When it launched operations in 2018, the IUPUI ECHO (Extension for Community Health Outcomes) Center, had one small project educating primary care physicians on Hepatitis C. ECHO is a nationwide model that facilitates medical knowledge sharing between specialist teams and primary care providers in rural areas, enabling better care for patients closer to home. By 2022, the IUPUI ECHO Center had grown to provide dozens of ongoing topics to providers across the state.
“We grew really fast. While that’s been amazing, the speed hasn’t led to strategic planning for the future,” said Andrea Janota, director of the IUPUI ECHO Center. “We’re trying to refocus on strategy, and this partnership with the Kelley School of Business was a chance to think about our vision: How can we be strategic in meeting our goal, and what does the path forward look like?”
The partnership was an opportunity for the IUPUI ECHO Center to gain business consulting insight from students in the Graduate Certificate in Medical Management Program at the Kelley School. In the final course of the program, an immersive capstone experience, student groups partner with a local organization seeking advice on business challenges. Students apply the lessons they’ve gained over the past year to recommend viable solutions.
For one of the students in the ECHO group, the concept of supporting rural healthcare providers with specialized care was particularly personal.
“I grew up in a very rural town. Seeing a specialist meant traveling an hour or more. In my late 20s, I needed a very specialized physician for brain surgery; moving to a bigger city for access to those resources helped me get diagnosed sooner,” said Becky Cooper, GCMM’21, MBA’23. “This project to help primary care doctors become more in tune with specialty medical care sounded very helpful. I wanted to learn more about it.”
The team Becky joined to help the IUPUI ECHO Center also included Thora Berndt, GCMM’21, MBA’23; Shar Taylor, GCMM’21, MBA’23; and Lora Estera, GCMM’21, and was advised by Pam Hunt, associate faculty in management at the Kelley School. After initial meetings to understand the background, challenges, and resources, the team noticed the center had access to an entire library of resources provided by the national Project ECHO organization, but they weren’t plugged in.
“This was a ready-made resource, so the first thing we did was help Andrea’s team gain access to that library, which included a lot of the helpful items they weren’t using,” said Becky. “Our team dove into the library, and each of us took sections and broke them down into opportunities and resources IUPUI ECHO could begin using.”
“Their synthesis of the resource library and explanation of what’s applicable to our work was one of the greatest takeaways of this project,” said Andrea. “It was incredibly helpful to have someone look at what we do, research what’s out there, and identify which tools are most useful.”
The IUPUI ECHO Center needed direction on how to grow more strategically. To create an effective business plan, the group reached out to ECHO centers across the country to learn how they grew their operations. Together with Andrea, they designed a survey and began collecting best practices.
“We reached out to several ECHO centers across the country with the survey,” Shar said. “It was helpful to gain perspective from other ECHO centers — to see what they were doing and determine if anything could be used in the IUPUI ECHO Center.”
“This kind of collaboration was something we’d been thinking about doing for a long time. But when your nose is to the daily grindstone, you don’t always have time for the extra things to ensure you’re developing in thorough and meaningful ways,” Andrea said. “To have not only additional capacity, but also outside perspective gathered by master’s-level students in business administration, who know far more than I do about such things, was really helpful. They brought time, expertise, and a fresh vision to our organization.”
The team also studied funding sources for their medical knowledge sharing events. They examined the strained staffing levels at the IUPUI ECHO Center to find ways to free up Andrea to do more strategic work.
“Andrea works with a lot of interns who stay at the ECHO center six to nine months, which forces Andrea to train new hires continuously,” Thora said. “We made staffing recommendations and provided guidance to stabilize her team.”
Ultimately, the teams delivered an extensive business plan and recommendations for the IUPUI ECHO Center, which they presented formally to Andrea and their instructor, Pam.
“The value the Kelley student group brought to the ECHO center was amazing. They researched and developed actionable recommendations for the program’s organizational structure and expansion, participant engagement improvements, and additional funding sources,” Pam said. “This project resulted in equipping the ECHO team with a plan to continue achieving its mission, to ‘serve the underserved,’ and to reduce disparity in care.”
“The students were phenomenal. I was so excited to work with such an impressive group, and I was amazed at how immersed they became in the project. When they presented their final project, they explained ECHO even better than we can!” Andrea said. “I appreciated that commitment, passion, and investment in our project. This team was able to help us reconsider some things and reassure us on others that we are on the right track. I can’t say how valuable it was to have someone from the outside look at your program and say, ‘These are really good moves; these are smart ways to set things up.’ Simply having that affirmation was very helpful to us.”
The Kelley student group put to practice a full year of the Graduate Certificate in Medical Management curriculum. The program is designed as a “mini-MBA” for professionals working in the healthcare industry.
“That was a nice thing about this group—we were able to play to each of our strengths,” said Shar, who’s a business administrator in the Department of Oral & Maxillofacial Surgery & Hospital Dentistry at the IU School of Dentistry. “My strength is analyzing the organizational chart, staffing, and coordinating communication. This graduate program has given me a broader perspective on healthcare and some great ideas to incorporate into my daily work.”
“Working in a group of people with different backgrounds was great,” Becky added. “I work in medical software, not clinical medicine, so learning the different ways of thinking and different approaches in a safe space with no guardrails was great. We were there to find the solution.”
“I thought the experience was amazing. Because we are from different backgrounds and employers, everyone brings something new to the table,” Thora said. “That was another benefit from this experience — you learn from other students as much as from the professors.”
In fact, Thora and Andrea have continued working together since the project. As the grants manager for the Indiana Center for Musculoskeletal Health, Thora has found opportunities for ECHO’s distance-based medical knowledge sharing in her office.
“I’m convinced ECHO is a great way of educating primary care physicians and providing better healthcare. I have been promoting these ECHO programs within the community that I serve,” Thora said. “Andrea’s team is planning a new ECHO for which they needed experts to join. I connected her with a couple of our researchers. It is a great way to stay in touch with Andrea and her team.”
Each year, the program seeks healthcare organizations to work with students on this capstone project. For her part, Andrea says the IUPUI ECHO Center has several potential projects for future student teams.
“We have at least three more challenges we could probably take back to Pam and get their help on phase three or four,” Andrea said. “If you have an idea for your organization where you could use some additional time, expertise, and fresh perspectives, I highly recommend this experience to other partners.”