Penn State's Project ECHO, Dominican Republic partner to improve disease care

HERSHEY, Pa. — Across the Dominican Republic, primary care clinicians serve as the first line of defense against a rising tide of chronic illnesses, including diabetes, hypertension and kidney disease. However, many of these healthcare providers work in community clinics far from urban medical centers. When a patient has a complex condition, these frontline doctors must often manage patient care without easy access to medical specialists.

To help bridge this gap in access and expertise, Project ECHO at Penn State has partnered with the Dominican Republic’s Ministry of Public Health and Social Assistance (MISPAS). Together, they have launched a new 14-session telementoring program: “Comprehensive Care at the Primary Care Level: Prevention and Management of Cardiometabolic and Renal Diseases.” It launched this past November, coinciding with World Diabetes Month.

The monthly series brings together approximately 75 primary care clinicians from across the Dominican Republic’s public health system and connects them virtually with a network of specialized medical experts in the United States. Each session provides practical tools to prevent and manage chronic conditions, with a special emphasis on patient-centered care and older adults.

Learning through connection

Led by Ariana Pichardo-Lowden, professor of medicine in the Division of Endocrinology and Diabetes at Penn State College of Medicine, the series uses an active, case-based approach.

Rather than traditional lectures, the program relies on a collective learning. Each session features a real-life patient case presented by a clinician from the audience. This is followed by an interactive discussion among the participants, guidance from the expert faculty and a question-and-answer segment.

According to Pichardo-Lowden, this collaborative style reflects the heart of the ECHO model: "All Teach, All Learn." Knowledge is shared through telementoring, allowing clinicians to build new skills, improve their competence and form lasting professional connections.

“This partnership is about building a connected network of care that shares knowledge across borders and improves lives,” Pichardo-Lowden said. “Through these collaborative sessions, we are showing how expertise and teamwork can empower primary care clinicians to make a lasting difference in their communities.”

A two-way street for medical experts

The program features a unique and highly dedicated interdisciplinary faculty, Pichardo-Lowden said. These specialists — who bring expertise in endocrinology, cardiology, nephrology, neurology, geriatrics, psychology, nutrition, and personal and professional wellness — are all clinicians who graduated from medical school in the Dominican Republic and now practice throughout the United States.

Dominican healthcare professionals working internationally offer practical tips adapted to the daily realities of the Dominican medical system. Session topics range from managing Type 2 diabetes and early recognition of stroke to basic ECG interpretation and nutritional care.

However, Pichardo-Lowden said, learning is not a one-way street.

"These U.S.-based faculty members are gaining valuable knowledge about the barriers and enablers of global medical practice," Pichardo-Lowden said. "By understanding these unique challenges, the faculty can bring new, diverse perspectives back to their own clinical and educational environments in the U.S."

Global goals, local impact

The educational content of the series is guided by the HEARTS in the Americas Initiative, a program by the Pan American Health Organization and the World Health Organization.

By strengthening primary care and promoting the prevention of noncommunicable diseases, the ECHO program directly aligns with the Dominican National Strategic Plan 2030, which aims to improve health for all communities. The presidency of the Dominican Republic and MISPAS have officially endorsed the HEARTS initiative as the foundation for strengthening healthcare nationwide.

"Ultimately, this partnership is about more than just education," Pichardo-Lowden said. "By bringing together local primary care doctors and global specialists, Project ECHO at Penn State and the Dominican Health Ministry are proving that when teamwork meets expertise, clinicians are empowered to improve health outcomes, one patient at a time."