A review of pediatric dermatology Extension for Community Healthcare Outcomes programs: Educational, diagnostic, and implementation outcomes

Pediatric skin conditions are a common reason for primary care visits, yet access to general dermatologists and pediatric dermatologists remains limited, particularly in rural areas. Primary care providers often manage these conditions with minimal formal dermatology training, which can result in diagnostic and treatment challenges. The Extension for Community Healthcare Outcomes (ECHO) model offers a telementoring framework that combines didactic learning with case-based discussions to improve provider knowledge and clinical decision-making. Seven peer-reviewed studies evaluating pediatric and general dermatology ECHO programs have been identified that include retrospective cohort studies, program evaluations using strengths, weaknesses, opportunities, and threats analysis, a prospective educational intervention, and a descriptive case report. While program structures varied, results consistently demonstrated improvements in provider confidence, diagnostic accuracy, and ability to develop more effective treatment plans. Diagnostic concordance between primary care providers and dermatology experts ranged from 40% to 54%, with the lowest agreement on treatment plans. Participants reported high satisfaction, and several programs demonstrated increased attendance over time. Pediatric dermatology ECHO programs represent a promising and scalable strategy to improve dermatologic care for children in underserved settings. Continued development of pediatric-focused curricula, sustainable delivery models, and strategies to better assess outcomes will be critical to realizing Project ECHO’s full potential.