Nearly 20 years ago, Dr. Sanjeev Arora walked into his clinic to find a 43-year-old woman with hepatitis C seeking treatment for the first time, after an initial diagnosis eight years earlier.
When questioned why she would delay treatment, she said she couldn’t afford to take the time off of work to make the five-hour trip to Albuquerque; she was also a widow with two children to care for. She finally sought help when her abdominal pain began interfering with her ability to work.
But it was too late.
The untreated hepatitis C had caused advanced liver cancer that was not amenable to surgery or liver transplantation. She died six months later.
The medicine and expertise needed to treat this mother of two were available. But she died because no doctor in her community had the expertise to treat her disease.
The right knowledge didn’t exist at the right place at the right time.
This mother’s story was one of many Dr. Arora witnessed in his Albuquerque clinic. At the time, there were 28,000 patients with hepatitis C in New Mexico and only 1,500 had been treated. People were dying of a treatable and curable disease because they could not access timely treatment.
He decided to take action.
First, he sent out his protocol for treating hepatitis C to primary care physicians across the state. But he soon realized that simply providing the right information was not enough. To master the complexity of treating hepatitis C, providers needed something more.
Dr. Arora recruited primary care clinicians throughout the state to create a virtual “community of practice” or a space where doctors could learn from experts and each other; where they could discuss real-life case examples that offered insight on New Mexico’s unique patients and systems. In one year, these clinicians became experts in the treatment of hepatitis C – the first success story of the global organization now known as “Project ECHO.”
