The mission at ECHO (Extension for Health Outcomes) is to democratize knowledge and get best practice care to the underserved, including the incarcerated. Corrections administrators are challenged with limited health care resources, high rates of infectious diseases including hepatitis C, and the epidemic of opioid addiction. ECHO is an ideal model to improve health care and provide education for medical staff and the incarcerated. The model allows for rapid learning and best-practice dissemination.