Interventions that were successfully delivered included functional behavioural analysis for management of behavioural problems and training parents to coach their children to develop new skills in different developmental domains. 8600 Rockville Pike Insurance Regulatory and Development Authority of India. This model of paediatric and adolescent telehealth in India can be replicated by other LMIC. In recent times, many governments and non-government entities have started to provide open EHR systems to the doctors. On Mar 25, 2020, Telemedicine Practice Guidelines (TPG, 2020)4 got legal approval and came into existence to facilitate the use of telemedicine by general practitioners. PDF GUIDELINES FOR TELE-PSYCHOTHERAPY SERVICES - National Institute of Telemedicine was initiated in India in 2001. Enter UHID. From April 2020 to August 2021, 250 adolescents were given therapeutic and follow-up telehealth services. They should also be alert and learn to troubleshoot any issues arising before or during a consultation. In 2014, India launched the national health portal. Currently, 45% of the population has internet connection, and 79% has a mobile phone connection [3]. The preliminary data on testing the feasibility of these modules revealed significant reduction in the total difficulty scores on the Strengths and Difficulties Questionnaire in children and adolescents. Some adolescents, especially those with social anxiety disorder felt more comfortable with the distance and remoteness that telepsychotherapy provided and were able to speak more freely than when they would come for sessions to the outpatient clinic. CMC Vellore Like other central government institutes in India, telemedicine services at NIMHANS have not been enabled for clients who are not previously registered with the institute. PDF NIMHANS Telenursing Practice Guidelines Few initiatives of telenursing in India include; conducting webinars to create awareness among nursing professionals during the COVID-19 pandemic, the Indian Nursing council uses telenursing for. All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards. Most children and their families found telemedicine acceptable, effective, and convenient. Telehealth was used by private and public health establishments, in urban, rural, and remote areas. Ministry of Consumer Affairs, Food and Public Distribution, Government of India. During the first wave of COVID 19 pandemic, it has contributed in designing the Telemedicine Practice Guidelines 2020 along with the Ministry of Health and Family Welfare, Govt. The site is secure. Telemedicine is likely to become an integral part of healthcare services in the post pandemic era. Telemedicine is here to stay and, in the coming years, would prove to be a game-changer in the field of medical care and education to ensure universal health coverage. Often E-mail, text messages, mobile apps, social media apps, or dedicated electronic health . Benefits, challenges and impact of teleconsultation - a literature Hence it can even be set at the home of a practitioner if all the general requirements can be satisfied. Jasti N, Bhargav H, George S, Varambally S, Gangadhar BN. Telepsychiatry service providers can, therefore, be held liable for any misuse or breach of privacy and data under any of the laws mentioned above. Follow-up consultations may be conducted telephonically or over text or email as well, for a time duration of up to 6months after which another video consultation is mandated. In 2006, a paediatric tertiary care centre in India established a teleconsultation service to reach out to underprivileged children in rural areas that resulted in considerable monetary savings for the families [8]. Vinekar A, Mangalesh S, Jayadev C, Gilbert C, Dogra M, Shetty B. Correspondence: Dr. P.Vijayalakshmi PhD College of Nursing, National Institute of Mental Health and Neuro Sciences, (Institute of National Importance), Bengaluru - 560 029 However, more extensive clinical trials with robust methodologies are encouraged to test the teleyoga modules that have been developed for both age groups. The Telemedicine Centre, NIMHANS is a recast of the Telemedicine Network Project of Karnataka which was introduced in 2001 with a hope of bridging the gap between speciality care and remote underserved villages. The teleconsultation can be conducted via the audio, text, or video modes, Asynchronous or synchronous methods can be adopted, It should be adopted for only non-emergency cases as a first consult or for follow-up or for health education or counselling purposes, The teleconsultation can be availed by the patient, caregiver, another RMP, or a healthcare worker, An individual above 16years of age can give consent for teleconsultation, while the caregivers consent is required for younger age groups. Resiliency Engagement and Care in Health (REaCH): a telephone befriending intervention for upskilled rural youth in the context of COVID-19 pandemic-study protocol for a multi-centre cluster randomised controlled trial. Thus, given the efficacy of teleyoga, we propose that this can be a way to inculcate the practice of yoga among children even during online schooling in the current scenario. The Psychiatric Rehabilitation Services unit temporarily closed its daycare services but connected . This is possible by obtaining feedback from both the person getting consulted and the consultant. Even before the onset of the pandemic, between 2017 and 2020, the Telepsychiatry after care Clinics at NIMHANS, India, had provided 780 teleconsultations for 232 clients with various psychiatric disorders [34]. The non-specialist assistants can manage the appointments, request for prior medical records via asynchronous modes of telepsychiatry. Four years of experience of telemedicine for paediatric care in three Punjab hospitals, North India: achievements and lessons. Followup Patient Portal Following the telemedicine guidelines, e-prescriptions were issued and scanned and sent to families. One of the major issues reported in telemedicine consultation is a loss of connectivity, usually because of electricity failures. These can also be used as a portal to manage appointments, exchange lab investigation reports, prescriptions, follow-up reminders, etc. Budget 2022: Sitharaman announces 24x7 free tele counselling for mental CMC Vellore That made affordable smartphones and faster, low-cost mobile internet, there has been wider penetration of mobile and internet accessibility. This is not possible over telemedicine; thus, a liaison with an accessible medical setup must be ensured for timely monitoring. Consumer Protection Act, 2019 and its implications for the medical profession and health care services in India. 2019;9:0204249.10.7189/jogh.09.020424. However, the List A medications that can be prescribed during the first teleconsultation are limited. The RMPs should ensure that a reasonable degree of care while hiring such a service.4. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. Banothu KK, Bhat JI, Das RR, Dhochak N, Ghimire JJ, Goyal JP, et al. It is sensible to have a backup connection in place to avoid any connectivity-related issues during the consultation. The Indian Psychiatric Society and Telemedicine Society of India, in collaboration with NIMHANS, had published Telepsychiatry Operational Guidelines in May 2020 [37]. Manglani M, Gabhale Y, Lala MM, Balakrishnan S, Bhuyan K, Rewari BB, Setia MS. As a library, NLM provides access to scientific literature. Perhaps, advances in augmented reality and virtual reality would help in bridging the empathy gap, which currently exists, by simulating a real-world experience for both the service user and the provider. Also, the service provider must take care to ensure that the services are disabled-friendly. In addition, due to travel restrictions, routine healthcare services and follow-up care of patients with chronic medical, mental, and neurodevelopment disorders were compromised [4]. It would be inaccurate to consider the Consumer Protection Act, 2019, as medical negligence blind law, but rather it sets the tone for ethical and patient-oriented medical professionalism and strives to curb unfair medical practices.24 As telemedicine is a new practice, it will be in the best interest of all parties involved that all be aware of the laws and regulations governing its use. Telehealth has literally brought health services to the doorstep of all citizens of India. Psychiatrists may either choose a telemedicine platform that has an integrated EHR or choose a standalone telemedicine solution without EHR and can enter all the notes into the patients physical file directly and have physical documents (similar to traditional in-person documentation). Telemedicine practice guidelines enabling registered medical practitioners to provide healthcare using tele-medicine. Allely EB. Contact Us Dr. Dwarakanath Srinivas is currently working as a Professor and Head of Neurosurgery at NIMHANS. A summary of its effective usage by paediatric hospitals and specialists is given below. In 2018, the Insurance Regulatory and Development Authority of India (IRDAI) issued a directive to health insurance providers to include mental illnesses in medical insurance policies,29 in accordance with MHCA, 2017. Services for women and children Peripheral departments / facilities Clinical services Diagnostic services Emergency services Pharmacy services Special areas Public utility services In the process of teleconsultation, the patient and family are likely to share any personal information with the psychiatrist. Carmichael SL, Mehta K, Srikantiah S, Mahapatra T, Chaudhuri I, Balakrishnan R et al; Ananya Study Group*. Based on the feasibility, ability to learn yoga, and the level of complexity in yoga practices, two separate yoga modules were developed for children aged 510years and 1015years, respectively. Sanjeeva Kumar, then Additional Secretary, Ministry of Health and Family Welfare, Government of India. [cited 2020 Aug 26], Consent in current psychiatric practice and research: an Indian perspective. Abraham SE, Jasti N, Bhargav H, Galagali PM, Varambally S. Design, validation and feasibility of a tele yoga module for adolescents well-being. We review the growth of telemedicine and psychiatry in India, focus on its role during the pandemic in child and adolescent medical and mental healthcare, and discuss a way forward for its integration in routine medical care in future. and transmitted securely. At the end of 1month, yoga performance assessment revealed that children and adolescents were able to learn the whole set of yoga practices through tele-mode. For example, among the antidepressants, escitalopram and fluoxetine may be prescribed during the initial consultation. Manglani M, Gabhale Y, Lala MM, Balakrishnan S, Bhuyan K, Rewari BB, Setia MS. Assessing the effectiveness of a telemedicine initiative in clinical management of children living with HIV/AIDS in Maharashtra. Gulati S, Sengar A. A total of sixteen such activities were conducted. Safe & structured video based clinical consultations between a doctor in a hospital and a patient in the confines of his home are being enabled. The authors received no financial support for the research, authorship, and/or publication of this article. Children and adolescents who had recently been admitted as in-patients with severe psychiatric problems were identified and contacted on priority to ensure remission from their illness and relapse prevention. 30 Jan 2023 13:35:23 . 1 Department of Psychiatry, NIMHANS Digital Academy and Centre for Addiction Medicine, IMHANS, Bengaluru, Karnataka, India. 10.1016/b978-0-12-815310-9.00011-3. 2 Spandana Health Care, Bengaluru, Karnataka, India. EHRs should not be seen as the core of healthcare but rather as an augmentation to the telepsychiatry consultation. There were certain situations when telepsychotherapy was deemed unsuitable, and the family was requested either to come to the OPD or consult a mental health practitioner locally. It is preferable to have an exclusive mobile phone/landline connection and a number for managing consultation. Subsequently, over the last decade or so, the telemedicine setup at NIMHANS, Bengaluru has had tremendous coverage and penetration independently with various clinical, academic and training activities across the country which emerged to be named officially as the Telemedicine Centre, NIMHANS. Service providers should invest in having good quality, high-speed broadband connections, and, if possible, have a separate link for teleconsultation. Use telemedicine safely for yourself and your loved ones. Supported by Ministry of Health and Family Welfare Government of India. NIMHANS psychiatry emergency services ward sealed after - The Hindu Ministry of Law and Justice (Legislative Department), Government of India. Furthermore, these services are also being used for providing psychiatric care to people in quarantine and those infected with COVID-19. In 2012, mobile technologies were used by frontline health workers to promote breast feeding and kangaroo mother care and improve complementary feeding practices [9]. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. A summary of the Indian telemedicine guidelines is given in Box 1. The National Institute of Mental Health and Neurosciences (NIMHANS) has also issued guidelines for tele-psychotherapy, telepsychiatry social work practice, in addition to telepsychiatry.57 Telemedicine is a convenient alternative and perhaps even ideal in scenarios where there is a difficulty for users to avail of quality healthcare owing to various constraints such as economic, transportation, social, or in places with no healthcare facilities. The YouTube link of the teleyoga module for children between 5 and 10years of age is https://youtu.be/SFZTCIfAm1A?t=2. With the aid of telemedicine, healthcare professionals and community frontline workers could triage paediatric patients, refer them to emergency services, treat minor illnesses, order investigations, receive reports, conduct follow-up consultations, impart health education regarding COVID appropriate behaviour, conduct research, and access continuing medical education (CME) programs and clinical protocols. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Telepsychiatry platforms can be used exclusively for giving appointment, video conferencing, and generating and transmitting prescriptions.
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