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Improving Outcomes in Chronic Intestinal Failure Using the ECHO Model: The LIFT-ECHO Last Mile Project

Award Number: R18HS029126
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)
PERIOD OF PERFORMANCE START DATE: 09/01/2023
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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Improving Outcomes in Chronic Intestinal Failure Using the ECHO Model: The LIFT-ECHO Last Mile Project - Chronic intestinal failure (CIF) is a devastating condition where individuals are unable to eat and drink enough to meet basic survival needs. Patients with CIF are dependent on parenteral nutrition (PN) delivered intravenously by a pump via an indwelling central venous catheter. While PN is lifesaving, life-threatening complications can cause considerable morbidity, impair quality of life (QOL) and carry significant mortality risk. Care of patients with CIF is very complex and best delivered by experienced multi-disciplinary teams working in intestinal rehabilitation programs (IRP). Our recent work has shown a critical lack of expertise in CIF among US gastroenterologists and over half the states in the US do not have IRP. This lack of widely available expertise results in significant healthcare disparities for patients with CIF. Our recent work has shown that use of technology to disseminate knowledge through the LIFT-ECHO Project, based on the well-established ECHO Model can fill a critical gap in CIF care. Application of LIFT-ECHO to improve CIF patient care requires a systematic dissemination and evaluation approach, engaging multiple key stakeholders. We will test the hypothesis that clinical outcomes in patients with CIF will improve by providing virtual multi- D support to non-expert physicians through an online learning model, the LIFT-ECHO Project. Through intensive stakeholder engagement, we can disseminate and establish LIFT-ECHO to improve clinical outcomes in CIF nationally. AIM 1: To develop and validate an intestinal failure disease activity index (IF-DAI) that assesses current clinical status in CIF patients and is sensitive to short-term and medium-term changes. AIM 2: To demonstrate improved clinical outcomes and CIF/PN specific patient-reported quality of life (PRQOL) in CIF patients by providing virtual multi-disciplinary support to their physicians through LIFT-ECHO. AIM 3: (a) We will undertake a pragmatic formative process evaluation of LIFT-ECHO in its current state. (b) To disseminate process evaluation results of LIFT-ECHO nationally and evaluate dissemination effectiveness. Our study is the first application of the ECHO Model™ to a rare disease like CIF – our dissemination strategy will provide a comprehensive evaluation framework and a toolkit for assessment of ECHO™ implementation in the context of a rare disease. Our application targets the SEN: NOT-HS-21-014 to develop and implement LIFT-ECHO to address the disparities in access to expert care for patients with a chronic disease.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $393,437 )
2026	2026	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	4/21/2026	NON-COMPETING CONTINUATION	$393,437
														Subtotal = $393,437

Issue Date FY: 2025 ( Subtotal = $395,068 )
2025	2025	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	6/16/2025	NON-COMPETING CONTINUATION	$395,068
														Subtotal = $395,068

Issue Date FY: 2024 ( Subtotal = $396,365 )
2024	2024	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Research on Healthcare Costs, Quality and Outcomes	001	2	6/20/2024	NON-COMPETING CONTINUATION	$396,365
2024	2023	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	1 GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	6/20/2024	NEW	$0
														Subtotal = $396,365

Issue Date FY: 2023 ( Subtotal = $396,437 )
2023	2023	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	ONE GUSTAVE L LEVY PL	NEW YORK	NY	10029	NEW YORK	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	8/18/2023	NEW	$396,437
														Subtotal = $396,437

Grand Total All Awards = $1,581,307

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Improving Outcomes in Chronic Intestinal Failure Using the ECHO Model: The LIFT-ECHO Last Mile Project

Award Number: R18HS029126

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

PERIOD OF PERFORMANCE START DATE: 09/01/2023

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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