Partnering to Change the Face of Cancer Care

The Bristol Myers Squibb Foundation awarded the ECHO Institute a five-year $10 million grant to apply the ECHO model of telementoring and collaborative care to cancer.  The goal of this partnership is  to bring high-quality care to patients living in places in the US and Africa where cancer specialists are not easily accessible.  ECHO and the Foundation are united in their commitment to health equity and to improving cancer health outcomes for these vulnerable populations and ensuring that the advances in the continuum of cancer prevention, treatment and care will have optimal and equitable benefit.

The Problem 

Global and national disparities in cancer care access, quality, and outcomes:

• While cancer mortality rates in the United States have been declining since the early 1990s, black Americans continue to have the highest cancer mortality and shortest survival time among racial or ethnic groups, with the exception of American Indian and Alaska Natives.
• In Sub-Saharan Africa, the mortality rate for cervical cancer is 22.5 per 100,000 people, in contrast to 15 per 100,000 people in North America.  Similarly, the mortality rate for prostate cancer is 20.9 per 100,000 people in Sub-Saharan Africa vs. 9.8 per 100,000 for North America.
• Even in the United States, rural Americans are more likely to die from cancer, as well as heart disease and other leading causes of death, than their urban counterparts. Only 3% of medical oncologists practice in rural areas, forcing rural cancer patients to travel great distances for care.
• Even though cervical cancer is largely preventable when screening guidelines and follow-up monitoring are pursued, recent studies have shown that racial disparities in United States death rates from cervical cancer are significantly wider than estimated: black women are dying from cervical cancer at twice the rate of white women. This puts black American women on par with women in low- and middle-income countries around the world, where lack of medical screening and limited access to care are the norm.
• The mortality rate for breast cancer in black American women is 31.0 vs. 21.9 for non-hispanic American white women.

The Solution

Transfer of and access to knowledge:  getting patients the right care, at the right place, and the right time. Project ECHO’s goal is to increase access to best practice cancer care for vulnerable populations in the United States and around the world, through pairing doctors at National Cancer Institute-designated Comprehensive Cancer Care Centers and academic medical centers with providers in community hospitals and health centers. The Bristol Myers Squibb Foundation funding will allow the ECHO Institute to significantly expand its footprint in cancer, domestically and internationally, and to train many more replicating partners or hubs in the implementation of the ECHO model.  During our five-year partnership with the Foundation, we will:

• Strengthen the cancer health system through training and capacity building.
• Accelerate the transmission of best practice cancer care and strengthen connections between cancer centers and communities.
• Reduce disparities across all phases of cancer care through the use of the ECHO model to facilitate best practice care in rural and underserved communities (including through programs that involve Community Health Workers as a bridge to populations less likely to engage with the healthcare system).
• Engage this growing community of cancer ECHO experts in an ongoing collaborative to share learnings, best practices, and innovations.
• Evaluate the impact of the ECHO model as a means of improving health outcomes and quality of life for cancer patients.
• Work with the leading organizations in cancer and healthcare payment experts to incorporate ECHO into the fabric of cancer prevention, screening, treatment, palliation, and survivorship in the United States.

Through our partnership with the Bristol Myers Squibb Foundation, we will build knowledge and awareness of the ECHO model within the cancer community, by cultivating support and buy-in from organizations and their leadership to implement one or multiple teleECHOs focused on cancer, establishing a strong inter-connected network of cancer-focused ECHO hubs that share best practices, innovate, learn, and potentially pursue collaborative research. Our replicating partners will address many aspects of the cancer continuum; together we will develop a strong evidence base demonstrating the value of the ECHO model in increasing access to best practice cancer care for the vulnerable populations in the United States and around the world.

In July 2018, Kimberley Hospital Complex (KHC) in Kimberley South Africa launched their first ECHO focused on providing Community Charity Workers (CCWs), oncology nurses and providers throughout the Northern Cape with best practices for diagnosing and treating lung cancer and mesothelioma. The Lung Cancer and Mesothelioma ECHO is led by Dr. Daniel Osei-Fofie, Medical Director, and Brenda Masuabi, Program Manager, who are working to launch two additional ECHOs focused on providing primary care physicians with case-based telementoring for best practice in breast and cervical cancers, as well as a program dedicated to prostate and colorectal cancers.

If you are interested in launching a cancer ECHO or want to learn more, please contact the team at cancerECHO@salud.unm.edu.

The Cancer Initiative is possible thanks to the generous support of the