Moving Knowledge Between Providers using the ECHO Chronic Pain Model 
e-Health ePoster Library. Salemohamed N. Jun 6, 2017; 167093; EP07.01
Ms. Naima Salemohamed
Ms. Naima Salemohamed
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Purpose/Objectives: One in five Canadians suffer from chronic pain, and given the long wait time for specialty pain programs, many are cared for by their family doctor. However, family doctors only receive a limited amount of pain training during medical school. Project ECHO (Extension for Community Healthcare Outcomes) is a telemedicine initiative that teaches primary health care providers (HCPs) how better to manage their patients’ chronic medical conditions using a hub (experts) and spoke (learners) model involving case-based discussions and didactics. Project ECHO Ontario Chronic Pain teaches HCPs best practices in the management of chronic pain, and responsible opioid stewardship. Research Questions: A) Do ECHO’s HCPs increase their skills and competence levels (in pain management and opioid stewardship) after attending Project ECHO? B) How is the knowledge diffusing within or outside the online community created by ECHO and is it leading to improved care for patients whose HCP attended Project ECHO? C) In what ways, if any,have HCPs gained insights into their own motivations, confidence levels and processes for managing their chronic pain patients after attending Project ECHO?

Methodology/Approach: This study is based on in-depth interviews conducted with HCPs who are either participating in Project ECHO or have completed their training with ECHO. Interviews will be conducted with 12-15 HCPs to evaluate their experience with ECHO, the impact of ECHO on their own clinical practice, how ECHO spreads to other HCPs, and how technology facilitates medical education. Maximum Variation sampling is being used to select the participants to ensure a representative provider population. The HCPs will include a mix of: a) those from rural and urban Ontario, b) presenters or non-presenters of ECHO cases, and c) a variety of HCP disciplines (e.g., physicians, nurse practitioners, physical therapists, occupational therapists, and social workers). Data analysis will use thematic analysis, which includes inductive and deductive coding strategies. The Diffusion of Innovations framework will guide inductive coding, while deductive coding will create codes and themes that fall outside of the framework. The codes will be generated on an ongoing basis with regular feedback from members of the research team. Multiple coders will take part in checking and interpreting the data.

Finding/Results: We have interviewed three HCPs to date. Preliminary results suggest that participation in Project ECHO increases HCPs’ a) confidence in managing patients, b) knowledge of specific pain resources, and c) skills for managing chronic pain in the community using a multi-modal approach. In addition, video-conferencing has been a successful continuing education method for HCPs to share their knowledge in a no-shame community and this online learning platform has increased the interactions of HCPs.

Conclusion/Implication/Recommendations: Preliminary results suggest that ECHO is increasing HCP knowledge, skill and confidence in caring for chronic pain patients in the community, and that this teleconferencing modality is a viable approach to educating primary care HCPs in managing chronic pain patients. This research can be used to guide further evaluations of ECHO programs and help researchers understand how knowledge can be shared innovatively through the use of online communities.

140 Character Summary: Understanding how Project ECHO is an innovative method to learn and share knowledge about chronic pain management with healthcare providers in online communities.
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