An ECHO-Based Program to Provide Geriatric Specialty Care Consultation and Education
Targeting specific practice changes and working directly with patient aligned care teams to change practice may be more productive than telehealth for improving outcomes in older veterans.
Dr. Guzman-Clark is a gerontological nurse practitioner and nurse scientist; Dr. Harrell is a clinical psychologist/neuropsychologist; and Dr. Henriques is a GRECC clinic manager; Ms. Ines is a registered nurse; Dr. Rofail is a pharmacist; and Dr. Castle is a geriatrician and GRECC clinical director; all at the Greater Los Angeles Healthcare System (GLAHS) in California. At the time of the manuscript preparation, Ms. Leff was an associate clinical social worker and Dr. Knapp was the SCAN-ECHO project manager at GLAHS. Dr. Guzman-Clarke is an assistant clinical professor at the UCLA School of Nursing, and Dr. Castle is a clinical professor at the UCLA School of Medicine.
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
Case-based education and training without follow-up of the recommendations likely is not the best approach to improve care of older veterans in the primary care setting. The authors hope that focusing on specific practice changes and working directly with PACTs and specific team members will be more productive and result in improved outcomes for older veterans. Due to the complexity of geriatric cases involving physical, cognitive, and emotional vulnerabilities, these cases may be better handled by direct multidisciplinary examinations.
Acknowledgments Funding for this project was supported by the Veterans Health Administration Office of Specialty Care Services T-21 funding initiative.
