Lee Memorial

ECHO project (Emergency Care Helping Others)

Fort Myers, Florida

Public Health System, including four acute care hospitals and two specialty hospitals

Lee Memorial’s Emergency Care Helping Others (ECHO) project was created in 2013 to help individuals that were frequently utilizing the emergency department due to lack of insurance and limited or no access to primary care. The goal of the program is to help patients with frequent emergency department visits meet their needs in the right place and time, including health care, social and physical needs.

For one patient, emergency department visits occurred 41 times in a one-year period.  After assistance from the ECHO project, the patient’s living situation was significantly improved thanks to a community-wide effort led by the ECHO team, which included care management staff and volunteers from the community.  Since the intervention, the patient has not had one emergency department visit.

Another patient with gastrointestinal issues came to the emergency department nearly five times a week for an extended period of time. A positive relationship with a caring physician who spent time to assist the patient, combined with the ECHO team’s assistance and a dietician at the hospital, has resulted in a loss of over 100 pounds.  The patient is now healthier and has only required an occasional emergency room visit.

Since 2013, the ECHO project has provided more than 3,150 interventions on more than 90 patients.  Many are without a home or a phone. The consistent relationship the patients have with the ECHO team allows them to call team members anytime to get the help they need.  Interventions have included:

  • Phone Follow-ups:1216
  • Home Visits: 531
  • Provider Visits:105
  • Hospital Visits: 329
  • Jail Visits: 2
  • The establishment of primary care providers: 179
  • Housing assistance: 213
  • Relocation assistance: 38
  • Transportation assistance: 288
  • Mental health assistance:193
  • Substance abuse assistance: 57
  • Medication assistance: 349
  • Food assistance: 68
  • Assistance with insurance issues: 132
  • Dental care:14

ECHO is comprised of nurses and social workers who build a relationship with patients in need of extra assistance, and act as a liaison between the hospitals, primary care providers, specialists, community resources and insurance plans to ensure patient-centered coordination of care.  The program leverages collaborative relationships with a wide variety of community organizations, including:

  • Florida Medicaid
  • Social Security
  • Lee County Health Department
  • Family Health Centers
  • Lee Physician Group Residency Program
  • Local corrections system
  • United Way Clinics
  • Asthma and COPD Management
  • Durable medical equipment companies
  • Pharmacies
  • Local social services, including food banks, substance abuse facilities and housing, the salvation army, the homeless coalition, and transportation companies
  • Lee Memorial’s business office (to facilitate funding issues)

Although the program started with one part-time employee, the need was great.  The program quickly grew to full-time roles funded by Lee Memorial.  For the first set of patient outcomes studied in the program, inpatient discharges decreased 21 percent, and emergency department outpatient visits decreased 35 percent.  This decrease represents improved patient health and a better quality of life, thanks to Lee Memorial’s commitment to ensure that patients get the right care at the right place at the right time.

“I want to thank the ECHO team for their assistance in getting me to my doctor appointments, getting my medications, and getting rides when I need them to the Hope Club House. Cathy, Michelle, Andrea, Lynn are very helpful and make it encouraging to stay healthy.  Thank you for all your help.” –Recent ECHO patient