Technology & Training Case Study: Using Polycom for Training Clinics in Rural New Mexico

As part of the Technology & Training Workgroup, this case study is an example of how technology can be used to satisfy a training objective, or solve a training problem. More case studies can be found by clicking on the "Technology & Training" tab under Categories on the ShareSpot home page. We encourage you to ask questions and leave comments for the authors to respond to.

What was your training situation or goal?

New Mexico AETC’s goal was to provide didactic and case consultation services to NM providers who treat patients with HIV.

Obstacle:  New Mexico is a rural and underserved state with few HIV expert providers.  Providing educational sessions to these providers is often difficult given the lack of resources and/or the financial and time constraints of traveling long distances, which highlights the challenge of maintaining long term relationships/mentorships. As a result, providers may be less likely to care for patients with HIV in this rural area if they do not feel they have the knowledge/skills or the consultative back-up to provide adequate care. 

Course:  The New Mexico AETC partnered with Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico Health Sciences Center, whose goal is to expand access to specialized care for vulnerable populations and underserved areas. 

Training:  Project ECHO-NMAETC clinics were held weekly from 10/2010-12/2011. The ECHO model of telehealth consultation was utilized, which includes: 1) use of technology to leverage specialized resources; 2) teaching best-practices care; 3) case-based learning, and 4) outcomes monitoring. ECHO used Polycom video conferencing and phone calls to conduct these clinics.  A total of 48 clinics were held with 228 unique attendees representing diverse professional disciplines (1462 provider participation hours). Sixty-two unique patient cases were presented.

Trouble shooting and support: Polycom video conferencing requires that participant’s computers have a camera and microphone, and downloading the software to access project ECHO is not as easy as other programs, like Adobe Connect, for example. We rely on the IT employees at ECHO to trouble shoot and make sure that participants are able to connect and can identify themselves in order to be HIPPA compliant.

Conclusion/lessons learned:  The biggest obstacle reported by participants was getting the initial software download and set up in place. Once that process was complete, participants did not typically experience technical difficulties on their end.  Relying on IT employees at ECHO adds another level of human resources to the project that is specialized and time consuming. The NMAETC has taken on the administrative responsibility of running the HIV clinic through project ECHO. This includes curriculum development, didactic and case presenter organization, data collection (PIFs/Evals), monthly reporting to the CME office and regional office, and IT updates to people as they occur. This too requires a large time commitment from the administrative staff and our medical director who facilitates clinics and organizes the speakers.  Adequate staffing is critical.

However, guided by expert consultation from the Project ECHO-NMAETC team, community-based PCPs were able to treat their HIV patients while gaining rapid learning of best-practices care and improving their ability treat HIV more efficiently. Evaluations of PCP self-efficacy toward the ability to treat HIV in the primary care setting under the aegis of this model are being pursued this year.