The Department of Veterans Affairs has started pilot tests of linking its primary care providers with specialists via videoconferencing technology.

VA medical centers in 12 regions will start the initiative, says Rajiv Jain, M.D., chief patient care services officer at VA. The project is called Specialty Care Access Network-Extension for Community Healthcare Outcomes, or SCAN-ECHO. It is the first national implementation of Project ECHO, developed by Sanjeev Arora, M.D., a liver disease specialist at University of New Mexico Health Sciences Center.

While the Robert Wood Johnson Foundation is supporting some regional Project ECHO implementations, the VA is paying for its program. At the VA, SCAN-ECHO will enable primary care providers and specialists at academic medical centers or other facilities to videoconference weekly. These sessions will be virtual clinics, similar to the grand rounds that teaching hospitals use to educate physicians on new research and treatments.

VA primary care physicians during the clinics will present patient cases to the specialist teams--but not the patient--and discuss new developments and treatment options.

The goal of Project ECHO is not to provide direct treatment to patients via telemedicine technologies, but to mentor and further develop the skills of PCPs so their practices can become new community-based centers of excellence.

The VA’s iteration of ECHO will start in VA centers in West Haven, Conn.; Pittsburgh; Richmond and Salem, Va.; Cleveland; Ann Arbor, Mich.; Albuquerque, N.M.; Denver; Portland, Ore.; San Francisco; Los Angeles and San Diego.

The Department of Health and Human Services recently awarded grants totaling $8.5 million to expand Project ECHO in New Mexico and Washington State. More information on the program is available at

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