The LIFT-ECHO Last Mile Project
Improving Outcomes in Chronic Intestinal Failure Using the ECHO Model: The LIFT-ECHO Last Mile Project
1 other identifier
interventional
150
2 countries
5
Brief Summary
This is a multi-site research study to evaluate the efficacy and effectiveness of the LIFT-ECHO program to improve clinical outcomes in patients and improve patient reported quality of life (PRQOL). LIFT-ECHO (Learn Intestinal Failure Tele-ECHO) is a tele-health learning program whereby non-specialist clinicians meet with and learn from CIF specialist teams with the goal of improving the knowledge of CIF. LIFT-ECHO sessions consist of group discussion of anonymized real-world patient cases, followed by a didactic presentation from an expert in intestinal failure. Sessions are held twice a month and last 60-90 minutes. The study will proceed in three distinct phases, correlating with Project Aims. During phase 1 (Aim 1), an intestinal failure disease activity index (IF-DAI) will be developed as a measure of short- to medium-term clinical activity in CIF patients; this phase will be undertaken through Delphi Rounds. During Phase 2 (corresponding to project Aim 2), the researchers will evaluate the impact of physician participation in LIFT-ECHO on patients with CIF on PN. Lastly, Phase 3, corresponding to Aim 3 will be the dissemination of LIFT-ECHO nationally. For Phase 2, the researchers had originally proposed that patients and physicians will be recruited from the records of Optum Home Infusion services. Patient reported quality of life and clinical status will be assessed using surveys at baseline. Physicians will then be invited to participate in a module of LIFT-ECHO consisting of 8 one- hour-long sessions held over the course of 2-4 months. Patients will then be followed for 12 months to assess if physician participation in LIFT-ECHO improves patient reported quality of life and/or treatment efficacy and effectiveness. The main procedures for physician participants in the study include: completion of baseline and monthly surveys, possible participation in an appreciative inquiry workshop and possible participation in a focus group discussion, optional, but encouraged, participation in LIFT-ECHO. The main procedures for patient participants include: completion of surveys at baseline, participation in 12 monthly follow-up phone calls with a study team member. The proposed trial has a total length of 34 months.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jul 2026
Longer than P75 for not_applicable
5 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
July 23, 2025
CompletedFirst Posted
Study publicly available on registry
July 30, 2025
CompletedStudy Start
First participant enrolled
July 1, 2026
ExpectedPrimary Completion
Last participant's last visit for primary outcome
June 30, 2030
Study Completion
Last participant's last visit for all outcomes
June 30, 2030
March 12, 2026
March 1, 2026
4 years
July 23, 2025
March 10, 2026
Conditions
Outcome Measures
Primary Outcomes (1)
Patient-Reported Quality of Life (PRQOL) Score
Patient-reported quality of life will be measured using the HPN-PROQ, a validated instrument designed for individuals receiving home parenteral nutrition (HPN). The total score ranges from 0 to 100, with higher scores indicating better quality of life. Subscales include physical health, emotional well-being, social functioning, and treatment burden, each also scored from 0 to 100, where higher scores indicate more favorable outcomes
Baseline, 6 months, and 12 months
Secondary Outcomes (11)
Intestinal Failure Disease Activity Index (IF-DAI) Score
Baseline through 12 months
Number of physicians recruited
Baseline through 12 months
Proportion of total physicians who completed at least 4 ECHO sessions
Baseline through 12 months
Attendance number at ECHO sessions
Baseline through 12 months
Number of ECHO sessions completed
Baseline through 12 months
- +6 more secondary outcomes
Study Arms (2)
Physicians with No Tele-Mentoring then with Tele-Mentoring
ACTIVE COMPARATORDyads consisting of a prescribing physician and one or more of their patients receiving parenteral nutrition (PN). Physicians in this arm will be invited to participate but would not yet have received the Tele-Mentoring (LIFT-ECHO) focused on the management of chronic intestinal failure. Patients of these physicians will be followed for a baseline period of 6 months (Control period) to assess evolution in clinical outcomes and patient-reported quality of life.
Physicians with Tele-Mentoring after No Tele-Mentoring
EXPERIMENTALDyads consisting of a prescribing physician and one or more of their patients receiving parenteral nutrition (PN). Physicians in this arm will participate in the LIFT-ECHO program. After patients complete a baseline period of 6 months (Control period), their physician receives the intervention (LIFT-ECHO).
Interventions
LIFT-ECHO (Learn Intestinal Failure Tele-ECHO) is a virtual tele-education program designed to improve the knowledge and clinical decision-making of non-specialist clinicians managing patients with chronic intestinal failure (CIF) on parenteral nutrition (PN). The intervention consists of eight 60-90-minute sessions delivered over 2-4 months. Each session includes the presentation of anonymized real-world CIF cases and a didactic lecture by an expert in intestinal rehabilitation. Participating physicians may also complete baseline and follow-up surveys, and optionally participate in focus groups or appreciative inquiry workshops.
Participants will receive routine clinical care for chronic intestinal failure from their usual providers. No additional educational programming or intervention is delivered during this period.
Eligibility Criteria
You may qualify if:
- CIF patient participants must meet the following criteria in order to be considered eligible for participation:
- Individuals of adult age (18 years or older), including pregnant women or Individuals of age \> 5 years with parental consent and patient assent.
- Diagnosis of chronic intestinal failure (ie. on PN \>6 months with no malignancy, no HIV and a malabsorption or post-surgical diagnosis)
- Currently receiving PN from a homecare infusion service company
- Physician participants must meet the following criteria in order to be considered eligible for participation:
- Individuals of adult age (18 years or older), including pregnant women
- Hold an MD or DO degree
- Be a licensed physician prescriber with a homecare infusion service company
You may not qualify if:
- Participants meeting one or more of the following criteria will be excluded from participation:
- Adults unable to consent (individuals with impaired decision-making capacity)
- Prisoners
- Children \> 5 years who dissent
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Icahn School of Medicine at Mount Sinailead
- Rhode Island Hospitalcollaborator
- The New York Academy of Medicinecollaborator
- University of Utahcollaborator
- London School of Economics and Political Sciencecollaborator
Study Sites (5)
Icahn School of Medicine at Mount Sinai
New York, New York, 10029, United States
New York Academy of Medicine (NYAM)
New York, New York, 10029, United States
Rhode Island Hospital
Providence, Rhode Island, 02903, United States
University of Utah
Salt Lake City, Utah, 84112, United States
London School of Economics and Political Science
London, WC2A 2AE, United Kingdom
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Kishore Iyer, MD
Icahn School of Medicine at Mount Sinai
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- CROSSOVER
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Professor of Surgery, Pediatrics & Global Health
Study Record Dates
First Submitted
July 23, 2025
First Posted
July 30, 2025
Study Start (Estimated)
July 1, 2026
Primary Completion (Estimated)
June 30, 2030
Study Completion (Estimated)
June 30, 2030
Last Updated
March 12, 2026
Record last verified: 2026-03
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ICF
- Time Frame
- Beginning 9 months and ending 36 months following article publication.
- Access Criteria
- Researchers who provide a methodologically sound proposal. To achieve aims in the approved proposal. Specify Other Mechanism Proposals should be submitted to marjorie.nisenholtz@mountsinai.org. All requests will be reviewed for methodological soundness and alignment with original consent and privacy protections. Approved users will be required to sign a Data Use Agreement. Data will be hosted on a secure institutional repository for a minimum of 5 years following publication.
Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices).