Show-Me ECHO Empowers Rural Physicians to Treat Hepatitis C, Other Chronic Conditions

Telehealth Webinar

According to the Missouri Department of Health and Senior Services, hepatitis C is on the rise in Missouri, and it is also being diagnosed earlier in younger individuals. Show-Me ECHO, a new telehealth training initiative from the University of Missouri School of Medicine, empowers physicians in rural parts of the state to treat the increasingly common condition.

Approximately 7,200 new cases of hepatitis C were identified in Missouri in 2015, an increase of nearly 1,700 cases from 2014. Funded by the Missouri legislature, Show-Me ECHO — which stands for Extension for Community Healthcare Outcomes — allows a team of experts to use videoconferencing technology to train providers throughout the state to identify and treat chronic conditions such as hepatitis C.

“Missouri mirrors national statistics that show an increase in both acute and chronic hepatitis C infections,” said Ashraf Almashhrawi, MD, an assistant professor in the Division of Gastroenterology and Hepatology at the MU School of Medicine and Show-Me ECHO panel expert. “While hepatitis C may seem like an intimidating condition to treat, we want to make primary care providers aware of resources available to help them care for their patients. Through Show-Me ECHO, we’re empowering physicians to recognize the symptoms of hepatitis C and to manage the condition or provide resources for specialized treatment if necessary.”

Hepatitis C is an inflammation of the liver caused by a blood-borne virus that can be deadly if left untreated. Infection is most commonly caused by the sharing of needles used to inject drugs. Approximately 70 to 80 percent of people with acute hepatitis C don’t show symptoms; however, some people experience mild to severe symptoms within two weeks to six months of infection. These symptoms can include jaundice, abdominal pain, fatigue, loss of appetite and unexplained weight loss, nausea and vomiting, a low-grade fever and more.

“It’s important to note that hepatitis C is a curable condition, and new medications are more effective, easier to use and have fewer side effects than previous drugs,” Almashhrawi said. “Through Show-Me ECHO, specialists serve as mentors and colleagues, sharing their medical knowledge and expertise with primary care providers. As a result, these providers are equipped to provide comprehensive, best-practice care to their patients with complex health conditions — right where they live.”

Participating providers present a patient case — in a de-identified format to protect patient privacy — to the expert panel for discussion. The specialists help the providers better understand the condition and make them aware of resources to aid in diagnosis and treatment. Web-based video technology is available to all participants at no cost. Participants need to have a device with a camera and a microphone and a robust Internet connection.

“Hepatitis C is unfortunately a common condition, but it’s one that can be effectively treated — if patients and doctors are aware,” said Bruce Burkett, executive director of the Missouri Hepatitis C Alliance, a Columbia-based nonprofit organization dedicated to creating awareness through education. “Using the Show-Me ECHO model, more doctors can be trained and educated, and ultimately the health of more patients and communities can be improved.”

In addition to offering training opportunities and resources for the treatment of hepatitis C, Show-Me ECHO offers clinics for asthma, autism, chronic pain management, dermatology and endocrinology. To learn about the common myths about hepatitis C treatment, download our infographic. For more information on Show-Me ECHO and how to participate, please visit