A Novel Approach to Build Virtual Communities of Practice for Health Care Capacity Building in Military Health...

The HIV/AIDS epidemic poses significant risks to military personnel, impacting operational readiness. For over 2 decades, the U.S. DoD HIV/AIDS Prevention Program (DHAPP) has partnered with international militaries to develop prevention and treatment programs. Military health systems, often in remote areas, face challenges in accessing and implementing updated guidelines, leading to suboptimal care. To address this, DHAPP adopted Project ECHO (Extension for Community Healthcare Outcomes) to establish virtual communities of practice (VCoPs), enhancing health care capacity. DoD HIV/AIDS Prevention Program supports 18 military-led ECHO programs in Africa and Central America, improving HIV care outcomes through innovative learning models.

Local military leaders lead VCoPs using the ECHO model, with DHAPP providing support in strategic planning, implementation materials, curriculum development, and logistical guidance. Sites are strategically selected by local military health services based on their ability to enhance provider expertise through virtual clinics featuring didactics, mentorship, and consultative feedback. The model disseminates updated policies and guidelines to health care workers, including those in remote or deployed areas, and promotes standardized care.

Between 2020 and 2024, 39 countries were approached to initiate ECHO programs, with 18 launching hubs in a median of 13.5 months. By November 2024, 727 sessions engaged 2,717 participants. Surveys conducted highlighted improved HIV care, policy implementation, and outcomes like reduced referral times and TB-related mortality. Respondents noted sustainable knowledge transfer, professional networks, and clinical advancements. Challenges included funding, infrastructure, and connectivity. In-person meetings in 2023 to 2024 strengthened the network, refined evaluations, and expanded ECHO's focus to broader health priorities, increasing its impact in different military contexts.

Using Project ECHO's VCoP model, military organizations have built self-sustaining health teams and increased access to quality care. Key success factors include country ownership, tailored mentorship, and structured curricula. This scalable and cost-effective approach empowers providers to manage complex diseases, overcoming barriers of distance, resources, and expertise.