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EVALUATING THE FEASIBILITY OF VIRTUAL
MENTORING CONNECTING AN ACADEMIC
CENTRE TO DISTRICT HEALTH PROFESSIONALS
FROM BIHAR ...
Goel et al. 2003
0
5000
10000
15000
20000
25000
Psychiatrists Psychologists Psychiatric
Social
Workers
Psychiatric
Nurses
...
2
5
5
NEED OF THE HOUR
NEW MODELS
FOR
MANPOWER DEVELOPMENT
AND
DELIVERY OF QUALITY CARE SERVICES
CAN TELEMENTORING BE A
SOLUTI...
Aims
The Medical Officer and Counsellor to be able to:
1. Identify and intervene to address alcohol use
disorder and addic...
22nd Feb-7th March (ONSITE)
ONSITE Training
Centre for Addiction
Medicine
NIMHANS
Participation
Certificate
Training certi...
Phase I: ONSITE 22nd Feb to 7th
March
8
 Didactic Lectures
 Bedside clinical teaching
 Emergency case
management
 Supportive followed by
independent case
mana...
Development of treatment protocol
10
Phase II: Virtual Knowledge
Network NIMHANS ECHO
Tele-mentoring, Handholding and
E-Certificate Module
March to September
12
Copyright Project
ECHO 2015
ECHO (Extension for Community
Health Outcomes)
13
Case discussion and
Expert Didactic
Knowledge Network: NIMHANS Hub and
District hospital Spokes
Weekly LIVE Tele-Mentoring...
Clinical Case Presentation
1. Ms Shalinipriya
2. Dr Sunil
3. Dr Haque
Brief case details should
be informed to CAM,
NIMHAN...
Micro-website
Standard practice & Treatment Guideline, Videos and
powerpoints (http://bit.ly/nimhans_bihar_echo)16
Resource Materials
17
27
• Number of trainees who
attended the onsite component –
Phase 1
20
• Number of trainees who
attended the online compon...
18
• 14 Online Sessions over 6 months
• Didactics –
– Opioid, cannabis and benzodiazepine use disorders
– Mental status ex...
19
• Instances of participation = 137
• Cases discussed = 50
As per the subjective report of trainees
• Online component c...
20
• Self rated questionnaire – At Baseline, 3
months and 6 months (Assess knowledge,
skills and self efficacy)
• Clinical...
VKN NIMHANS BIHAR ECHO Clinicians
Knowledge Skills and Abilities in
Management of Alcohol Use Disorders
0
0.5
1
1.5
2
2.5
...
22
Outcomes of Treatment of Alcohol Use Disorders
by VKN NIMHANS BIHAR ECHO Clinicians
Cases
screened 2695
Inpatients
536 ...
• Blended training with virtual mentoring of non
specialist physicians and counselors is feasible,
acceptable and translat...
24
Clinical
• Emergence
of other
substance
use
Technological
• High speed
internet
connectivity
• Cost
Pedagogical
• Susta...
25
• Dr. Prabhat Chand, Additional Professor,
Department of Psychiatry, NIMHANS,
Bangalore
• Doctors and Counselors of Sta...
26
QUESTIONS AND
CLARIFICATIONS
E – mail: jayantmahadevan@gmail.com
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Evaluating feasibility of Virtual Mentoring connecting an academic centre by Jayant Mahadevan

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Evaluating feasibility of Virtual Mentoring connecting an academic centre by Jayant Mahadevan, NIMHANS, India

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Evaluating feasibility of Virtual Mentoring connecting an academic centre by Jayant Mahadevan

  1. 1. EVALUATING THE FEASIBILITY OF VIRTUAL MENTORING CONNECTING AN ACADEMIC CENTRE TO DISTRICT HEALTH PROFESSIONALS FROM BIHAR IN PROVIDING QUALITY CARE FOR ALCOHOL USE DISORDERS Jayant M, Lekhansh S, Ashfaq A, Sunil K*, Narendra Sinha*,A K Shahi*, Prabhat C, Arun K, Lakshmanan S, Pratima Murthy, Vivek Benegal, Miriam Komaromy#, Sanjeev Arora# *State Health Society Bihar # ECHO Institute USA Centre for Addiction Medicine, Dept. of Psychiatry, NIMHANS 1
  2. 2. Goel et al. 2003 0 5000 10000 15000 20000 25000 Psychiatrists Psychologists Psychiatric Social Workers Psychiatric Nurses Current Required SHORTAGE OF SKILLED MENTAL HEALTH PROFESSIONALS IN INDIA 3
  3. 3. 2
  4. 4. 5
  5. 5. 5 NEED OF THE HOUR NEW MODELS FOR MANPOWER DEVELOPMENT AND DELIVERY OF QUALITY CARE SERVICES CAN TELEMENTORING BE A SOLUTION ?
  6. 6. Aims The Medical Officer and Counsellor to be able to: 1. Identify and intervene to address alcohol use disorder and addiction in the district hospitals. 2. Fortnightly discuss the clinical cases and expert didactics with NIMHANS multi-disciplinary team from their work place through VKN NIMHANS ECHO. 6
  7. 7. 22nd Feb-7th March (ONSITE) ONSITE Training Centre for Addiction Medicine NIMHANS Participation Certificate Training certificate part 1 Virtual Knowledge Network (ONLINE LIVE) (March to September fortnightly) Live Online Handholding 2nd and 4th Wednesdays 2.30 PM-4PM) Training Certificate FINAL CERTIFICATE* *Based on regular participation (>75%), 4 (minimum) Case Presentation & Case Discussion required to entry into the FINAL ONLINE assessment for a trained e-certificate in Alcohol addiction Methods – Blended Training 7
  8. 8. Phase I: ONSITE 22nd Feb to 7th March 8
  9. 9.  Didactic Lectures  Bedside clinical teaching  Emergency case management  Supportive followed by independent case management  Working in a multidisciplinary team  Learning best practices  Training about public awareness dissemination  Steps to initiate the deaddiction services in their district Components 9
  10. 10. Development of treatment protocol 10
  11. 11. Phase II: Virtual Knowledge Network NIMHANS ECHO Tele-mentoring, Handholding and E-Certificate Module March to September 12
  12. 12. Copyright Project ECHO 2015 ECHO (Extension for Community Health Outcomes) 13
  13. 13. Case discussion and Expert Didactic Knowledge Network: NIMHANS Hub and District hospital Spokes Weekly LIVE Tele-Mentoring session (VIDEO) 14 Easy to access anywhere: No cost to participants Secured, encrypted, HIPAA compliant
  14. 14. Clinical Case Presentation 1. Ms Shalinipriya 2. Dr Sunil 3. Dr Haque Brief case details should be informed to CAM, NIMHANS by email two days before presentation Didactic Lecture Depression: Identification and Treatment Dr. Prabhat Chand Example of Tele-Health session 25th May 2016 2.30PM 15
  15. 15. Micro-website Standard practice & Treatment Guideline, Videos and powerpoints (http://bit.ly/nimhans_bihar_echo)16
  16. 16. Resource Materials 17
  17. 17. 27 • Number of trainees who attended the onsite component – Phase 1 20 • Number of trainees who attended the online component – Phase 2 8 • Number of trainees who gave the exit exam and received training completion certificate Results – Flow of participants 18
  18. 18. 18 • 14 Online Sessions over 6 months • Didactics – – Opioid, cannabis and benzodiazepine use disorders – Mental status examination and cognitive functions – Anxiety, depression and suicide – Counselling skills and relapse prevention – Anti-craving agents for alcohol and acute methanol poisoning Results - Online component
  19. 19. 19 • Instances of participation = 137 • Cases discussed = 50 As per the subjective report of trainees • Online component contributed 72% of the TOTAL LEARNING gained from the BLENDED TRAINING Results - Online component
  20. 20. 20 • Self rated questionnaire – At Baseline, 3 months and 6 months (Assess knowledge, skills and self efficacy) • Clinical reporting forms – Number of patients seen, interventions provided and outcomes daily and monthly Assessing Outcomes of VKN NIMHANS BIHAR ECHO programme
  21. 21. VKN NIMHANS BIHAR ECHO Clinicians Knowledge Skills and Abilities in Management of Alcohol Use Disorders 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 Details of alcohol use Discuss risks of alcohol Identifying triggers and managing craving Prescribing appropriate medications BEFORE TRAINING AFTER TRAINING 24
  22. 22. 22 Outcomes of Treatment of Alcohol Use Disorders by VKN NIMHANS BIHAR ECHO Clinicians Cases screened 2695 Inpatients 536 (19.8%) Referred to higher centers 80 (14.9 %) Severe alcohol use problems 832 (30.8%) Follow up 1336 (49.1%) Other substances 581 (21.5%) No deaths reported
  23. 23. • Blended training with virtual mentoring of non specialist physicians and counselors is feasible, acceptable and translates to a good standard of patient care • Relatively low cost • Importance of involvement of local leadership Conclusions AND Lessons 26
  24. 24. 24 Clinical • Emergence of other substance use Technological • High speed internet connectivity • Cost Pedagogical • Sustaining interest of health care providers Future Challenges
  25. 25. 25 • Dr. Prabhat Chand, Additional Professor, Department of Psychiatry, NIMHANS, Bangalore • Doctors and Counselors of State Health Society, Bihar • Faculty of Centre for Addiction Medicine, Department of Psychiatry, NIMHANS, Bangalore Acknowlegements
  26. 26. 26 QUESTIONS AND CLARIFICATIONS E – mail: jayantmahadevan@gmail.com

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