Establishing Performance Indicators of Telemedicine-Based "On-Consultation Training" of Primary Care Doctors: An Innovation to Integrate Psychiatry at Primary Care.

On-consultation training primary care doctors primary health centres psychiatry telemedicine

Journal

Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
ISSN: 0970-0218
Titre abrégé: Indian J Community Med
Pays: India
ID NLM: 9315574

Informations de publication

Date de publication:
Historique:
received: 10 04 2020
accepted: 30 11 2020
entrez: 26 5 2021
pubmed: 27 5 2021
medline: 27 5 2021
Statut: ppublish

Résumé

A "functional treatment gap" exists in primary care of India despite the higher prevalence of psychiatric disorders at primary care. Traditional classroom training for primary care doctors (PCDs) fails to translate into adequate clinical skills to provide basic psychiatric treatment. An innovative telepsychiatric on-consultation training (Tele-OCT) is designed exclusively for practicing PCDs where a telepsychiatrist trains PCDs in live video streaming of their own real-time general consultations of primary health centres. The aim of this study is to establish performance indicators of Tele-OCT for its effective implementation. The data collected using a file review method from a naturalistic design of the implementation of Tele-OCT for 73 PCDs from August-2016 to October-2018 across Mandya district, Karnataka, India. Flexibility in the scheduling of Tele-OCT sessions is key to success. Personal smartphones of PCDs with available videoconference applications are the popular choice. Four consecutive Tele-OCT sessions are planned for each PCD with a gap of 2-4 weeks over two months. The first three sessions are considered the "optimum Tele-OCT training package" for each PCD, followed by the fourth one as a 'Tele-OCT impact evaluation session' in a live, real-time general consultation. Each Tele-OCT is conducted in an average ten general patients in about two hours per session, totalling about 30 patients in 6 hours of Tele-OCT training package per PCD. Patient's profiles especially common mental disorders are reflective of a true picture of Indian primary care. Performance indicators of Tele-OCT for future implementation are established. Tele-OCT appears to be a path-breaking training model for PCDs to integrate psychiatric care in their general practice.

Sections du résumé

BACKGROUND BACKGROUND
A "functional treatment gap" exists in primary care of India despite the higher prevalence of psychiatric disorders at primary care. Traditional classroom training for primary care doctors (PCDs) fails to translate into adequate clinical skills to provide basic psychiatric treatment. An innovative telepsychiatric on-consultation training (Tele-OCT) is designed exclusively for practicing PCDs where a telepsychiatrist trains PCDs in live video streaming of their own real-time general consultations of primary health centres. The aim of this study is to establish performance indicators of Tele-OCT for its effective implementation.
METHODOLOGY METHODS
The data collected using a file review method from a naturalistic design of the implementation of Tele-OCT for 73 PCDs from August-2016 to October-2018 across Mandya district, Karnataka, India.
RESULTS RESULTS
Flexibility in the scheduling of Tele-OCT sessions is key to success. Personal smartphones of PCDs with available videoconference applications are the popular choice. Four consecutive Tele-OCT sessions are planned for each PCD with a gap of 2-4 weeks over two months. The first three sessions are considered the "optimum Tele-OCT training package" for each PCD, followed by the fourth one as a 'Tele-OCT impact evaluation session' in a live, real-time general consultation. Each Tele-OCT is conducted in an average ten general patients in about two hours per session, totalling about 30 patients in 6 hours of Tele-OCT training package per PCD. Patient's profiles especially common mental disorders are reflective of a true picture of Indian primary care.
CONCLUSIONS CONCLUSIONS
Performance indicators of Tele-OCT for future implementation are established. Tele-OCT appears to be a path-breaking training model for PCDs to integrate psychiatric care in their general practice.

Identifiants

pubmed: 34035581
doi: 10.4103/ijcm.IJCM_223_20
pii: IJCM-46-75
pmc: PMC8117904
doi:

Types de publication

Journal Article

Langues

eng

Pagination

75-79

Informations de copyright

Copyright: © 2021 Indian Journal of Community Medicine.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

Références

Front Comput Neurosci. 2014 Jul 01;8:64
pubmed: 25071536
Lancet. 2016 Feb 13;387(10019):647-8
pubmed: 26876713
J Family Med Prim Care. 2014 Oct-Dec;3(4):362-7
pubmed: 25657944
Lancet Glob Health. 2016 Aug;4(8):e518
pubmed: 27443774
Cold Spring Harb Perspect Biol. 2015 Aug 03;7(8):a021766
pubmed: 26238360
J Rural Health. 2018 Dec;34(1):48-62
pubmed: 28084667
Natl Med J India. 2002 Nov-Dec;15(6):331-5
pubmed: 12540066
BMJ Open. 2017 Nov 8;7(10):e017902
pubmed: 29118053
Am J Physiol. 1975 Dec;229(6):1641-8
pubmed: 2019
Lancet. 2016 Jun 11;387(10036):2383-401
pubmed: 27174305
Indian J Psychiatry. 2018 Apr-Jun;60(2):236-244
pubmed: 30166682
Indian J Med Res. 2017 Feb;145(2):163-165
pubmed: 28639591
Int J Ment Health Syst. 2014 Jul 16;8:30
pubmed: 25089154
J Neurosci Rural Pract. 2019 Jul;10(3):483-488
pubmed: 31595121

Auteurs

Narayana Manjunatha (N)

Department of Psychiatry, Tele-Medicine Centre, Bengaluru, Karnataka, India.

Kamaldeep Sadh (K)

Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Harihara N Shashidhara (HN)

Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

B R Manjunatha (BR)

Department of Psychiatry, Tele-Medicine Centre, Bengaluru, Karnataka, India.

H P Shashank (HP)

District Mental Health Program, District Health and Family Welfare Office, Mandya, Karnataka, India.

K Puttaswamy Ashwatha (KP)

District Mental Health Program, District Health and Family Welfare Office, Mandya, Karnataka, India.

Rajani Parthasarathy (R)

Department of Health and Family Welfare, National Health Mission, Government of Karnataka, Arogya Soudha, Magadi Road, Bengaluru, Karnataka, India.

Channaveerachari Naveen Kumar (CN)

Department of Psychiatry, Tele-Medicine Centre, Bengaluru, Karnataka, India.

Suresh Bada Math (SB)

Department of Psychiatry, Tele-Medicine Centre, Bengaluru, Karnataka, India.

Jagadisha Thirthalli (J)

Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Classifications MeSH