Extension of Community Healthcare Outcomes (ECHO™ ) is a tele-mentoring model which will break down the walls between specialty and primary care using widely available telehealth technologies. It links addiction specialist team at an academic ‘hub’ with primary care clinicians in local communities– the ‘spokes’ of the model. Together, they participate in scheduled ECHO clinics, discuss de-identified case studies in real-time, discuss new developments relating to their patients, determine treatment and benefit from a variety of didactic presentations to develop the skills they need to treat patients and improve patient outcomes.

Launched in 2003 by Sanjeev Arora, M.D. at the University of New Mexico, the ECHO model™ is an innovative moment that bridges the healthcare accessibility gaps by connecting local providers to specialist teams to share knowledge and foster relationships to improve patient outcomes. This virtual connection of the local providers to specialist teams saves the patient’s time and resources that would have been used to go see a specialist.


VCU clinical team is being led by Dr. Mishka Terplan, MD, MPH professor in Obstetrics and Gynecology and Psychiatry, a nationally known addiction specialist in partnership with robust multidisciplinary team ranging from addiction psychologist to rehabilitation counseling. The Project ECHO program at VCU is administratively housed within the School of Medicine department of Internal Medicine and the Office of Telemedicine with Dr. Vimal Mishra, MD, MMCi serving as principal investigator, a dedicated Project ECHO program manager Nanah Fofanah, and David Collins, Practice Administrator with close partnership with VCU Health Continuing Medical Education.

Clinical Team Leader
Dr. Mishka Terplan, MD, MPH
Department of Obstetrics and Gynecology

Principal Investigator
Dr. Vimal Mishra, MD, MMCi
Assistant Professor
Medical Director, Office of Telemedicine
Physician Informaticist, Chair Orders Council, Office of Clinical Transformation
Department of Internal Medicine
Division of Hospital Medicine

Practice Administrator

Program Manager
Nanah Fofanah, CPH, MPH


Virginia Commonwealth University, University of Virginia, and Virginia Tech Carilion and have partnered with the Virginia Department of Health, and the Department of Behavioral Health and Developmental Services tackle the opioid crisis. Using the ECHO model, they have developed the Virginia Opioid Addiction ECHO, an innovative mentoring based learning network that connects subject matter experts to practicing providers, clinicians and social health professionals in the field.


In order to support the growth of the ECHO movement, Project ECHO® collects participation data for each teleECHO™ program. This data allows Project ECHO to measure, analyze, and report on the movement’s reach. It is used in reports, on maps and visualizations, for research, for communications and surveys, for data quality assurance activities, and for decision-making related to new initiatives.