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ORIGINAL ARTICLE Table of Contents   
Year : 2021  |  Volume : 46  |  Issue : 1  |  Page : 75-79
Establishing performance indicators of telemedicine-based “On-Consultation Training” of primary care doctors: An innovation to integrate psychiatry at primary care


1 Department of Psychiatry, Tele-Medicine Centre, Bengaluru, Karnataka, India
2 Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
3 District Mental Health Program, District Health and Family Welfare Office, Mandya, Karnataka, India
4 Department of Health and Family Welfare, National Health Mission, Government of Karnataka, Arogya Soudha, Magadi Road, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Narayana Manjunatha
Department of Psychiatry, Tele-Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijcm.IJCM_223_20

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Background: 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. Methodology: 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. Results: 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. Conclusions: 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.


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