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Innovative Tele-mentoring on Addiction Management for Remote Primary Care Physicians: A Feasibility Study


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A pilot from the Virtual Knowledge Network (VKN) NIMHANS ECHO

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Innovative Tele-mentoring on Addiction Management for Remote Primary Care Physicians: A Feasibility Study

  1. 1. A pilot from the Virtual Knowledge Network (VKN) NIMHANS ECHO (Funded by State Health Society Bihar, Bihar state) Innovative Tele-mentoring on Addiction Management for Remote Primary Care Physicians: A Feasibility Study Presenter: Aurobind G, IT-Programmer Moderator: Dr. Mallikarjun Rao Sagi, Senior Scientific Officer cum Consultant National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru Mallikarjun Rao Sagi, Aurobind G, Prabhat C, Ashfak A, Karthick C, Kubenthiran N, Pratima M, Miriam K, Sanjeev A
  2. 2. Problem statement • Addiction and related issues : a public health problem • Associated with both personal, familial as well as (Non Communicable Diseases) NCD • Not enough health providers who can provide “quality” intervention • Centre for Addiction Medicine (CAM) has been involved in short term training human resources • Challenges: lack of handholding, follow ups, limited resources 0 5000 10000 15000 20000 25000 Psychiatrists Psychologists Psychiatric Social Workers Psychiatric Nurses Current Required
  3. 3. Innovative Solution Can modern Technology leverage bridge this GAP, so that Patients/People get “optimum” care where they stay and from local health professionals? Especially rural and underserved population CAN TELEMENTORING BE A SOLUTION ?
  4. 4. Virtual Knowledge Network NIMHANS HUB & Bihar District Spokes Model • Hub: Centre for Addiction Medicine NIMHANS • Spokes: Remote District PCPs Bihar Bihar
  5. 5. VKN NIMHANS Bihar Drug ECHO Tele-Mentoring Clinic5 The Primary Care Physicians (PCPs) to be able to: 1. Identify and intervene to address Drug use disorders and addiction in the district hospitals. 2. Fortnightly PCPs will discuss the clinical cases and expert didactics with NIMHANS multi-disciplinary team from their work place through VKN NIMHANS tele-ECHO clinics. AIMS
  6. 6. Tele-Mentoring : Course Development Schema Step 1: Onsite Sensitization (10 days) Step 2: Tele-mentoring Mobile based Multipoint tele-ECHO clinics every fortnight for 2hours & e-learning Periodic Outcome Assessments (1, 3, 6 & 9 months)
  7. 7. Synchronous: Live Tele-ECHO clinic • Fortnightly Tele-Mentoring • Sharing relevant and culturally appropriate “best practices” to reduce treatment disparities • “Patient-centric” learning to master complexities • Continued training, “Handholding” and developing a “Learning loop” “Virtual” Knowledge Network (VKN) Virtual NIMHANS HUB and Community SPOKEs Accessible any Smartphone/PC & from any where Remote Districts PCPs
  8. 8. Video clip (LIVE tele-ECHO)
  9. 9. Asynchronous: Mobile Learning (Anytime)
  10. 10. Results
  11. 11. Synchronous virtual tele-ECHO (at the end of 6 months: 11 Clinics) No. of PCPs participated No. of districts No. of PCPs joined for 6 or more tele-ECHO clinics (>60%) No. of case presenters No. of case presented 38 36 18 (47.36%) 29 (76.31%) 41
  12. 12. Mobile Learning: Asynchronous Total No. of e-learning assignments No. of PCPs completed all assignments in specified duration (2 weeks) No. of PCPs required >5 attempts to complete assignment No. of reminders for each participants (calls/texts/WhatsApp) to continue engagement 03 34 (89.47%) 07 (25.92%) 18-20
  13. 13. Knowledge, Skills, Satisfaction & self-confidence 0 1 2 3 4 5 6 7 Baseline After 1 month After 3 months SelfScoring Time Point of Assessment Confidence level
  14. 14. Conclusion Lessons learnt • Feasible and Easy to implement • Smartphone with 4G changing the scenario of learning • Rural and underserved patients at district hospital level could get “quality care “ by PCPs remotely trained by academic HUB (NIMHANS) • Inexpensive and significant impact Challenges • Content in local language • Making the environment more peer led learning • General problem with digital technology • Engagement and Motivation
  15. 15. Moving Knowledge: Instead of Patients Virtual Knowledge Network NIMHANS Linking Academic Multidisciplinary Specialists to Community Primary Health Care Physicians Thank you INNOVATIVE VIRTUAL TELE-MENTORING MODEL FOR SKILLED CAPACITY AND QUALITY CARE in ADDICTION MENTAL HEALTH Join the Movement Vknnimhans @virtual_NIMHANS