[Congressional Record Volume 162, Number 170 (Tuesday, November 29, 2016)]
[Senate]
[Pages S6524-S6525]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               ECHO BILL

  Mr. HATCH. Mr. President, today, the Senate is voting on S. 2873, the 
ECHO Act. In April, Senator Schatz and I introduced this bill to 
highlight the impressive work of technology-enabled collaborative 
learning and capacity-building models.
  One such model that has brought promising new ideas to our Nation's 
healthcare delivery system is Project ECHO, which started in New Mexico 
and quickly expanded to Utah. Today, Project ECHO is thriving in more 
than 30 States.
  Our bill draws on the success of Project ECHO to improve health 
services on a national scale. Our proposal is not political; rather, it 
is the culmination of a broad bipartisan effort to bring about 
meaningful healthcare reform that will benefit families across the 
country in red States and blue States alike.
  Our legislation improves medical services for all Americans by 
providing healthcare professionals in rural and underserved communities 
with access to a network of peers and specialists who can teach 
specialty care. By connecting doctors and nurses with teams of experts, 
patients can receive the care they need when they need it. Most 
importantly, patients will not have to travel long distances to receive 
treatments; they can stay close to home and receive treatment from 
doctors they know and trust.
  In today's bustling healthcare environment, policymakers often forget 
that healthcare delivery works differently in urban and rural settings. 
To bridge the urban-rural divide, the ECHO Act brings expertise to 
providers serving rural populations by enabling them to gain the skills 
they need to care for people living in their communities. Through this 
exchange, urban providers in return can learn how rural health is 
operationalized in real time. Ultimately, our proposal prioritizes 
rural health needs and reconciles differences in care delivery for 
diverse populations.
  Today, I am grateful that a majority of my colleagues have agreed to 
support this forward-thinking, commonsense legislation. Like the 21st 
Century Cures bill, our proposal demonstrates our common commitment to 
improving health care for all patients.
  Telehealth is a topic of particular interest in my home State of 
Utah. Under the existing Project ECHO programs, medical experts based 
at the University of Utah use videoconferencing to train healthcare 
professionals who are hundreds, sometimes even thousands, of miles 
away. As we work to improve telehealth, models like those in the ECHO 
Act will enable telementorship and provider education to occur via 
avenues more tailored to health professionals' needs. This 
customization is an essential step to achieving person-centered health 
care.
  As a body, we must be dedicated to improving health services for all 
Americans, no matter where they live. Through this bill, we are making 
significant progress toward achieving that goal. Using groundbreaking 
new technologies, the ECHO Act will enable us to take better care of 
our family members, neighbors, and friends. By putting communication 
front and center, Project ECHO will allow health professionals to share 
innovations and new discoveries in an efficient, timely manner.
  Before turning the floor over to my esteemed colleague from Hawaii, 
whose collaboration on this proposal has proven invaluable, I first 
wish to share how our legislation came to be. Several months ago, 
doctors at the University of Utah--including Dr. Terry Box and Dr. 
Vivian Lee, as well as some of the most renowned disease experts in the 
country--reached out to me to demonstrate how Project ECHO was 
benefiting families across Utah and the Intermountain Region. Their 
innovative approach to telehealth piqued my interest. As it turns out, 
Senator Schatz had a very similar experience with his own constituents. 
After discussing our shared experiences, we joined forces to draft a 
bill that would allow Americans in rural counties access across the 
country to reap the benefits of telehealth.
  The founder of Project ECHO, Dr. Sanjeev Arora, was an instrumental 
partner throughout this process. He worked with us to share ideas from 
ECHO hubs across the country, allowing us to incorporate a broad array 
of viewpoints. With his help, we were able to hear from countless 
stakeholders and medical professionals who understood the potential of 
our legislation. We also worked alongside the leadership of the Health, 
Education, Labor, and Pensions Committee. With the assistance of 
Senators Alexander and Murray, as well as the majority and minority 
leaders, we were able to shepherd this legislation through the 
committee process and bring it to the Senate floor.
  This bill was born fresh, from a bottom-up approach, which enabled us 
to solicit ideas and opinions from numerous healthcare professionals 
across the country. Thanks to their input and the support of Members on 
both sides of the aisle, we are poised to pass legislation that will 
dramatically improve the quality of our Nation's health care.
  I wish to thank all those who assisted in this bipartisan effort. 
Today is a victory for everyone involved. I appreciate the efforts of 
Senator Schatz.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Hawaii.
  Mr. SCHATZ. Mr. President, I thank the President pro tempore, the 
Senator from Utah, Mr. Hatch, for his leadership on this and many other 
issues.

[[Page S6525]]

  Healthcare policy can be a particularly vexing area for those of us 
who like to get things done because over the last 8 years we have 
mostly just been at each other's throats, arguing about the Affordable 
Care Act. But we are here to talk about a bright spot--something we are 
not arguing about--which can reduce costs and improve outcomes. 
Telehealth is the future of health care. It harnesses technology to 
provide patients with high-quality care, whenever and wherever they 
need it. That is why we need to update Medicare to take advantage of 
these new technologies in telemedicine and remote patient monitoring. 
That is why I and 18 other Senators from both parties have introduced 
and cosponsored the CONNECT for Health Act.
  I thank Senator Hatch for his support in including provisions from 
our bill in the Senate Finance Committee's chronic care package.
  Telehealth will improve the delivery of care to patients, but it will 
also support providers by giving doctors and nurses the tools to work 
with and learn from each other. Simply put, a lot of medical education 
is financially or geographically out of reach for providers on the 
frontlines, but we can fix that using technology. It is called Project 
ECHO, and that is what we are about to vote on. Based at the University 
of New Mexico and with the strong support of Senators Heinrich and 
Udall, Project ECHO has already had a positive impact across the Nation 
on patients, providers, and communities.

  How does it work? Imagine a VTC--video teleconference--with 15 people 
on the screen. Participants assemble online 2 hours every week for 6 
weeks to learn about a selected disease condition--for example, 
depression. The leader of the VTC is a specialist physician from an 
academic medical center with a team which would include, for example, a 
psychologist, a pharmacist, and a social worker. Throughout the 6 
weeks, the session time is divided between lessons, case presentations, 
and discussions. Providers from across the country can learn the latest 
best practices and develop a network of colleagues to share information 
and help with the hard questions. This is a game changer. This is the 
kind of ongoing training for folks in rural areas that has not been 
available until now.
  Project ECHO has already been used for infectious disease outbreaks 
and public health emergencies, such as H1N1 and Zika; chronic diseases, 
such as hepatitis C and diabetes; and mental health conditions, such as 
anxiety and schizophrenia.
  The results are impressive. Patients in rural or underserved areas 
now have more access to better trained doctors in their own 
communities, which decreases costs and improves outcomes. Providers 
feel less isolated and more connected to a network of high-quality 
providers across their State. As a result, they are more likely to stay 
in underserved areas where they are needed the most. The health system 
runs more efficiently and effectively. Providers have the training to 
see and treat more patients.
  We still have many questions about this model, which is new, but 
among them: What are the best successors? What are the barriers to 
adoption? For which conditions is it best suited? The ECHO Act, as 
amended, will direct HHS to study this model and give us the answers we 
need to make decisions at the Federal level about how to best support 
expanding it nationally.
  One final note of thanks. It is not a coincidence that several of the 
successful health care-related efforts this year have been a result of 
collaboration with and leadership of Senator Hatch. His bipartisan 
spirit, his pragmatism, and his understanding of the legislative 
process make working with him and his staff a true pleasure.
  I encourage my colleagues to continue to join us in supporting this 
revolutionary health care model.

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