Leading Virtual Telementoring Education to Rapidly Disseminate Knowledge of COVID-19 and Sickle Cell Disease for Healthcare Providers in the Midwest

Sickle cell disease (SCD) is the most common genetic disorder in the US, with approximately 15,000 children and adults living with the disease in the Midwest. SCD is a painful, lifelong disorder of the red blood cells that causes complications difficult for providers to manage, in addition to a shortage of specialty providers.  Healthcare providers frequently self-report limited knowledge and confidence with evidence-based best practices to provide high-quality care to children and adults with SCD.  Beginning in March 2020, the emergence of the COVID-19 pandemic created significant knowledge gaps about the medical and psychosocial impact specifically on children and adults with SCD.  Moreover, the Centers for Disease Control quickly classified this population as “severe at-risk” with increased hospitalization and complications from COVID-19.  Additionally this vulnerable patient population is predominantly comprised of minorities, including African-Americans, that were already facing socioeconomic challenges, health care inequities and disparities, all of which created additional emerging threats during the COVID-19 pandemic.

Educational Strategy:

Sickle Treatment and Outcomes Research in the Midwest (STORM) is a federally-funded, regional sickle cell network, established to improve outcomes for individuals with SCD living Indiana, Illinois, Michigan, Minnesota, North Dakota, Ohio, South Dakota and Wisconsin.  An important goal of STORM is to increase provider knowledge about evidence-based management of SCD.  STORM TeleECHO, a replication of the Project ECHO telementoring model, was launched in March 2016 as an innovative, virtual approach to provider education in the Midwest.  Evaluation data over the years has determined this novel Project ECHO approach was successful to spread evidence-based management of SCD.

 
In response to the COVID-19 pandemic, the STORM coordinating team quickly emerged as a leader in COVID-19 and SCD targeted provider education with the evolution of the existing STORM TeleECHO framework to launch additional sessions in March 2020.  COVID-19 and SCD TeleECHO sessions were designed to provide didactics focused on emerging medical and psychosocial issues.  Topics included patient precautions, socioeconomic needs including food security and home schooling, development of vaccines, multi-system-inflammatory syndrome in children, and dissemination of advisories for SCD patients and providers from the national SCD organization.  Providers presented pediatric and adult de-identified cases of children and adults with COVID-19 and SCD to discuss medical treatment and outcomes during sessions.  Moreover, in the beginning of the pandemic, the sessions provided an open forum for leading providers to share rapidly emerging changes in clinical practices (i.e. best practices for the shift to telehealth) and to share patient resources and educational materials.

Patient-Level Outcome(s) Measured:

From March 2020 – March 2022, there were 20 COVID-19 sessions held as there were emerging issues, including multiple virus variants and the FDA approval of vaccinations, leading to education about vaccine communication.  Attendance participation showed a 172% increase compared to non-COVID sessions over the two year span.  Over 190 providers attended at least 1 session and 675 ABIM/ABP MOC Part 2 credits were awarded to 49 physicians in 11 states and 3 countries.  The majority of participants were physicians (40%), registered nurses (14%), nurse practitioners (9%) and others, including newborn screening coordinators, clinical research coordinators, social workers, community health workers, public health officials, pharmacists and medical trainees.  Mixed-methods evaluation data has consistently shown that the majority report learning evidence-based guidelines, applying new knowledge to practice behaviors and increasing confidence in managing COVID-19 and SCD.

STORM’s existing use of Project ECHO as a successful educational strategy allowed our team to quickly and successfully adapt to lead impactful, virtual multidisciplinary educational efforts focused on COVID-19 and SCD.  There was a need to provide real-time COVID-19 education during the emerging public health crisis, including dissemination of research and patient education resources, and to create a community of practice among providers to overcome the challenges from COVID-19 facing practices and patients.  Moreover, the increased session participation sustained throughout the past two years has demonstrated the desire and need of healthcare providers for this virtual educational resource which allowed providers to participate remotely with Zoom© technology for high-quality CPD.