Physicians at an integrated health system based in Sioux Falls, South Dakota launched an Extension for Community Healthcare Outcomes (ECHO) project to provide ongoing professional development and support for maternal health providers in rural and underserved areas. The Perinatal Tele-ECHO provides engaged medical teaching for physicians, advanced practice providers, and registered nurses across the state. The ECHO model was chosen for its Web-based program delivery and 60-minute sessions that include both a didactic component and a case study discussion.1 Ultimately, the Perinatal Tele-ECHO aims to maintain the number of providers who are competent to manage maternal health care, particularly at low-birth-volume facilities.
To guide these efforts locally, an internal planning hub was established and meets monthly to determine session topics and speakers, which are identified through relevant clinical practice, clinical updates, and from solicitation by session attendees. Training has been offered on topics including the following: mood disorders in pregnancy, syphilis screening, hypertension, seizures in pregnancy, maternal transport, hemorrhage, digital diabetes management, evidence-based cesareans, postpartum cardiomyopathy, medical marijuana, placenta accreta, management of category II fetal heart tones, postpartum pelvic floor therapy, genetic testing, and others.
Monthly webinar sessions were launched in June 2022 and moderated by obstetric specialists from one of the state’s tertiary obstetric care centers. Didactic presentations were given by local physicians and health care experts in clinical obstetrics, maternal fetal medicine, neonatology, and public health. This was followed by presentation of a case submitted by an attendee and a moderated group discussion for identification of best practice recommendations and key learning points. As a result, collective understanding of how to disseminate and implement best practices across diverse perinatal disciplines in South Dakota continues to improve and expand.
TYPE AND NUMBER OF LEARNERS
Participants invited to attend included physicians providing maternal health care or caring for prenatal patients (including family medicine physicians), advanced practice providers, perinatal specialists, certified nurse midwives, registered nurses, social workers, medical students, and perinatal fellows. We particularly looked to target low-volume obstetric facilities as an opportunity to provide the greatest benefit in the highest geographical areas of need.
Over a 15-month period between June 2022 and August 2023, 17 sessions were held, with an average of 27 individuals in attendance per session.
EVALUATION METHOD
We aimed to determine program reach and participant engagement in the Perinatal Tele-ECHO program by using session attendance rosters, postsession surveys, and an annual survey of all previous Tele-ECHO attendees that included both multiple choice and open-ended questions.
EVALUATION FINDINGS
Participants in the Perinatal Tele-ECHO, which spanned three states and nine different health care entities, included physicians, advanced practice providers, and registered nurses. Overall, program participants strongly agreed that the Perinatal Tele-ECHO was meeting its stated objectives and providing unbiased evidence-based content, and that topics were appropriate and had practical clinical application. Specifically, participants indicated that they trusted the individuals presenting and that the sessions provided a good opportunity to ask questions. Additionally, participants indicated that their knowledge had increased, and that they were now aware of changes to guidelines that they previously were not. Specifically, one participant noted that the sessions “help me stay up to date on the newest guidelines. It’s so easy to fall out of date in rural practices.” Participants suggested continuing to review certain topics as they adjust to and implement new recommendations. Future evaluations will include the assessment of key maternal health outcomes at participating facilities.
ACKNOWLEDGMENTS
This publication was supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) as part of an award totaling $2 335 542 with approximately 8% financed with nongovernmental sources.
Note. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, the HRSA, the HHS, or the US Government.
CONFLICTS OF INTEREST
The authors have no conflicts of interest to declare.
REFERENCE
- 1.Arora S, Geppert CM, Kalishman S, et al. Academic health center management of chronic diseases through knowledge networks: Project ECHO. Acad Med. 2007;82(2):154–160. 10.1097/ACM.0b013e31802d8f68 [DOI] [PMC free article] [PubMed] [Google Scholar]