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World J Hepatol. Apr 18, 2016; 8(11): 509-512
Published online Apr 18, 2016. doi: 10.4254/wjh.v8.i11.509
Extension for Community Health Outcomes-hepatitis C: Small steps carve big footprints in the allocation of scarce resources for hepatitis C virus treatment to remote developing areas
Veysel Tahan, Ashraf Almashhrawi, Ali M Kahveci, Rachel Mutrux, Jamal A Ibdah
Veysel Tahan, Ashraf Almashhrawi, Ali M Kahveci, Jamal A Ibdah, Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65201, United States
Rachel Mutrux, Missouri Telehealth Network and Missouri Health IT Assistance Center, Columbia, MO 65201 United States
Author contributions: Tahan V, Almashrawi A and Kahveci AM performed the majority of the writing, prepared the figure; Mutrux R performed data accusation and writing; Ibdah JA provided the input in writing the paper, designed the outline with outer authors and coordinated the writing of the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the authors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Veysel Tahan, MD, Assistant Professor, Division of Gastroenterology and Hepatology, University of Missouri, 1 Hospital Dr, Columbia, MO 65201, United States. tahanv@health.missouri.edu
Telephone: +1-573-8846044 Fax: +1-573-8844595
Received: February 2, 2016
Peer-review started: February 2, 2016
First decision: March 1, 2016
Revised: March 7, 2016
Accepted: March 24, 2016
Article in press: March 25, 2016
Published online: April 18, 2016
Abstract

Hepatitis C virus (HCV) infection is still a major health problem throughout the world. HCV patients living in rural areas are less fortunate than their counterparts residing in populous urbanized regions. The lack of medical resources and properly trained medical personnel in rural regions make it especially burdensome for HCV patients seeking treatment. Dr. Sanjeev Arora at the University of New Mexico Health Sciences Center took initiative to resolve the issue at hand by developing a model named Project Extension for Community Health Outcomes (ECHO). ECHO connects primary care providers (PCPs), usually family medicine physicians, in local communities with specialists. ECHO providers test the efficacy of treatment given using the ECHO model vs that at academic medical centers. The ECHO model has produced promising results such that the sustained virologic response rates for both types of sites were near-equivalent. Show Me ECHO was adapted from Project ECHO to train PCPs in Missouri and equip them with the tools and skills to properly treat and diagnose HCV in a timely manner. This healthcare model can be implemented for treating other common infections and chronic diseases. Telemedicine is the direction healthcare is headed for the next several decades. It has potential to be applied in developing countries to alleviate agony and despair resulting from limited resources and lack of access to expert medical care.

Keywords: Hepatitis C, Treatment, Community, Health care, Outcome, Rural, Primary care, Extension for Community Health Outcomes

Core tip: The American Association for the Study of Liver Diseases recommends Project Extension for Community Health Outcomes (ECHO). Project ECHO aims to move the knowledge not the patients. By bringing expertise to primary care physicians, patients from rural and underserved communities will benefit by alleviating the struggle associated with travel and appointment delays. The framework of this project can be used to manage other diseases that require specialty physician care that may not be feasible. Telemedicine represents the future of healthcare, its success will substantially reshape the healthcare delivery in developing countries and is pivotal for geographically isolated and underserved populations.