S971 Shifting the Center of Gravity in EoE Care: Advancing Community Clinician Preparedness for Biologic Integration Through Innovative ECHO-Based Learning

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Introduction: Eosinophilic esophagitis (EoE) is a chronic, progressive disease requiring nuanced management beyond standard of care interventions. With the availability of biologic therapies, providers face increasingly complex management decisions. This Project ECHO initiative aimed to build competency in gastroenterologists, specialty advanced practice providers, and other healthcare professionals involved in the care of people with EoE through case-based learning and collaborative dialogue. Methods: From January-April 2025, 4 live, interactive sessions engaged learners with a multidisciplinary faculty in learner-directed, case-based discussions. Each featured a brief didactic segment, facilitated case presentation and Q and A with specialists in gastroenterology, emergency medicine, pediatrics, allergy, family medicine, and a patient with EoE. By highlighting real-world challenges in care, community-based professionals received guidance enabling a rapid enhancement of their practice. A comprehensive on-demand activity, launched in November 2024, served as a reference for ECHO participants and expanded the initiative to a national audience. Transcripts were analyzed thematically to identify patterns in learning and inquiry. Outcomes were assessed through pre/post-activity surveys and intent-to-change metrics. Results: A total of 1,655 learners participated (188 in live sessions; 1,467 on-demand). Qualitative data from the ECHO revealed significant value and cross-disciplinary learning. Across sessions, 15+ distinct biologic-related questions emerged, such as optimal timing to initiate biologics in pediatric vs adult patients and comparing biologics to proton pump inhibitors (PPIs)/diet in long-term remission and safety. The ECHO also demonstrated impact on clinical decision-making: post-session evaluations showed gains of 16-33 percentage points in skills related to biologic therapy selection for pediatric and young adult patients and in the understanding of PPI limitations. Conclusion: This program highlights the value of multiformat educational design. As the enduring content achieved scale, ECHO’s peer-driven format provided opportunities for deeper inquiry and problem-solving, surfacing critical clinical ambiguities—how to personalize treatment, how to manage comorbid atopy—that highlighted community voices as integral to evolving best practices. This example of combining scale and depth to meet learner needs may serve as a model to benefit future educational design in evolving therapeutic areas.

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