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在印度设计并实施一项创新的数字驱动型初级保健精神病学项目。

Designing and implementing an innovative digitally driven primary care psychiatry program in India.

作者信息

Manjunatha Narayana, Kumar Channaveerachari Naveen, Math Suresh Bada, Thirthalli Jagadisha

机构信息

Primary Care Psychiatry Program, Tele Medicine Centre, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

出版信息

Indian J Psychiatry. 2018 Apr-Jun;60(2):236-244. doi: 10.4103/psychiatry.IndianJPsychiatry_214_18.

Abstract

BACKGROUND

Primary Care Doctors (PCDs) are the first contact for majority of patients with psychiatric disorders across the world including India. They often provide symptomatic treatment which is naturally inadequate. Absence or inadequate exposure to psychiatric training during undergraduate medical education is one of the prime reasons. Classroom training (CRT), a standard practice to train PCDs is driven by specialist based psychiatric curriculum and inherently lacks clinical translational value.

AIM AND CONTEXT

The 'Department of Psychiatry' of 'National Institute of Mental Health and Neurosciences', Bengaluru, India has recently come up with an innovative digitally driven modules of 'Primary Care Psychiatry Program' (PCPP) for practicing PCDs. Goal of this paper is to provide an overview of all these (five) modules with its various stages of implementation.

METHODS

Authors briefly discuss the current status of primary care psychiatry in India and also narrate the newly designed five modules of PCPP in this paper.

RESULTS AND DISCUSSION

An adopted psychiatric curriculum is designed in 'Clinical Schedules for Primary Care Psychiatry' (CSP) which is an integral part of PCPP. This is brief clinical schedules contains culturally appropriate screening questionnaire, transdiagnostic classification of 8 core psychiatric disorders, diagnostic, referral and management guidelines. PCPP contains 5 modules named as orientation module, basic module, advanced module [Tele-psychiatric 'On-Consultation Training' (Tele-OCT)], videoconference based continuing skill development module, and collaborative video consultation modules which covers all essential areas of primary care psychiatry for practicing PCDs. Last three modules are fully designed digital modules in hub and spoke model of Tele Medicine. In this designed program, the CSP and Tele-OCT are two path braking innovations having inbuilt higher clinical translation value. The challenges and opportunities that could be faced during its implementation across India are also discussed.

CONCLUSION AND FUTURE DIRECTIONS

Innovative PCPP is pragmatic in nature and has potential for higher clinical translational value. Once validated thoroughly, PCPP has potential for pan-India expansion. There is a need for artificial intelligence-based modules for next phase of PCPP in India considering her population and lesser number of available psychiatrists.

摘要

背景

在包括印度在内的全球范围内,初级保健医生(PCD)是大多数精神疾病患者的首诊医生。他们通常仅提供对症治疗,这自然是不够的。本科医学教育期间缺乏或接触精神科培训不足是主要原因之一。课堂培训(CRT)作为培训初级保健医生的标准做法,是由基于专科的精神科课程驱动的,本质上缺乏临床转化价值。

目的与背景

印度班加罗尔国家心理健康和神经科学研究所的精神科最近为执业初级保健医生推出了创新的数字化驱动的“初级保健精神病学项目”(PCPP)模块。本文的目的是概述所有这些(五个)模块及其实施的各个阶段。

方法

作者简要讨论了印度初级保健精神病学的现状,并在本文中叙述了新设计的PCPP的五个模块。

结果与讨论

在“初级保健精神病学临床日程”(CSP)中设计了一个采用的精神科课程,它是PCPP的一个组成部分。这个简短的临床日程包含文化上合适的筛查问卷、8种核心精神疾病的跨诊断分类、诊断、转诊和管理指南。PCPP包含5个模块,分别称为入门模块、基础模块、高级模块[远程精神病学“会诊培训”(Tele - OCT)]、基于视频会议的持续技能发展模块以及协作视频咨询模块,这些模块涵盖了执业初级保健医生初级保健精神病学的所有重要领域。最后三个模块是远程医疗中心辐射模式下完全设计的数字模块。在这个设计的项目中,CSP和Tele - OCT是两项具有更高临床转化价值的突破性创新。还讨论了在印度各地实施过程中可能面临的挑战和机遇。

结论与未来方向

创新的PCPP本质上是务实的,具有较高临床转化价值的潜力。一旦经过全面验证,PCPP有在全印度推广的潜力。考虑到印度的人口和可用精神科医生数量较少,印度PCPP的下一阶段需要基于人工智能的模块。

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