Rapid Deployment of a Statewide COVID‐19 ECHO Program for Frontline Clinicians: Early Results and Lessons Learned

In a pattern repeated around the country, Oregon reported its first coronavirus patient on February 28, 2020.1 A week later, the governor declared a state of emergency.2 While the media initially focused on efforts to address COVID‐19 in large cities, many rural communities were working in parallel to prepare. In these rural areas, there was an increasing concern that the burden of COVID‐19 may be particularly dire due to factors such as older populations, higher prevalence of chronic diseases and poverty, and less health care access.3-6 Rural clinicians, especially those working in outpatient settings, are caring for patients during the pandemic with few resources and many questions. There was, and continues to be, an urgent need for the rapid dissemination of emerging public health and treatment best practices, scientific evidence, and available resources for rural clinicians. Project ECHO (Extension for Community Healthcare Outcomes) provides an ideal model for the rapid dissemination of pertinent information to rural clinicians during a crisis. Developed at the University of New Mexico in 2003, Project ECHO is a telementoring education model that expands primary care clinicians’ ability to manage complex health conditions. An interdisciplinary expert faculty, an “all teach, all learn” approach, and a combination of didactic and case‐based learning characterize ECHO programs.7-9 Since 2016, the Oregon ECHO Network (OEN) has provided telementoring to rural and urban clinicians through a variety of ECHO programs, including substance use disorders, adult and pediatric psychiatry, and smoking cessation. The OEN is housed within a statewide primary care practice‐based research network, the Oregon Rural Practice‐based Research Network (ORPRN).10-12 Shortly after the first COVID‐19 case, OEN, ORPRN staff and consultants realized Project ECHO could provide a unique and valuable tool to connect and share emerging information with clinicians across the state. While OEN leadership initially wondered whether we had the resources to create and implement a COVID‐19 program in just a few days, we could not sit on the sidelines when we had a successful, well‐established Project ECHO program that could bring together public health and health care experts to share timely information in response to this novel situation. The process of creating the COVID‐19 ECHO program for frontline clinicians, along with results from the first 4 weekly sessions, confirm crucial factors a