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How Project ECHO @ Joslin Works

ECHO is a virtual case-based learning network using the ZOOM videoconferencing platform that is easily accessed anywhere across the United States and globally. Project ECHO @ Joslin focuses on diabetes care and aims to remove the barriers that exist between primary care providers and specialists. The Joslin team includes a lead endocrinologist specializing in diabetes care along with one or more experts on various topics related to diabetes management. This is classically referred to as the “hub and spokes” model, where Joslin is the hub and primary clinicians in local communities are the spokes.

ECHO sessions enable primary care providers to treat patients with complex diabetes in their own practices and their own communities.
At each ECHO session, a primary care provider presents a de-identified HIPPA-compliant clinical case from their own practice for discussion.

  • A Clinical Case is presented followed by discussions about providing expert care.
  • Experts mentor and participate in mutual learning with primary care physicians regarding constraints in providing accessible diabetes care.
  • Experts give 10-minute didactic presentations on a general topic that is practical for diabetes care.
  • Cases that have been presented can be followed up in three months during another one of the ECHO rounds.

ECHO sessions have covered…

• ADA guidelines for management of type 2 diabetes
• Weight management in the patient with diabetes
• MNT in patients with diabetes
• Physical activity in the patient with diabetes
• Management of kidney disease in patients with diabetes
• Management of neuropathy in patients with diabetes
• Mental health in patients with diabetes 
• Insulin Initiation
• Updates in the management of type 1 diabetes
• Updates on anti-diabetes medications and cardiovascular outcomes
• Diabetes management in the elderly population
• Newly available insulin analogues, insulin pen demonstration
• Management of ocular complications in patients with diabetes
• Continuous glucose monitors, indications and interpretation of data
• Obtaining coverage for continuous glucose monitoring
• Foot health and disease management in patients with diabetes
• Diabetes burnout
• Introduction to insulin pumps
• Surgical intervention for the treatment of type 2 diabetes
• Atypical presentations of diabetes in the adult
• Diabetes in pregnancy
• Diabetes in adolescents


Page last updated: November 07, 2019