Project ECHO for Pain Management (ECHO-PM): A Technology-Enabled Quality Improvement Approach within a University Health System

Kansas mirrors the nation in substantial gaps in evidence-based assessment and treatment of chronic pain, including primary care practices affiliated with our University of Kansas Health System. Many of these practices are, or in the process of becoming, Patient-Centered Medical Homes and serve underserved patient in urban and rural settings. Leveraging broad educational activities associated with the Kansas Partnership for Pain Management, this project is the next logical step in a statewide initiative developed from a needs  assessment/gap analysis.

The ECHO-PM goals are:
a.) To support practice change and lasting integrative, evidence-based pain management by developing and continuously improving a multi-pronged ECHO-PM curriculum including:
(1) American Academy of Pain Management’s comprehensive, integrative curriculum; (2) quality improvement curriculum; & (3) interprofessional, team communication curriculum from AHRQ’s TeamSTEPPS.
b.) To evaluate the ECHO-PM approach using a waitlist control design, with two cohorts (12 practices/cohort) lasting 8 months each and recruitment across metropolitan and rural sites.
c.) To utilize iterative feedback to refine the approach and finalize an online Project ECHO-PM toolkit, disseminating lessons learned with state, regional, and national audiences. More specifically, the waitlist control design addresses three aims:

Aim 1. To compare the ECHO-PM intervention group to a randomly assigned Waitlist Control in health system affiliated primary care practices.
Aim 2. To evaluate the impact of dose of ECHO-PM training on practice and provider outcomes. and
Aim 3. To assess the influence of organizational components on ECHO-PM participation.