Training the healthcare workforce: the global experience with telementorship for hepatitis B and hepatitis C.

Healthcare worker training Hepatitis B Hepatitis C Hepatitis elimination Project ECHO Telehealth Telementorship

Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
02 Aug 2023
Historique:
received: 19 01 2023
accepted: 26 07 2023
medline: 4 8 2023
pubmed: 3 8 2023
entrez: 2 8 2023
Statut: epublish

Résumé

Telementorship has emerged as an innovative strategy to decentralise medical knowledge and increase healthcare capacity across a wide range of disease processes. We report the global experience with telementorship to support healthcare workers delivering hepatitis B virus (HBV) and hepatitis C virus (HCV) care and treatment. In early 2020, we conducted a survey of HBV and HCV telementorship programmes, followed by an in-depth interview with programme leads. Programmes were eligible to participate if they were located outside of the United States (U.S.), focused on support to healthcare workers in management of HBV and/or HCV, and were affiliated with or maintained adherence to the Project ECHO model, a telementorship programme pioneered at the University of New Mexico. One programme in the U.S., focused on HCV treatment in the Native American community, was purposively sampled and invited to participate. Surveys were administered online, and all qualitative interviews were performed remotely. Descriptive statistics were calculated for survey responses, and qualitative interviews were assessed for major themes. Eleven of 18 eligible programmes completed the survey and follow up interview. Sixty-four percent of programmes were located at regional academic medical centers. The majority of programmes (64%) were led by hepatologists. Most programmes (82%) addressed both HBV and HCV, and the remainder focused on HCV only. The median number of participating clinical spoke sites per programme was 22, and most spoke site participants were primary care providers. Most ECHO sessions were held monthly (36%) or bimonthly (27%), with sessions ranging from 45 min to 2 h in length. Programme leaders identified collective learning, empowerment and collaboration to be key strengths of their telementorship programme, while insufficient funding and a lack of protected time for telementorship leaders and participants were identified as major barriers to success. The Project ECHO model for telementorship can be successfully implemented across high and low-and-middle-income countries to improve provider knowledge and experience in management of viral hepatitis. There is a tremendous opportunity to further expand upon the existing experience with telementorship to support non-specialist healthcare workers and promote elimination of viral hepatitis.

Sections du résumé

BACKGROUND BACKGROUND
Telementorship has emerged as an innovative strategy to decentralise medical knowledge and increase healthcare capacity across a wide range of disease processes. We report the global experience with telementorship to support healthcare workers delivering hepatitis B virus (HBV) and hepatitis C virus (HCV) care and treatment.
METHODS METHODS
In early 2020, we conducted a survey of HBV and HCV telementorship programmes, followed by an in-depth interview with programme leads. Programmes were eligible to participate if they were located outside of the United States (U.S.), focused on support to healthcare workers in management of HBV and/or HCV, and were affiliated with or maintained adherence to the Project ECHO model, a telementorship programme pioneered at the University of New Mexico. One programme in the U.S., focused on HCV treatment in the Native American community, was purposively sampled and invited to participate. Surveys were administered online, and all qualitative interviews were performed remotely. Descriptive statistics were calculated for survey responses, and qualitative interviews were assessed for major themes.
RESULTS RESULTS
Eleven of 18 eligible programmes completed the survey and follow up interview. Sixty-four percent of programmes were located at regional academic medical centers. The majority of programmes (64%) were led by hepatologists. Most programmes (82%) addressed both HBV and HCV, and the remainder focused on HCV only. The median number of participating clinical spoke sites per programme was 22, and most spoke site participants were primary care providers. Most ECHO sessions were held monthly (36%) or bimonthly (27%), with sessions ranging from 45 min to 2 h in length. Programme leaders identified collective learning, empowerment and collaboration to be key strengths of their telementorship programme, while insufficient funding and a lack of protected time for telementorship leaders and participants were identified as major barriers to success.
CONCLUSION CONCLUSIONS
The Project ECHO model for telementorship can be successfully implemented across high and low-and-middle-income countries to improve provider knowledge and experience in management of viral hepatitis. There is a tremendous opportunity to further expand upon the existing experience with telementorship to support non-specialist healthcare workers and promote elimination of viral hepatitis.

Identifiants

pubmed: 37533025
doi: 10.1186/s12913-023-09849-y
pii: 10.1186/s12913-023-09849-y
pmc: PMC10394928
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

824

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : NIDDK NIH HHS
ID : 5T32DK007742-22
Pays : United States

Informations de copyright

© 2023. The Author(s).

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Auteurs

Maria A Corcorran (MA)

Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA. corcom@uw.edu.
Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Harborview Medical Center, 325 9th Ave, Box 359782, Seattle, WA, 98104, USA. corcom@uw.edu.

Karla Thornton (K)

Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
Project ECHO, University of New Mexico, Albuquerque, NM, USA.

Bruce Struminger (B)

Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
Project ECHO, University of New Mexico, Albuquerque, NM, USA.

Philippa Easterbrook (P)

Department of Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.

John D Scott (JD)

Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.

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Classifications MeSH