The goal is to improve access of specialty care to veterans in nine medical areas - cardiology, diabetes, endocrinology, HCV infection, liver disease, nephrology, pain management, and vascular medicine (Pfeifer 2012). Improvement in the access to specialty care for veterans is crucial since "according to the Veterans Health Administration, about 41% of the 3.4 million veterans live in "rural or highly rural areas of the country "(Pfeifer 2012). .
Many veterans in rural areas do not have access to specialty care and "in California veterans can travel up to 8 hours round trip to seek specialty care" (Canavan 2011). Several veterans have complex chronic conditions including PTSD in which excessive traveling to see specialists can be inconvenient, and exhausting. .
Also by seeing a variety of specialists and a primary care provider, a veteran risks a disruption in the continuity of care. This is especially important if each specialist and the primary doctor are prescribing medications as some medications may interact with others. "The SCAN-ECHO program aims not only to improve access to specialist, improve care quality and safety, and reduce variations in care, but it also offers opportunities for primary care providers to gain the skills and knowledge to be able to manage more complex cases without imposing travel burdens and costs on the veterans"(Pfeifer 2012). Veterans can now seek specialty care from their primary care provider in a comfortable setting in which both the provider and the patient are familiar with each other. SCAN-ECHO is currently being piloted in eleven VA medical centers including the San Francisco, Los Angeles, and San Diego VA medical centers. Also, "[Dr.] Arora and his team have trained more than 120 VA physicians, nurse, and other primary care clinicians on using the ECHO model (Project ECHO Brings Complex, Chronic Care to Veterans 2012).
How ECHO Based Programs are Providing Opportunities for Nurses.
