The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. 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. Ministry of Law and Justice (Legislative Department), Government of India. The module for children from 5 to 10years of age was 30min in duration and focused more on asanas, mantra chanting, and yogic games with a small component of pranayama such as right and left nostril breathing and humming breath. In the process of teleconsultation, the patient and family are likely to share any personal information with the psychiatrist. These provide software solutions for video consultation, text-based consultation, e-prescription generation, and maintenance of health records. Role of telemedicine in follow-up care of children with respiratory illnesses at a tertiary care hospital - an ambispective observational study. It comprises a consultation chamber specially designed for patient interaction along with a team trained with the basic technical knowledge required to facilitate a smooth hassle-free teleconsultation. Giordano A, Bonometti GP, Vanoglio F. Thara R, John S, Rao K. Telepsychiatry in Chennai, India: the SCARF experience. Indian Pediatrics, Manuscript submitted, 2021. 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. Post-consultation formalities are usually handled by non-specialist assistants as discussed earlier and involve the following: Regular monitoring can help to improve the quality of services provided. The provider can decide whether it be a separate (dedicated) telemedicine facility or an integrated one that may be used for other purposes too. Services for women and children Peripheral departments / facilities Clinical services Diagnostic services Emergency services Pharmacy services Special areas Public utility services official website and that any information you provide is encrypted The user must be familiarized with the consultation platform and the software for a seamless consultation. The latest research endorses telemedicine as a successful strategy in resource-limited settings to provide accessible and equitable healthcare. sharing sensitive information, make sure youre on a federal This crucial ethical issue of duty of care can be addressed by consultant services rather than therapist services via telepsychiatry. . Manjunatha N, Kumar CN, Math SB. Vinekar A, Mangalesh S, Jayadev C, Gilbert C, Dogra M, Shetty B. Recently, 45 rural health centres were connected to 15 specialized hospitals for eye, cardiac, and cancer care services via telemedicine. In the National Institute of Mental Health and Neuro Sciences (NIMHANS), services have pivoted to deliver telemental health services during the COVID-19 crisis to ensure continuity of care for patients who were unable to avail outpatient services. Ray A, Sharma S, Sadasivam B. Telephonic triage in times of COVID-19: experiences at a telemedicine center in India. The gap of benefits between teleconsultation and regular consultation will diminish as patients grow fonder into technology.The economic value of this type of consultation remains a difficult subject, so a small budget economic analysis, based on a break-even method, is suggested. India is a large country with a population of 1.3 billion people and limited economic and human resources. A study on collaborative telepsychiatric consultations to outpatients of district hospitals of Karnataka, India, https://creativecommons.org/licenses/by-nc/4.0/, https://us.sagepub.com/en-us/nam/open-access-at-sage, https://dot.gov.in/sites/default/files/Telecom%20Statistics%20India-2019.pdf, https://www.who.int/goe/publications/goe_telemedicine_2010.pdf, https://www.mohfw.gov.in/pdf/Telemedicine.pdf, http://nimhans.co.in/wp-content/uploads/2020/06/Telepsychiatry-Operational-Guidelines-2020-Inaug.pdf, https://nimhans.ac.in/wp-content/uploads/2020/04/Guidelines-for-Telepsychotherapy-Services-17.4.2020.pdf, https://nimhans.ac.in/wp-content/uploads/2020/06/Guidelines-for-Tele-Psychiatric-Social-Work-Practice.pdf, http://indianmhs.nimhans.ac.in/Docs/Report2.pdf, https://www.hipaajournal.com/hipaa-guidelines-on-telemedicine/, https://www.prsindia.org/uploads/media/Mental%20Health/Mental%20Healthcare%20Act,%202017.pdf, https://www.nrces.in/standards/ehr-standards-for-india#need_for_electronic_health_record, https://ehrc.iiitb.ac.in/project/e-manas-karnataka-mental-health-management-system, https://www.mciindia.org/documents/rulesAndRegulations/Ethics%20Regulations-2002.pdf, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5142145/, http://egazette.nic.in/WriteReadData/2019/210422.pdf, https://www.indiacode.nic.in/bitstream/123456789/1999/3/A2000-21.pdf, https://www.wipo.int/edocs/lexdocs/laws/en/in/in098en.pdf, https://www.ncpedp.org/sites/all/themes/marinelli/documents/Rights%20of%20Persons%20with%20Disabilities%20(RPWD)%20Act%202016.pdf, https://www.thequint.com/news/insurance-to-cover-mental-health, https://gicpensioners.com/images/postfile/20200622042641-guidelines-_telemedicine.pdf. Login for Appointment/ Health Record. The telepsychiatry setup should be compliant with the Information Technology Act, 2000,25 the Information Technology (Intermediaries guidelines) Rules, published by the Ministry of Communication and Information Technology in 2011,26 and the TPG, 2020 issued by the Indian Medical Council. This teleconsultation platform not only contained the spread of . Furthermore, these services are also being used for providing psychiatric care to people in quarantine and those infected with COVID-19. In the initial few weeks of starting medication, children/adolescents need to be monitored for specific side effects that may become particularly problematic for sensitive individuals in this population. Deodhar J. Telemedicine by emailexperience in neonatal care at a primary care facility in rural India. Federal government websites often end in .gov or .mil. However, psychiatrists while maintaining EHR need to comply with the Mental Healthcare Act (MHCA), 2017, Sec11 25 which stresses on the need for preserving basic medical records in hard copy and the guidelines framed by the Ministry of Health & Family Welfare (MoHFW) which notified the EHR Standards for India in September 2013.12. . National Teleconsultation Service aims to provide healthcare services to patients in their homes. Consent can be recorded in any form, either audio, video conference, written form, which is in line with IMC TPG. Due to the pandemic, the services were shifted to the online mode. 80% of surveyed doctors are being consulted using informal means of consultation such as audio, video, texts on various messaging apps. In 2005, a National Telemedicine Taskforce was established by the Government of India that initiated various programs like the Integrated Disease Surveillance Project, the National Cancer Network, the National Rural Telemedicine Network, the Digital Medical Library Network, and the National Medical College Network [2, 7]. Any successful telemedicine services would require adequately trained people who are well versed in the system. Supported by Ministry of Health and Family Welfare Government of India. Safe and structured video-based clinical consultations between a doctor in a hospital and a patient in the confines of his home are offered.15 Various platforms, which are mostly offered by private enterprises like Practo Pro,16 Ment Doc,17 TeleArogya,18 are available for psychiatrists; some of them are free for both service providers and the users, whereas others offer software solutions for a fee. Download the CMC Patient Portal (Android) Mobile App by scanning the code: Our New Ranipet Campus Ministry of Health and Family Welfare, Government of India. 8600 Rockville Pike 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. Authors are not liable for any loss of profit, commercial damages, including but not limited to special, incidental, consequential, or other damage incurred from the use of applications. Math SB, Manjunatha N, Kumar CN, et al. The exponential growth of technology in the past few decades has benefitted the healthcare sector. 528, 10th Main Ram Mandir Road, 2nd Block Rajajinagar, Bengaluru, Karnataka 560079 India, 2National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka India, 3Department of Integrative Medicine, NIMHANS, Bengaluru, India. According to the TPG, 2020, an RMP should abide by the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 and with the relevant provisions of the IT Act, Data protection and privacy laws or any applicable rules notified from time to time for protecting patient privacy and confidentiality.4 However, it exonerates the RMP of any responsibility for breach of confidentiality if there is reasonable evidence to believe that patients privacy and confidentiality has been compromised by a technology breach or by a person other than RMP. The Department of Integrative Medicine, NIMHANS, Bengaluru, has been offering teleyoga services for managing stress levels of parents, children, and adolescents for over a year now. Use telemedicine safely for yourself and your loved ones. The results of this survey were used to design the contents of the adolescent education programs. Orthopedist 14 years experience overall Electronics City,Bangalore Practo Hospitals - Neo + 3 more 700 Consultation fee at clinic 100% 2 Patient Stories Show doctors near me Dr. Ananya Orthopedist 20 years experience overall Magrath Road,Bangalore HOSMAT Hospital + 1 more 600 Consultation fee at clinic 99% 63 Patient Stories An official hospital/ institute email can be set up and be used for all other support services. Mental health professionals need to be aware of the user data being collected by these platforms and understand the extent of control one has over the data. The .gov means its official. The Psychiatric Rehabilitation Services unit temporarily closed its daycare services but connected . Neuro Science Faculty Buiding, HosurRoad,NIMHANS, UK-India Telemedicine Project & COVID-19. The assistant should brief the user about proper teleconsultation etiquette, for example, wearing decent professional attire, being in a well-lit room with minimum noise and interruptions from others, having good internet and power backup, and a capable camera on their gadgets (mobile phone/computer) to ensure a seamless consultation from the users end. Google survey among attendees revealed that morning slot of 7:00 AM to 7:45 AM was the most feasible time to impart these sessions. NIMHANS-Telenursing Practice . Say Hello to India's top doctors via video consultation, get digital prescriptions, order medicines, book doctor appointments & lab tests, find doctors near you, get health packages, ask a free health question to doctors via messaging mobile applications such as WhatsApp. They should also be alert and learn to troubleshoot any issues arising before or during a consultation. It is also advisable to prescribe medications to patients rather than routing to pharmacies. The pandemic has led to the expansion of telepsychiatry services in government and private medical institutes. Mittal A, Pareek P. Telephonic triage and telemedicine during the peak of COVID-19 pandemic - restricting exposure to healthcare professionals. It requires minimal equipment and space in the form of a single room with a laptop or even a smartphone with a good camera and a good network connection will suffice. General consultation General consultation registration is done from 07.00 am to 12.30 pm General consultation registration at the Silver Jubilee Block is based on the token number Special consultation Special consultation is available during morning from 07.00 am to 10.30 am. India: WHO Coronavirus Disease (COVID-19) Dashboard [Internet]. Safe & structured video based clinical consultations between a doctor in a hospital and a patient in the confines of his home are being enabled. In 2012, mobile technologies were used by frontline health workers to promote breast feeding and kangaroo mother care and improve complementary feeding practices [9]. 080 - 26991699 After dialing, they can select the language and services option. We did face difficulties in assessing and treating younger children. Saini L, Madaan P, Bhagwat C, Einspieler C. Home-videos for neurodevelopmental follow-up of high-risk infants during COVID-19 pandemic: a simple and inexpensive tool. Ministry of Communications and Information Technology (Department of Information Technology), Government of India. Bethesda, MD 20894, Web Policies [ 7] 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. Telemedicine practice guidelines enabling registered medical practitioners to provide healthcare using tele-medicine. 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 pandemic restrictions resulted in an increase in its use. Panda PK, Dawman L, Panda P, Sharawat IK. The https:// ensures that you are connecting to the For instance, doctors at NIMHANS have developed guidelines for telepsychotherapy services, introduced IVRS-based Telephone Outpatient Services, and started a 247 toll-free helpline for psychosocial support and mental health services during disasters. [cited 2020 Aug 9]. The Government of India also has a hospital management system with EHR services, named e-hospital from the National Informatics Centre (NIC)13 and e-manas,14 a platform from National Health Mission, Government of Karnataka, provides the EHR, state-wide registry of mental health facilities and professionals. et al. Another telepsychiatry project in India by Thara et al. E-Health Research Centre. Muthukrishnan J, Venugopal N, Basavaraj AP, Bagga G, Jayakrishnan VY, Bharadwaj K, Thoke SV. An alternative power backup can be linked in the form of a UPS or generator to avoid this. In response to the healthcare crisis precipitated by the pandemic, India released its first national telemedicine guidelines on 25 March 2020. Telepsychiatry operational guidelines. The modules included different yoga practices ranging from yogic games (krida yoga), physical postures (asanas), and breathing techniques (pranayama) to meditations. The engagement was also difficult with toddlers and younger children because it is common during in-person practice for the child psychiatrist to move along with the child, trying to engage the child. This analysis conducted on Finland shows that teleconsultation . of India and thereby making clinical practice possible amidst the contagious disease spread. Pub; NIMHANS, Beng aluru-560 029. Springer Nature - PMC COVID-19 Collection, https://iapindia.org/guidelines-for-parents/, https://covid19.who.int/region/searo/country/in, https://datareportal.com/reports/digital-2021-india, https://www.mohfw.gov.in/pdf/Telemedicine.pdf, https://indianpsychiatricsociety.org/e-book-Telepsychiatry-operational-guidelines-2020, https://www.indiacode.nic.in/bitstream/123456789/2249/1/a2017-10.pdf. The https:// ensures that you are connecting to the The .gov means its official. Telemedicine in the current scenario has played a pivotal role in catering to physical and mental well-being and has reached the majority of our population. Experience with telemedicine in paediatric nephrology during the COVID pandemic. However, any software application being used must adhere to the guidelines laid down by HIPAA.10, According to the Integrated Care Electronic Health Record (EHR), an Electronic Medical Record (EMR) is a repository of information regarding the health of a subject of care in computer-processable form that can be stored and transmitted securely and is accessible by multiple authorized users.8, 9 Telemedicine EHR is a framework that ensures encoding, storing, and retrieval of the medical records that are maintained online. 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. Registration required More Health ID - Key to your Digital Healthcare Journey Fully Online It involves setting up a telemedicine setup having one or more consultants of different or same specialties. of India Service providers should invest in having good quality, high-speed broadband connections, and, if possible, have a separate link for teleconsultation. Bengaluru, Karnataka, India Connect with the speaker? For over a decade, mHealth has been in use in the field of neonatology in India for dissemination of evidence-based guidelines for neonatal care, collection of data, and research purposes [10]. National Teleconsultation Service, MoHFW. Ganguly S, Bakhshi S. Teleconsultations and shared care in pediatric oncology during COVID-19. 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. Pataki C, Singhal P, Dastidar AG. Identifying the patient and verification of the patients identity by checking their ID document (AADHAR/ driving license, voters identity card, etc. However, more extensive clinical trials with robust methodologies are encouraged to test the teleyoga modules that have been developed for both age groups. e-Hospital@NIC Govt. A shared care model was followed by paediatric oncologists by partnering with local healthcare facilities and guiding them regarding chemotherapy, blood product infusion, and management of complications [, Nephrology: Telehealth services via video and audio consultation were used successfully to follow up children with chronic kidney disease, and a few new cases were diagnosed with high caregiver satisfaction [, Diabetes care: Telemedicine services were used for triaging, follow-up, parent education, and health education of children with diabetes mellitus [, Human and Animal Rights and Informed Consent, Telemedicine, Telepsychiatry, Teleyoga, India, Pandemic, Children and adolescents. Through telemedicine, health professionals were able to reach the population living in remote areas of the country. Telepsychiatry helps in realizing the vision of the WHO to provide cost-effective, good quality services to all irrespective of their socio-economic status. The health portal also provides health education, details of health facilities, hospitals, blood transfusion centres, mobile apps, and personalized health records [11]. In India, tremendous contributions from the Department of Information Technology (DIT), Indian Space Research Organization, North Eastern Council (NEC) Telemedicine Program for the North-Eastern States, Karnataka State Wide Area Network (KSWAN) have led to delivery and advancement of telemedicine health care delivery services. Further advancement and the ease of use of technology has increased its usability and acceptance among larger populations.2 All these have resulted in the amalgamation of the IT sector and healthcare, giving rise to telemedicine. QJM. INS-IM 2022 Secretariat Dr. Paresh Doshi Director of Neurosurgery, 11th Floor, Jaslok Hospital and Research Centre, 15, Dr. Deshmukh Marg, Mumbai - 400 026. It also up to the service provider to decide on investing in a dedicated comprehensive software solution, EHR/EMR services, or use one of the freely available platforms; each will have its advantages and disadvantages. Well-lit rooms that have minimal noise should be sufficient for conducting a teleconsultation session. Pandey V, Srivastava V, Imran M, Mishra A. Federal government websites often end in .gov or .mil. The synchronous, two-way, interactive telecommunication format is more popular, often in video teleconferencing (VTC). An ideal application would be something that has a minimal cost, with good accessibility, and is secure and user friendly. 8600 Rockville Pike Telemedicine has also been used to deliver healthcare during mass religious gatherings like Maha Kumbh Mela. The guidelines advise a detailed in-person face-to-face assessment before initiating teletherapy. With an ageing population and increasing incidence of chronic disease, telemedicine can improve access to care for patients, by helping to bridge the constraints of distance, time, and cost. In 2002, there was a report of triaging neonatal cases in rural areas via email [6]. Modifications of the current guidelines, enhanced digital awareness of the population, and technological advances would help to overcome the shortcomings of illiteracy, breach of data privacy, confidentiality, and poor internet connectivity. Most of the parents (90%) have opined that yoga should be included in school curriculum for the enhancement of physical, mental, and emotional well-being of the students. Abraham SE, Jasti N, Bhargav H, Galagali PM, Varambally S. Design, validation and feasibility of a tele yoga module for adolescents well-being. It is preferable to have an exclusive mobile phone/landline connection and a number for managing consultation. Ministry of Health and Family welfare, Government of India. Proper informed consent requires all necessary information,19 and the patient and his family must be made to understand the limitations and procedures of the consultation, taking extra care to explain what data may be collected and how it will be stored and used. HHS Vulnerability Disclosure, Help In 2014, India launched the national health portal. COVID19 National Teleconsultation Centre (CoNTeC) has been initiated, which connects the doctors across India to All India Institute of Medical Sciences (AIIMS) in realtime for accessing expert guidance on the treatment of the COVID19 patients. 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. Availability of economical internet connectivity further increased the use of telehealth services. If a medical condition requires a particular protocol to be followed to diagnose and prescribe as in a case of the in-person consult, then the same prevailing principle will apply to a telepsychiatry consult. Gulati S, Sengar A. The psychiatrist can choose not to proceed with a teletherapy consultation at any time and, at any point, may feel free to advise an in-person therapy consultation. Telemedicine has been widely used by primary healthcare centres, clinics, and tertiary care hospitals during the pandemic. Several children and adolescents require psychotropic medication alongside psychosocial interventions to manage their behavioural and emotional problems adequately. However, sertraline, an extremely useful beneficial drug especially for paediatric mood and anxiety disorders, is a List B medication that can only be prescribed during a follow-up consultation. Careers, Unable to load your collection due to an error. The assistants need to seek permission to record the consultation and brief the user about maintaining confidentiality. 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. Bengaluru Adolescent Care and Counselling Centre is a private establishment providing comprehensive healthcare services to adolescents and young adults for 16 years. This involves setting up of a teleconsultation in a corporate hospital or a medical college. Guru S Gowda, Dept. 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. Menon J, Kannankulangara A. Broadly, they can be divided into the following two categories. In Understanding uniqueness and diversity in child and adolescent mental health. Pub; NIMHANS, Bengaluru-560 029. However, if feasible, sound-proofed places are preferred. Items related to patient satisfaction with telemedicine were identified through a review of the literature. Based on these factors, a telemedicine service can be of different types. Bhaskaran K, Sharma P. Distancing?
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