVID-19 ECHO program.
4. Building Community and Resilience in Massachusetts Nursing Homes During the COVID‐19 Pandemic
   This article discusses a partnership between the Massachusetts Senior Care Association and the Agency for Healthcare Research and Quality AHRQ ECHO National Nursing Home COVID-19 Action Network to support nursing homes in evidence-based infection control practices.
5. Virtual Peer-to-Peer Learning to Enhance and Accelerate the Health System Response to COVID-19
   The HHS ASPR Project ECHO COVID-19 Clinical Rounds Initiative: This article discusses the partnership between the US Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response and the University of New Mexico’s Project ECHO and other institutions to create the COVID-19 Clinical Rounds Initiative – a real-time virtual peer-to-peer clinical education opportunity. 
6. A Multipronged Digital Response to Increased Demand for Telehealth Support and Training During the COVID-19 Pandemic
   This article discusses the University of Kansa Center for Telemedicine and Telehealth’s multi-pronged digital strategy to rapidly disseminate federal policy updates and telehealth implementation guidance. This effort included a multi-phase ECHO series on patient care and telehealth during COVID-19. 
7. The Development and Implementation of a COVID-19 Project ECHO: A Program for Community Health Workers Serving Populations from Rural and Medically Underserved Areas in South Texas