title: The educational impact of the Specialty Care Access Network-Extension of Community Healthcare Outcomes program.
abstract: BACKGROUND
  With the aging hepatitis C cohort and increasing prevalence of fatty liver disease, the burden on primary care providers (PCPs) to care for patients with liver disease is growing. In response, the Veterans Administration implemented initiatives for primary care-specialty referral to increase PCP competency in complex disease management. The Specialty Care Access Network-Extension of Community Healthcare Outcomes (SCAN-ECHO) program initiative was designed to transfer subspecialty knowledge to PCPs through case-based distance learning combined with real-time consultation. There is limited information regarding the initiative's ability to engage PCPs to learn and influence their practice.
  
  
  METHODS
  We surveyed PCPs to determine the factors that led to their participation in this program and the educational impact of participation.
  
  
  RESULTS
  Of 51 potential participants, 24 responded to an anonymous survey. More than 75% of respondents participated more than one time in a SCAN-ECHO clinic. Providers were motivated to participate by a desire to learn more about liver disease, to apply the knowledge gained to future patients, and to save their patients time traveling to another center for specialty consultation. Seventy-one percent responded that the didactic component and case-based discussion were equally important. It is important that participation changed clinical practice: 75% of providers indicated they had personally discussed the information they learned from the case presentations with their colleague(s), and 42% indicated they helped a colleague care for their patient with the knowledge learned during discussions of other participants' cases.
  
  
  CONCLUSIONS
  This study shows that the SCAN-ECHO videoconferencing program between PCPs and specialists can educate providers in the delivery of specialty care from a distance and potentially improve healthcare delivery.
authors.affiliation: 1 Department of Internal Medicine, University of Michigan Medical School , Ann Arbor, Michigan.
authors.forename: Reena J
authors.initials: RJ
authors.lastname: Salgia
authors.forename: Patricia B
authors.initials: PB
authors.lastname: Mullan
authors.forename: Heather
authors.initials: H
authors.lastname: McCurdy
authors.forename: Anne
authors.initials: A
authors.lastname: Sales
authors.forename: Richard H
authors.initials: RH
authors.lastname: Moseley
authors.forename: Grace L
authors.initials: GL
authors.lastname: Su
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D004496:Education, Continuing / Q000458:organization & administration*; D020375:Education, Distance; D005260:Female; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D008297:Male; D008824:Michigan; D009042:Motivation; D011320:Primary Health Care / Q000458:organization & administration*; D019114:Remote Consultation; D014481:United States; D014493:United States Department of Veterans Affairs
keywords: distance learning; telecommunications; telehealth; telemedicine