This profile was prepared when Sanjeev Arora was elected to the Ashoka Fellowship in 2009.
The New Idea
In 2003, nearly 30,000 New Mexicans were infected with Hepatitis C, yet only 5 percent were able to access treatment which is available almost exclusively through specialists at the University of New Mexico (UNM) in Albuquerque. The plight of these underserved patients inspired Sanjeev Arora, one of the top Hep C specialists in the country to develop a plan to deliver state of the art treatment to these communities through Project ECHO (Extension for Community Healthcare Outcomes).Project ECHO creates a one-to-many “knowledge network” of specialists and up to 40 rural providers, who meet by videoconference to co-manage specific patients and share two-way teachings in which the ECHO staff works with remote clinics to coordinate and educate. Sanjeev calls this aspect of ECHO the “workforce multiplier.” Through the “knowledge networks” of the clinics, specialists co-manage patients and teach rural medical professionals to be mini-specialists, to whom patients from that area are increasingly referred, This eventually saturates the state with the ability to treat Hep C and also helps deconstruct stereotypes and prejudices that often have existed between specialists and providers. By pushing the ability to treat chronic, complex diseases down the work chain, ECHO is not only bringing specialized treatment to thousands of patients who would have otherwise gone untreated, but it is also keeping remote providers where they are most needed. Retention rates for rural medical professionals in New Mexico are notoriously low, and Sanjeev’s work is changing this by empowering isolated providers with stimulating, practical, cost-effective continuing education.Sanjeev has expanded ECHO beyond Hep C to ten other diseases and conditions, including HIV/AIDS, pediatric obesity, asthma and high-risk pregnancy. As public health experts, doctors and health professionals in the US and abroad beat a path to his door, he is envisioning ECHO’s “knowledge networks” being used outside of medicine to meet needs anywhere in the world where knowledge is transmitted from a specialist to more general practitioners, including in the fields of education, engineering, and agriculture.