P2.055: Increasing Access of Military Children to Developmental and Behavioral Care Through Project ECHO

Background: Project ECHO (Extension for Community Healthcare Outcomes) is a learning framework using tele-education to connect professionals in rural/underserved areas with specialists using a hub and spoke model. Designed to move knowledge, not patients, Project ECHO builds community by connecting providers to one another in an ‘all teach, all learn’ videoconferencing format. This advocacy project will describe the Project ECHO model applied to military- and community-based providers who support military-connected children with mental, emotional, developmental, or behavioral (MEDB) disorders. It is estimated that 23.7 8% of children in the US ages 3-17 with at least one caregiver on active duty has at least one MEDB. There is a concerning decrease in the workforce specializing in these disorders. Many military families live in rural areas with health care shortages. Recommendations to address the workforce shortage include training the larger network of care providers to work with specialists and extending existing specialty workforce by supporting local professionals through virtual consultation.

Project Description: Kennedy Krieger’s Military Child ECHO launched in Fall 2022. The Military Child ECHO meets biweekly for a one-hour case consultation and didactic presentation. Topics are generated from participant-identified learning priorities.

Discussion: Topics across the seven series have included overview of MEDB, autism, medical complexity, and behavior disorders. We have had 145 participants across 18 professions. Participants have joined from 21 states and 5 countries (US personnel stationed at overseas installations), including at least eight states where participants have less than one developmental behavioral pediatrician per 100,000 children, and one state in which there are no developmental behavioral pediatricians. The highest learning priorities identified by participants and therefore incorporated in Military Child ECHO sessions include ADHD, anxiety, disruptive behavior, trauma, and autism.
The Military Child ECHO is a flexible option for providers who can be as mobile as the military patients they serve. Providers can participate in the Military Child ECHO as long as they have the hour reserved in their calendar and have access to a computer with audiovisual capabilities.

Conclusion: The ECHO model, implemented with the military children as the intended focus, has been effective in reaching professionals across the U.S and in bases outside of the continental U.S., particularly in areas of low resources for developmental pediatrics.
The ECHO team can adapt to meet the learning needs and priorities of the participants and is scheduled to include just in time teaching sessions for topics raised by participants based on recent trends in their practice.
ECHO is a workforce multiplier, and a way for professionals caring for military children to access experts for case consultation and broaden their knowledge and skills in the care of children with MEDB disorders.