Friday 15 August 2025 | 10:50-12:20 

Format: Presentation

Stream: Populations

Part 1: Building The Learning Community of ECHO-Pediatrics Through Telehealth in Vietnam

The Project Extension for Community Healthcare Outcomes (ECHO) model is considered a platform for academic medical centers to expand their healthcare workforce capacity to medically underserved populations. It has been known as an effective solution of continuing medical education (CME) for healthcare workers that used a hub-and-spoke model to leverage knowledge from specialists to primary healthcare providers in different regions. The ECHO model was born in 2003 by Prof. Sanjeev Arora at the University of New Mexico, USA, in response to the hepatitis C epidemic with 28,000 people infected in remote areas in New Mexico. Since then, the model has been replicated across 195 countries, 6 continents with 1000 hubs and 33 superhubs, and is committed to the United Nations (UN), World Health Organization (WHO), countries in Asia, Africa, Latin America in responding to epidemics and chronic diseases such as HIV, Ebola, Covid-19, Cancer, Tuberculosis, Hepatitis C, Epilepsy, Autism, Geriatrics.

In 2019, the National Children’s Hospital became an ECHO hub, in 2022 became a superhub, sharing the same mission and vision with ECHO in the community with the holistic health care strategy, creating equity in children’s health care in the regions, especially remote areas. 

Nhung Le Vietnam National Children’s Hospital; Vietnam

Part 2: How Can We Facilitate Co-Creation of Care Plans for Patients Living With Type 2 Diabetes at System Level

Wagner’s Chronic Care Model has been adopted by many health systems as a framework to optimize care for patients living with chronic disease. Productive interactions between an informed, empowered patient (one who plays an active role in their care) and a prepared, proactive team of healthcare providers lie at the heart of the model. The model identifies multiple elements that can be modified to facilitate these interactions. However, resource constraints and pressures in the healthcare system often lead to interactions which fail to achieve the goal of having healthcare providers work with the patient to jointly identify problems, set goals, establish priorities, and develop an action plan and strategy for solving the problems that have been identified. To address this, the NUHS, in collaboration with the Year of Care Partnerships in the United Kingdom, has implemented and evaluated a system of person centered care and support planning which is now being scaled across our primary care system. Delegates may wish to attend this session if they are interested in building systems that facilitate patient involvement in co-designing their care journey, the outcomes of associated with implementing these systems, and the lessons from over the past decade from a system that may inform system level implementation based on a decade of experience.

Tai E Shyong National University of Singapore; Singapore

Part 3: COMBED: COMmunity BasED Intervention to Empower and Effect Positive Behavioural Change in Patients with Diabetes Mellitus

An exploratory pilot helmed by multi-disciplinary community partners to identify patients who are not followed up with a primary care provider for DM management, to be engaged for a personalised care planning, which includes behavioural change towards being cared for by a General Practitioner of their choice. Harnessing on currently available care partners, the personalised psychosocial support and health coaching offered to our identified patients have shared useful insights on:

• Sharing of experiences and challenges in identifying the appropriate patient group who will benefit from this pilot.


• Strategies adopted to overcome these challenges.


• Putting in place a programme that addresses the psychosocial and clinical needs of the DM patients.


• The tools for measuring and evaluation Proposed for future directions for community-based diabetes care.


• This session offers valuable insights for both clinical and administrative healthcare professionals.

Chee Wei Tan Changi General Hospital; Singapore