ECHO, which stands for Extension for Community Healthcare Outcomes, is an all-teach-all-learn tele-mentoring model that uses case-based learning. Specialists and experts at a “Hub” meet regularly with physicians, nurse practitioners and other clinicians at “Spokes” via videoconferencing to support in the delivery of specialty care services. To learn more about the ECHO model and its history, watch this short video by Project ECHO’s founder, Dr. Sanjeev Arora and visit echo.unm.edu.
The ECHO MOLST + eMOLST clinic series was launched in September 2018 to connect MOLST experts with learners to create knowledge networks. The overall goal was to improve outcomes by reducing variations in processes of care and sharing best practices through case-based learning. The aims of ECHO MOLST + eMOLST are to improve the quality of thoughtful MOLST discussions and the MOLST process to ensure patient preferences are honored. Today, ECHO MOLST + eMOLST is a trusted platform for MOLST education in New York State.
Through clinic series evaluations, case presentations and participant feedback, it became apparent that additional education was needed on the MOLST completion process for individuals with intellectual or developmental disabilities (I/DD). In September 2022, a 2nd ECHO MOLST clinic, ECHO MOLST for Individuals with I/DD, was launched to provide education on special considerations and MOLST completion elements unique to these individuals. The goal of ECHO MOST for Individuals with I/DD is to increase the frequency of thoughtful end-of-life discussions for seriously ill individuals with I/DD who are appropriate for MOLST, ensuring conversations occur earlier in the disease trajectory before an emergency occurs.
ECHO clinic sessions take place via real-time videoconferencing using Zoom.
A facilitator who is also a subject matter expert will lead each session. Each session begins with brief introductions of all participants. This is followed by a short 15-minute formal didactic presentation and Q&A on a scheduled topic presented by the subject matter expert for the session.
Community healthcare providers (spoke sites) then present pre-submitted cases for discussion by the entire group, using de-identified information only. All participants are encouraged to contribute actively to the case discussion. Each participating site is invited to present at least one case during the clinic series.
Recommendations are summarized at the end of each case presentation.
The ECHO MOLST + eMOLST clinic series and the ECHO MOLST for Individuals with I/DD clinic series will run weekly for 8 weeks. Clinic series schedules are as follows:
| Clinic Title | Date Range | Day of Week | Time |
| ECHO MOLST for Individuals with I/DD | 9/7/22-10/26/22 | Wednesday | 12:00-1:00pm |
| ECHO MOLST + eMOLST | 9/8/22-10/27/22 | Thursday | 12:00-1:00pm |
ECHO MOLST clinics are open to all. The following groups are the target audiences of each clinic series:
ECHO MOLST + eMOLST: physicians, nurse practitioners, physician assistants, nurses, social workers and all others who participate in the MOLST process.
ECHO MOLST for Individuals with I/DD: physicians, nurse practitioners, physician assistants, psychologists, NYS Office for People with Developmental Disabilities (OPWDD) staff and all others who participate in the MOLST process for individuals with I/DD.
Upon Completion of the 8-week ECHO MOLST + eMOLST Clinic Series, Participants Will:
Upon completion of the 8-week ECHO MOLST for Individuals with I/DD clinic series, participants will:
Session 1 – MOLST: A Key Pillar of Palliative Care
Session 2 – More Than a Form – It’s a Process
Session 3 – Who Determines Who Has the Right to Make Decisions
Session 4 – Ethics and the Law: Updates on Public Health Law, Authority & Accountability
Session 5 – Crucial Conversations: Use Both Sides of Your Brain
Session 6 – MOLST Form: Improve Quality & Reduce Harm
Session 7 – Conflict Resolution: Authority of Health Care Agents & Surrogates
Session 8 – Care Plan Strategies
Session 9 – eMOLST
Session 1 – MOLST: A Key Pillar of Palliative Care
Session 2 – Who Determines Who Has the Right to Make Decisions
Session 3 – Safeguarding the Voice of Individuals with I/DD
Sessions 4 & 5 – Ensuring MOLST is Done Right for Individuals with I/DD
Session 6 – Shared Decision Making & MOLST
Session 7 – Addressing Feeding Challenges
Session 8 – Notifications: Who, What, When & Why
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