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Telemedicine Project to Help Rural Docs Identify Autism in Young Children

Analysis  |  By Eric Wicklund  
   June 01, 2022

The University of Missouri is partnering with Cognoa on a Project ECHO telemedicine program that will help train rural and remote primary care providers to use digital health technology to diagnose autism spectrum disorder (ASD).

The University of Missouri is launching a telemedicine program aimed at helping rural and remote primary care providers use digital health to diagnose children living with autism.

The university’s ECHO Autism Communities Research Team is partnering with pediatric digital health company Cognoa on the project, which will train remote PCPs on a Project ECHO telemedicine platform to use Cognoa’s Canvas Dx in the diagnosis of autism spectrum disorder (ASD).

“We are excited to incorporate Cognoa’s Canvas Dx within our existing diagnostic model in hopes of expanding primary care physicians’ tools to reliably identify and diagnose children with autism,” Kristin Sohl, MD, executive director of ECHO Autism Communities and a pediatrician who specializes in autism at University of Missouri Health Care, said in a press release. “We are continuously exploring how innovations like Canvas Dx may help streamline the pathway to care, make more efficient use of specialty centers, and drive down wait times in a way that overcomes geographic and socio-economic barriers.”

The project aims to help PCPs who may not have easy access to resources to coordinate and manage care for their patients living with autism, and it may help prove the value of virtual care and digital health tools in treating this population.

And it’s a significant population. Studies estimate as many as one in every four children is at risk for a developmental delay, while one in 44 are affected by ASD. Autism can be diagnosed in children as early as 18 months, yet many aren’t diagnosed until they’re 4 years old. Earlier interventions, especially prior to age 3, can significantly improve lifelong outcomes.

Telehealth advocates say those interventions can be improved by giving primary care providers access to more resources through digital health and telehealth channels, enabling those providers to connect with families in their homes or community health clinics instead of making them drive to a distant clinic or specialist.

The study, conducted by the University of Missouri’s ECHO Autism Communities Research Team, will connect as many as 15 primary care providers in both rural and suburban areas of the state and involve as many as 100 children in their care who are at risk of ASD or developmental delay.

The Project ECHO (Extension for Community Health Outcomes) platform, developed in 2003 at the University of New Mexico, enables experts at a large health system or teaching hospital to mentor and train rural care providers on a specific topic through a hub-and-spoke telemedicine model.

Classified as software-as-a-medical device (SaMD), Canvas Dx uses AI technology to help clinicians identify signs of autism in children between the ages of 18 and 72 months who are at risk of developmental delay. It includes a questionnaire for the parent/caregiver, a separate questionnaire completed by a video analyst who reviews two videos of the child recorded by the parent/caregiver, and an HCP questionnaire completed by the PCP who meets with the child and parent/caregiver, with the data gathered through a telehealth portal.

“We are excited to collaborate with the ECHO Autism team to evaluate how Canvas Dx can support physicians to diagnose or rule out autism in the primary care setting,” Sharief Taraman, MD, Cognoa’s chief medical officer, said in the press release. “The demand for diagnosing children at risk of developmental delay far exceeds the ability of prevalent processes to provide timely diagnosis. ECHO Autism is an exemplary model to increase the capacity of care for children with neurodevelopmental conditions. Through this study, we hope to learn that the combination of Cognoa’s … technology, along with improvements in clinician knowledge, clinical expertise and longitudinal care that is the basis of ECHO Autism, can improve the quality of care for children and families.”

Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, and Pharma for HealthLeaders.

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