Building Primary Care Capacity in Dementia Care Using Project ECHO

Project start: 9/01/2022

More than six million people live with Alzheimer’s disease and related dementias (ADRD) in the United States, a number that is rapidly growing. Primary care providers are gatekeepers to patients with suspected ADRD, yet as many as 66% of patients in primary care are not diagnosed in the early stages of the disease. Primary care physicians report a lack of familiarity with evaluation tools, issues of time, difficulty accessing specialists, reimbursement, difficulty connecting with service agencies, and lack of confidence managing patient and family preferences as major barriers. Building primary care workforce capacity will better handle rising number of patients with ADRD.

The Alzheimer’s and Dementia Care-ECHO (Extension for Community Healthcare Outcomes) (AD-ECHO) program is a certified Project ECHO training program developed as a collaboration between UCSF and the Alzheimer’s Association. Project ECHO is a nationally renowned model of specialty care in rural, low-income, and underinsured areas of the United States involving a hub-and-spoke model of education and consultation. AD-ECHO recruitment targets primary care practices serving vulnerable populations, and enables primary care teams (physicians, nurse practitioners, social workers, physical therapists) to provide dementia expertise within their practice settings upon completion of the program.

This project will assess the primary care workforce implications of AD-ECHO, a telehealth learning model that involves primary care teams and interdisciplinary dementia experts. We will conduct surveys, qualitative interviews, and direct observations to assess primary care workforce knowledge and training gaps, as well as the impact of AD-ECHO on dementia care capacity and workforce development.


Key Questions

This project aims to answer three questions:

  • What are the major challenges, knowledge gaps, and training needs primary care providers identify during AD-ECHO sessions that represent barriers to providing quality dementia care?
  • How does participation in AD-ECHO affect primary care provider confidence and practices providing dementia assessment and care?
  • What are specific examples of the impact of participating in AD-ECHO on the primary care workforce (domains of focus include: improvements in quality of care, building supply of primary care providers knowledgeable in ADRD diagnosis and care, and increasing access to ADRD care)?


For more information, contact Joanne Spetz or Alissa Bernstein Sideman.