• Ruth E Dubin, John Flannery, Paul Taenzer, Andrew Smith, Karen Smith, Ralph Fabico, Jane Zhao, Lindsay Cameron, Dana Chmelnitsky, Rob Williams, Leslie Carlin, Hannah Sidrak, Sanjeev Arora, and Andrea D Furlan.
• Department of Family Medicine, Queen's University, Kingston, Canada.
• Stud Health Technol Inform. 2015 Jan 1; 209: 15-22.

AbstractChronic pain is a prevalent and serious problem in the province of Ontario. Frontline primary care providers (PCPs) manage the majority of chronic pain patients, yet receive minimal training in chronic pain. ECHO (Extension for Community Healthcare Outcomes) Ontario Chronic Pain & Opioid Stewardship aims to address the problem of chronic pain management in Ontario. This paper describes the development, operation, and evaluation of the ECHO Ontario Chronic Pain project. We discuss how ECHO increases PCP access and capacity to manage chronic pain, the development of a community of practice, as well as the limitations of our approach. The ECHO model is a promising approach for healthcare system improvement. ECHO's strength lies in its simplicity, adaptability, and use of existing telemedicine infrastructure to increase both access and capacity of PCPs in underserviced, rural, and remote communities.

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