Improving the Delivery of Musculoskeletal Education in Primary Care Using the Innovative Echo (Extension for Community Healthcare Outcomes) Technology

Background: Extension for Community Healthcare Outcomes (ECHO) is a programme that employs videoconferencing technology to train community-based primary care providers to improve and standardize care across a wide geographical region. This method has not yet been trialled in the UK for improving the capacity of primary care services in managing common musculoskeletal (MSK) complaints. Aim: The aim was to assess the impact of introducing a year-long MSK ECHO education programme in Northern Ireland for general practitioners (GPs). Design and setting: Monthly sessions were held consisting of teaching and case based discussions. Each session lasted on average 90 minutes. A ‘hub’ consisting of local GP lead educators, supported by colleagues from secondary care, where linked to GPs around Belfast using video conferencing technology. Methods: Topics covered were chosen by participants at the start and covered common MSK complaints in primary care. An initial questionnaire was performed at the start and compared to an evaluation questionnaire at the end. Results: Ten GPs completed the evaluation one year after the project was initiated. The weighted average of the selfconfidence scores in examining a range of individual body parts in general practice increased from a baseline of 3.45 to 4.08. There was an increase in self-assessed ability in diagnosing and treating a number of common MSK complaints and the whole year-long programme was delivered for £ 14,980. Conclusion: This trial shows how a 12-month ECHO intervention can improve self-efficacy in a number of MSK capacities within GP. These preliminary results suggest that ECHO is an affordable, effective solution for providing postgraduate education to working GPs.