title: Demonopolizing medical knowledge.
abstract: In the past 100 years, there has been an explosion of medical knowledge-and in the next 50 years, more medical knowledge will be available than ever before. Regrettably, current medical practice has been unable to keep pace with this explosion of medical knowledge. Specialized medical knowledge has been confined largely to academic medical centers (i.e., teaching hospitals) and to specialists in major cities; it has been disconnected from primary care clinicians on the front lines of patient care. To bridge this disconnect, medical knowledge must be demonopolized, and a platform for collaborative practice amongst all clinicians needs to be created. A new model of health care and education delivery called Project ECHO (Extension for Community Healthcare Outcomes), developed by the first author, does just this. Using videoconferencing technology and case-based learning, ECHO's medical specialists provide training and mentoring to primary care clinicians working in rural and urban underserved areas so that the latter can deliver the best evidence-based care to patients with complex health conditions in their own communities. The ECHO model increases access to care in rural and underserved areas, and it demonopolizes specialized medical knowledge and expertise.
authors.affiliation: Dr. Arora is professor of medicine and director, Project ECHO (Extension for Community Healthcare Outcomes), University of New Mexico Health Sciences Center, Albuquerque, New Mexico. Dr. Thornton is professor of medicine and associate director, Project ECHO (Extension for Community Healthcare Outcomes), University of New Mexico Health Sciences Center, Albuquerque, New Mexico. Dr. Komaromy is associate professor of medicine and associate director, Project ECHO (Extension for Community Healthcare Outcomes), University of New Mexico Health Sciences Center, Albuquerque, New Mexico. Dr. Kalishman is associate professor and clinician evaluation director, Project ECHO (Extension for Community Healthcare Outcomes), University of New Mexico Health Sciences Center, Albuquerque, New Mexico. Dr. Katzman is associate professor and medical director, Project ECHO (Extension for Community Healthcare Outcomes), University of New Mexico Health Sciences Center, Albuquerque, New Mexico. Dr. Duhigg is assistant professor and psychiatry faculty, Project ECHO (Extension for Community Healthcare Outcomes), University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Arora
authors.forename: Karla
authors.initials: K
authors.lastname: Thornton
authors.forename: Miriam
authors.initials: M
authors.lastname: Komaromy
authors.forename: Summers
authors.initials: S
authors.lastname: Kalishman
authors.forename: Joanna
authors.initials: J
authors.lastname: Katzman
authors.forename: Daniel
authors.initials: D
authors.lastname: Duhigg
mesh_terms: D003153:Community Health Services / Q000639:trends*; D003625:Data Collection; D004059:Diffusion of Innovation; D006297:Health Services Accessibility / Q000639:trends*; D006526:Hepatitis C / Q000188:drug therapy; D006801:Humans; D019359:Knowledge; D017146:Models, Organizational; D009516:New Mexico; D017063:Outcome Assessment, Health Care; D016730:Program Development; D012424:Rural Population; D014481:United States; D049269:Videoconferencing