Manjunatha Narayana, Sadh Kamaldeep, Shashidhara Harihara N, Manjunatha B R, Shashank H P, Ashwatha K Puttaswamy, Parthasarathy Rajani, Kumar Channaveerachari Naveen, Math Suresh Bada, Thirthalli Jagadisha
Department of Psychiatry, Tele-Medicine Centre, Bengaluru, Karnataka, India.
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Community Med. 2021 Jan-Mar;46(1):75-79. doi: 10.4103/ijcm.IJCM_223_20. Epub 2021 Mar 1.
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.
尽管印度基层医疗中精神疾病的患病率较高，但在基层医疗中仍存在“功能性治疗缺口”。针对基层医疗医生（PCD）的传统课堂培训未能转化为提供基本精神科治疗的足够临床技能。一种创新的远程精神科会诊培训（Tele-OCT）专为执业PCD设计，由远程精神科医生在基层医疗中心的实时普通会诊视频直播中培训PCD。本研究的目的是确定Tele-OCT的绩效指标以便有效实施。
采用文件审查方法收集2016年8月至2018年10月期间印度卡纳塔克邦曼迪亚区73名PCD实施Tele-OCT自然主义设计的数据。
Tele-OCT课程安排的灵活性是成功的关键。配备可用视频会议应用程序的PCD个人智能手机是常用选择。为每位PCD计划连续进行四次Tele-OCT课程，在两个月内间隔2至4周。前三节课程被认为是每位PCD的“最佳Tele-OCT培训套餐”，随后第四节作为实时普通会诊中的“Tele-OCT影响评估课程”。每次Tele-OCT平均在约两小时内为十名普通患者进行，每位PCD在6小时的Tele-OCT培训套餐中总共约30名患者。患者的病历，尤其是常见精神障碍，反映了印度基层医疗的真实情况。
确定了Tele-OCT未来实施的绩效指标。Tele-OCT似乎是一种开创性的培训模式，可让PCD在其全科医疗中整合精神科护理。
