Designing and implementing an innovative digitally driven primary care psychiatry program in India
Designing and implementing an innovative digitally driven primary care psychiatry program in India
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DOI：
10.4103/psychiatry.indianjpsychiatry_214_18
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发表时间：
2018-04-01
影响因子：
3.1
通讯作者：
Thirthalli, Jagadisha
中科院分区：
文献类型：
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作者：
Manjunatha, Narayana;Kumar, Channaveerachari Naveen;Thirthalli, Jagadisha
背景：初级保健医生 (PCD) 是包括印度在内的世界各地大多数精神疾病患者的第一联系人。他们经常提供对症治疗，但这自然是不够的。本科医学教育期间缺乏或充分接触精神病学培训是主要原因之一。课堂培训 (CRT) 是培训 PCD 的标准做法，由基于专业的精神病学课程驱动，本质上缺乏临床转化价值。目标和背景：印度班加罗尔“国家心理健康和神经科学研究所”的“精神病学系”最近提出了用于实践 PCD 的“初级保健精神病学计划”(PCPP) 的创新数字驱动模块。本文的目标是概述所有这（五个）模块及其各个实施阶段。方法：作者简要讨论了印度初级保健精神病学的现状，并叙述了本文新设计的 PCPP 的五个模块。结果和讨论：采用的精神病学课程是在“初级保健精神病学临床时间表”（CSP）中设计的，它是 PCPP 的组成部分。这是一份简短的临床时间表，包含适合文化背景的筛查问卷、8 种核心精神疾病的跨诊断分类、诊断、转诊和管理指南。 PCPP 包含 5 个模块，分别为定向模块、基本模块、高级模块 [远程精神病学“咨询培训”(Tele-OCT)]、基于视频会议的持续技能发展模块和协作视频咨询模块，涵盖了执业 PCD 初级保健精神病学的所有重要领域。后三个模块是完全设计的远程医疗中心辐射模型中的数字模块。在这个设计方案中，CSP和Tele-OCT是两种路径制动创新，具有更高的临床转化价值。还讨论了在印度实施过程中可能面临的挑战和机遇。结论和未来方向：创新的PCPP本质上是务实的，具有更高的临床转化价值的潜力。一旦经过彻底验证，PCPP 就有在全印度扩张的潜力。考虑到印度的人口数量和可用的精神科医生数量较少，下一阶段的 PCPP 需要基于人工智能的模块。
Background: Primary Care Doctors (PCDs) are the first contact for majority of patients with psychiatric disorders across the world including India. They often provide symptomatic treatment which is naturally inadequate. Absence or inadequate exposure to psychiatric training during undergraduate medical education is one of the prime reasons. Classroom training (CRT), a standard practice to train PCDs is driven by specialist based psychiatric curriculum and inherently lacks clinical translational value. Aim and Context: The ` Department of Psychiatry' of ` National Institute of Mental Health and Neurosciences', Bengaluru, India has recently come up with an innovative digitally driven modules of ` Primary Care Psychiatry Program' (PCPP) for practicing PCDs. Goal of this paper is to provide an overview of all these (five) modules with its various stages of implementation. Methods: Authors briefly discuss the current status of primary care psychiatry in India and also narrate the newly designed five modules of PCPP in this paper. Results and Discussion: An adopted psychiatric curriculum is designed in ` Clinical Schedules for Primary Care Psychiatry' (CSP) which is an integral part of PCPP. This is brief clinical schedules contains culturally appropriate screening questionnaire, transdiagnostic classification of 8 core psychiatric disorders, diagnostic, referral and management guidelines. PCPP contains 5 modules named as orientation module, basic module, advanced module [ Telepsychiatric ` On-Consultation Training' (Tele-OCT)], videoconference based continuing skill development module, and collaborative video consultation modules which covers all essential areas of primary care psychiatry for practicing PCDs. Last three modules are fully designed digital modules in hub and spoke model of Tele Medicine. In this designed program, the CSP and Tele-OCT are two path braking innovations having inbuilt higher clinical translation value. The challenges and opportunities that could be faced during its implementation across India are also discussed. Conclusion and Future Directions: Innovative PCPP is pragmatic in nature and has potential for higher clinical translational value. Once validated thoroughly, PCPP has potential for pan-India expansion. There is a need for artificial intelligencebased modules for next phase of PCPP in India considering her population and lesser number of available psychiatrists.