Project ECHO (Extension for Community Healthcare Outcomes) for Cancer Care

Partnership objectives

Project ECHO’s overarching goal is to increase access to best practice cancer care for the vulnerable populations in the United States and around the world. To accomplish this, two supporting goals are to expand the ECHO footprint in cancer both domestically and internationally to overcome some of the health disparities in cancer care and for the ECHO model to become part of the fabric of cancer prevention, screening, treatment, palliation and survivorship in the United States and Africa. The purpose of this five-year project funded by the Bristol-Myers Squibb Foundation is to develop and test this new paradigm for providing cancer prevention, screening, care, treatment, palliative care and survivorship to poor and vulnerable communities.

Project ECHO Project ECHO Copyright Bristol-Myers Squibb Foundation

What are the health needs and challenges?

For many poor and vulnerable patients, quality prevention, screening, treatment, palliative care and survivorship services are either unavailable or access to them is very limited. A significant driver of these disparities is a gap in knowledge transfer and access, which inhibits patients from getting the right care at the right place and at the right time.

By 2030, the global burden of cancer is expected to grow to 21.7 million new cancer cases and 13 million new cancer deaths due to the growth and aging of the population. The future burden is likely to be even larger than these estimates given the adoption of western lifestyles including smoking, poor diet, physical inactivity and fewer childbirths in economically developing countries.5 Given the burden of disease from cancer, much work still needs to be done to reduce overall cancer deaths and increase the knowledge of cancer prevention, screening, control, treatment, care and survivorship best practices across all segments of the healthcare workforce and the general population.

Globally, cancers figure among the leading causes of morbidity and mortality with approximately 14 million new cases and 8.2 million cancer-related deaths in 2012.6 The number of new cases is expected to rise by approximately 70% over the next 2 decades, increasing from 14 million in 2012 to 22 million by 2032. More than 60% of the world’s total new annual cases occur in Africa, Asia and Central and South America, accounting for more than 70% of the world’s cancer deaths. The most common causes of cancer deaths worldwide are cancers of the lung (1.59 million deaths), liver (745,000 deaths), stomach (723,000 deaths), colorectal (694,000), breast (521,000 deaths), and esophagus (400,000 deaths). 

Description of partnership activities and how they address needs and challenges

Project ECHO® (Extension for Community Healthcare Outcomes) improves capacity and access to specialty care for rural and underserved populations. This low-cost, high-impact intervention is accomplished by linking expert multidisciplinary specialist teams with multiple primary care clinicians through teleECHOTM clinics, where experts mentor and share their expertise via case-based learning, enabling primary care clinicians to develop the ability to care for patients with complex conditions in their own communities. Initially implemented to increase access to HCV care in 2003, the model has since been expanded to 56 other conditions with more than 103 replicating partners in 19 countries.

Summary of impact and forward looking information

The anticipated evidence of impact of this project includes: higher provider self-efficacy, increased adherence to current national best practices for cancer screening, prevention and treatment; increased capacity for care of patients with cancer; development of tools that support the use of the ECHO model to train CHWs and others in cancer screening, prevention and survivorship; increased replication of the ECHO model for cancer; and positive movement towards long-term sustainability for cancer-focused ECHOs.

Measurement of progress towards objectives

Estimated overall value of partnership: $10+ million (U.S.)

A minimum of 25 cancer hubs in the US are fully operational (e.g. holding regular clinics, engaging spoke participants, including a multidisciplinary hub team, utilizing the case-based learning model, and tracking outcomes). 

Pending the assessment and outreach process, at least one country or region serving hub in African country is fully operational to address cancer. 

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Project ECHO

Partnership information

Company(ies) Bristol-Myers Squibb

Partner(s) Project ECHO

Type of Partner(s) Academia / Hospitals

Therapeutic Focus Non-Communicable Diseases

Disease(s) Cancer

Program Type(s) Health System Infrastructure - Outreach & Medical Services, Health System Infrastructure - Training, Research & Development - Operations Research

Region(s) North America

Number of Countries 1

Country(ies) United States of America

Start Date 2017

Anticipated completion date 2022

« Instead of requiring patients to travel long distances to major cancer centers to receive care, Project ECHO for Cancer Care will move knowledge by pairing experts at NCI-designated Comprehensive Cancer Centers, cancer centers of excellence and academic m »

John L. Damonti, president, Bristol-Myers Squibb Foundation