Abstracts

Rationale: Project ECHO (Extension for Community Healthcare Outcomes) aims to build primary care capacity to reduce health care disparities for underserved population. It uses videoconferencing technology to connect primary care providers (PCPs) with specialty providers. Most people with epilepsy rely on PCPs with limited expertise for epilepsy care. Delays in referrals to epilepsy centers for advanced treatments like surgery are well documented. In partnership with the national office of the Epilepsy Foundation (EF), the University of Cincinnati Gardner Neuroscience Institute instituted an ECHO for Epilepsy and Neurology topics to reach PCPs in OH and surrounding states. Methods: Ten one-hour sessions at noon on the first Thursday of the month started September 2018. Epilepsy topics (seizure differential diagnosis, refractory epilepsy and role of the epilepsy center, women and epilepsy, marijuana for epilepsy, mood disorders in epilepsy) alternated monthly with non-epilepsy neurology topics like migraine, dementia, movement disorders, stroke or back pain. All presentations focused on knowledge level for PCPs. We used standard ECHO format of 15-20 minute didactic presentation, followed by discussion of cases provided by participants, with active question and answer throughout the session. Each session had a moderator (MP) and 1 or 2 topic experts. After all sessions, didactic presentations were available for review on the website. Recruitment strategies included: communications with multiple regional primary care and rural health practitioners and leaders, presentations to several larger (>100 PCP) primary care organizations, targeted mailings of PCPs, newsletters of medical societies, and marketing through the Epilepsy Foundation website. Participants received CME and provided online evaluations. Results: Attendance for the first two sessions was below 15, but from the third session on, attendance ranged from 23 to 30. The majority of attendees were from Ohio, but we had several out of state and one attendee from Germany who found out about the program on the EF website. Attendees were a mix of practicing PCPs, trainees and nurse practitioners. Over the first 8 sessions, on a scale of 4, participants rated the following items: pertinent and relevant to my practice (3.9); increased my confidence in managing this type of patient (3.9); case provided valuable information to my practice needs (3.9); knowledge on topic increased (4). 95% of respondents (n=28) reported increased interest in improving care of patients with neurological disorders. More than half the participants reported seeing 1-5 people with epilepsy per week. Requested future topics included antiepileptic drugs and non-epileptic seizures. Didactic presentations posted on the website were viewed 81 times, with seizure topics the most viewed. Conclusions: An online videoconferencing ECHO program on epilepsy and neurology topics was well attended and received high evaluation scores from PCPs. Targeted, sustained, and personal outreach efforts contributed to growing participation rates. ECHO has the potential to improve epilepsy care and facilitate referral of appropriate cases requiring advanced treatments. Funding: This project was made possible with funding from the Centers for Disease Control (CDC) to the Epilepsy Foundation under cooperative agreement number 1 NU58DP006256-03-00, CFDA 93.850. Project contents are solely the responsibility of the authors and do not necessarily represent the views of the CDC.