When Knowledge Management Saves Lives

If there are days when you doubt the value of knowledge management, take a closer look at Project ECHO:  it saves lives by sharing specialist knowledge from teaching hospitals with a wide network of primary care physicians in far-flung areas.  As a a result, the patients in those areas get the benefit of cutting edge medical treatment without having to travel hundreds of miles to academic centers.

Founded by Dr. Sanjeev Arora and his colleagues at the University of New Mexico, Extension for Community Healthcare Outcomes (Project ECHO) has become a shining model for innovative medical practices and for KM.  Here’s the back story:

In 2003, nearly 30,000 New Mexicans were infected with Hepatitis C, yet only 5 percent were able to access treatment which is available almost exclusively through specialists at the University of New Mexico (UNM) in Albuquerque. The plight of these underserved patients inspired Sanjeev Arora, one of the top Hep C specialists in the country to develop a plan to deliver state of the art treatment to these communities through Project ECHO (Extension for Community Healthcare Outcomes).

Project ECHO creates a one-to-many “knowledge network” of specialists and … rural providers, who meet by videoconference to co-manage specific patients and share two-way teachings in which the ECHO staff works with remote clinics to coordinate and educate. Sanjeev calls this aspect of ECHO the “workforce multiplier.”  Through the “knowledge networks” of the clinics, specialists co-manage patients and teach rural medical professionals to be mini-specialists, to whom patients from that area are increasingly referred, This eventually saturates the state with the ability to treat Hep C and also helps deconstruct stereotypes and prejudices that often have existed between specialists and providers.

By pushing the ability to treat chronic, complex diseases down the work chain, ECHO is not only bringing specialized treatment to thousands of patients who would have otherwise gone untreated, but it is also keeping remote providers where they are most needed. Retention rates for rural medical professionals in New Mexico are notoriously low, and Sanjeev’s work is changing this by empowering isolated providers with stimulating, practical, cost-effective continuing education.

The key components of Project ECHO are:

  • Use technology to leverage and share scarce specialist knowledge through knowledge networks
  • Create best practice protocols for treating complex diseases and then share the protocols with primary care clinicians
  • Specialists in academic centers mentor physicians in rural areas using the same case-based learning these doctors learned in medical school
    • through videoconferences, groups of rural physicians hold “virtual rounds” in which they present cases and collaborate with academic and rural colleagues to identify the best course of treatment
    • these sessions build communities of practice and facilitate knowledge sharing, thereby spreading expertise across the state
  • Use the internet to track outcomes in order to have the metrics necessary to establish ROI on the program
  • Knowledge sharing + mentoring + technology act together as a “force multiplier” for the delivery of high-quality services

While you may not have the responsibility for saving lives in your daily work, Project ECHO is a wonderful reminder that smart KM together with good technology can have a transformative effect.  Remember that on the days when you find yourself struggling with KM skeptics.


Here are some brief videos that will tell you more about the impressive work of Project ECHO:

Project ECHO: Spreading Access to Quality Healthcare:


Project ECHO:


TEDMED Q&A with Dr. Sanjeev Arora, Project ECHO Director:


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