# Improving Outcomes in Chronic Intestinal Failure Using the ECHO Model: The LIFT-ECHO Last Mile Project

> **NIH AHRQ R18** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2024 · $396,365

## Abstract

Chronic intestinal failure (CIF) is a devastating condition where individuals are unable to eat and
drink enough to meet basic survival needs. Patients with CIF are dependent on parenteral
nutrition (PN) delivered intravenously by a pump via an indwelling central venous catheter.
While PN is lifesaving, life-threatening complications can cause considerable morbidity, impair
quality of life (QOL) and carry significant mortality risk. Care of patients with CIF is very complex
and best delivered by experienced multi-disciplinary teams working in intestinal rehabilitation
programs (IRP). Our recent work has shown a critical lack of expertise in CIF among US
gastroenterologists and over half the states in the US do not have IRP. This lack of widely
available expertise results in significant healthcare disparities for patients with CIF. Our recent
work has shown that use of technology to disseminate knowledge through the LIFT-ECHO
Project, based on the well-established ECHO Model can fill a critical gap in CIF care.
Application of LIFT-ECHO to improve CIF patient care requires a systematic
dissemination and evaluation approach, engaging multiple key stakeholders. We will test
the hypothesis that clinical outcomes in patients with CIF will improve by providing virtual multi-
D support to non-expert physicians through an online learning model, the LIFT-ECHO Project.
Through intensive stakeholder engagement, we can disseminate and establish LIFT-ECHO to
improve clinical outcomes in CIF nationally.
AIM 1: To develop and validate an intestinal failure disease activity index (IF-DAI) that assesses
current clinical status in CIF patients and is sensitive to short-term and medium-term changes.
AIM 2: To demonstrate improved clinical outcomes and CIF/PN specific patient-reported quality
of life (PRQOL) in CIF patients by providing virtual multi-disciplinary support to their physicians
through LIFT-ECHO.
AIM 3: (a) We will undertake a pragmatic formative process evaluation of LIFT-ECHO in its
current state. (b) To disseminate process evaluation results of LIFT-ECHO nationally and
evaluate dissemination effectiveness.
Our study is the first application of the ECHO Model™ to a rare disease like CIF – our
dissemination strategy will provide a comprehensive evaluation framework and a toolkit
for assessment of ECHO™ implementation in the context of a rare disease.
Our application targets the SEN: NOT-HS-21-014 to develop and implement LIFT-ECHO to
address the disparities in access to expert care for patients with a chronic disease.

## Key facts

- **NIH application ID:** 10909924
- **Project number:** 5R18HS029126-02
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Kishore R Iyer
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $396,365
- **Award type:** 5
- **Project period:** 2023-09-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10909924

## Citation

> US National Institutes of Health, RePORTER application 10909924, Improving Outcomes in Chronic Intestinal Failure Using the ECHO Model: The LIFT-ECHO Last Mile Project (5R18HS029126-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10909924. Licensed CC0.

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