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The key components of Project ECHO are: Use technology to leverage and share scarce specialist knowledge through knowledge networks Create best practice protocols for treating complex diseases and then share the protocols with primary care clinicians Specialists in academic centers mentor physicians in rural areas using the same case-based learning these doctors learned in medical school through videoconferences, groups of rural physicians hold “virtual rounds” in which they present cases and collaborate with academic and rural colleagues to identify the best course of treatment these sessions build communities of practice and facilitate knowledge sharing, thereby spreading expertise across the state Use the internet to track outcomes in order to have the metrics necessary to establish ROI on the program Knowledge sharing + mentoring + technology act together as a “force multiplier” for the delivery of high-quality services