U.S. Air Force Telehealth Initiative to Assist Primary Care Providers in the Management of Diabetes
M ore than 50,000 active-duty U.S. Air Force (USAF) service members, retirees, and family members with diabetes receive care at more than 50 military treatment facilities (MTFs) throughout the continental United States.1 Although many of these patients are referred to civilian network diabetes specialists because of a scarcity of military endocrinologists, most are managed by USAF primary care providers (PCPs). In an effort to assist PCPs in managing complex diabetes cases, a team from the USAF Diabetes Center of Excellence (DCOE) in San Antonio, Tex., adopted the Extension for Community Healthcare Outcomes (ECHO) model of care.

The ECHO model of health care delivery was developed and implemented originally by Dr. Sanjeev Aurora and his team at the University of New Mexico2 to treat underserved patient populations with hepatitis C. The model uses technology, specifically video teleconferencing, to provide support to PCPs in remote areas who may lack the experience, knowledge, or confidence needed to manage this complex condition. Results demonstrated that patients treated remotely through ECHO experienced similar clinical improvement with fewer adverse events than those treated at the university specialty clinic. The University of New Mexico has adapted the ECHO model for ~ 20 other chronic illnesses, including diabetes.

After training with the New Mexico team, DCOE endocrinologists and support personnel adapted the ECHO model to address the unique needs of military PCPs and their patients with diabetes. The USAF ECHO initiative was designed such that sessions, open to all military …