338-OR: Leveraging the Project ECHO Model for Type 1 Diabetes (T1D) in California and Florida: Democratizing Knowledge in Underserved T1D Communities

T1D care for many patients in both the pediatric and adult populations in the U.S. falls on primary care providers (PCPs). Persistently suboptimal outcomes for people with T1D and a lack of access to subspecialty care mandates the development of innovative healthcare delivery models. Using the Project ECHO (Extension for Community Healthcare Outcomes) model, Stanford University and the University of Florida partnered to develop and pilot a “ECHO T1D” teleECHOTM clinic. The goal of the pilot was to demonstrate the feasibility of an ECHO model for T1D and improve the ability of PCPs to manage patients with T1D. Utilizing a “Hub-and-Spoke” model, we recruited and partnered with PCPs at non-specialty diabetes practices across Florida and California and held weekly hour teleECHO sessions consisting of didactic presentations and case reviews. Precision recruitment methods to target clinics in remote and medically underserved regions included: (1) geocoding to identify high-need areas, (2) claims data to identify PCPs treating T1D, (3) survey data from PCPs. The 18-month pilot program is ongoing and enrollment demonstrated extremely high interest amongst PCPs as the pilot program filled beyond capacity. In California, 11 Spoke sites enrolled with 37 clinics serving roughly 900 adult and pediatric patients with T1D who do not receive specialty T1D care. In Florida, 12 Spoke sites enrolled with 67 clinics who serve roughly 1,300 patients with T1D. PCPs and their clinic staff have become local experts in T1D, providing a more informed level of care for the many patients who lack access to endocrinologists. Project ECHO T1D is an innovative healthcare delivery model which appears capable of building capacity for diabetes management education in the medically underserved. Having demonstrated proof-of-concept for ECHO T1D, future efforts will focus on replicating the model and on designing studies to demonstrate improvements in patient level outcomes. Disclosure N. Cuttriss: None. C. Anez-Zabala: None. L.G. Baer: None. A. Bernier: None. M. Basina: None. S.L. Filipp: None. K.K. Hood: Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc. Speaker9s Bureau; Self; Johnson & Johnson Diabetes Institute. M.J. Gurka: None. R. Lal: Consultant; Self; Abbott. M.J. Haller: Advisory Panel; Self; Pancreum, SAB Biotherapeutics. D.M. Maahs: Advisory Panel; Self; Novo Nordisk Inc. Consultant; Self; Abbott, Sanofi. Research Support; Self; Dexcom, Inc., Tandem Diabetes Care. H. Hu: None. M. Town: None. E. Sheehan: None. C. Wang: None. K. Yabut: None. A.F. Walker: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust