New York State Health Foundation

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University of Rochester

  • Project Title: Project ECHO—Enhancing Primary Care Services in Rural New York
  • Priority Area: Advancing Primary Care
  • Grant Amount: $344,484
  • Date Awarded: February 24, 2014
  • Region: Statewide
  • Region: Finger Lakes
  • Website: http://www.rochester.edu/
  • Grant Status: In Progress

Overview

In rural areas of New York, primary care physicians (PCPs) must serve as mental health providers because of shortages in physician supply. PCPs, however, may be inadequately equipped to manage patients with behavioral health issues: 93% of PCPs describe problematic access to and communication with mental health specialists as barriers to effective care for patients with dementia. As the State’s older population is expected to double in the next 20 years, the number of senior citizens with mental illness and dementia will also grow dramatically. The costs associated with inadequate mental health and dementia care are profound. In 2011, New York State spent $690 million on health care for patients with dementia. In response to these needs, NYSHealth awarded a grant to University of Rochester Medical Center (URMC) to implement the Extension for Community Healthcare Outcomes (ECHO®) model to enhance primary care capacity in rural and underserved communities of New York State.

Under this grant, URMC will work with rural PCPs to enhance their capacity to provide geriatric mental health care to patients using Project ECHO®—an innovative model of health care education and delivery that improves the treatment of chronic and complex diseases for rural and underserved populations. Acting as an ECHO hub, URMC will use Web-based videoconferencing to connect a team of its specialists from medicine, nursing, social work, psychology, and pharmacy to rural PCPs and help them develop expertise in geriatric mental health. Through biweekly TeleECHO clinics, didactic presentations, virtual grand rounds, and case-based learning, URMC will facilitate coordination between specialists and PCPs at spoke sites that will be initially located in Allegany, Livingston, Monroe, Ontario, Steuben, Yates, Genesee, Seneca, Schuyler, and Wyoming counties. These spoke sites will operate with increased independence and self-efficacy using Project ECHO® and will become regional centers of excellence on geriatric mental health issues over time. An advisory committee will also be formed to examine more systemic sustainability options for future implementation of this model and build the business case for its continuation.