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

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. 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. 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. Virtual Knowledge Network
NIMHANS HUB
&
Bihar District Spokes Model
• Hub: Centre for Addiction
Medicine NIMHANS
• Spokes: Remote District
PCPs
Bihar
Bihar

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. 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. 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. Video clip (LIVE tele-ECHO)

9. Asynchronous: Mobile Learning (Anytime)

10. Results

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. 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. 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. 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. 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
vlc.nimhans.ac.in
Vknnimhans @virtual_NIMHANS
vkn.nimhans@gmail.com