The prescription of psychiatric medicines is also an area of concern. Telepsychiatry Operational Guidelines2020. 8600 Rockville Pike 1Bengaluru Adolescent Care and Counselling Centre, No. Safe & structured video based clinical consultations between a doctor in a hospital and a patient in the confines of his home are being enabled. Kumar, C. N. Prakash, N. 2.1.7.1. . Reaching the unreached: providing quality care to HIV-infected children through telemedicine-an innovative pilot initiative from Maharashtra. Through telehealth, a community health worker can now legally seek help from specialists from any part of the country for treating patients in villages. Malhotra S, Shah R. Telepsychiatry and digital mental health care in child and adolescent psychiatry. The Technical groups worked, and the process involved in developing telemedicine guidelines has been a part of the guidelines in other countries (Intan Sabrina & Defi,2021; Ministry of Health Singapore,2015; National Initiative for Telehealth Guidelines,2003; Province of BC Health Authorities,2014) National initiative for telehealth guidelines was established in Canada to have a more comprehensive consultation and participative process to arrive on the recommendations for telehealth (National Initiative for Telehealth Guidelines,2003). National Teleconsultation Service aims to provide healthcare services to patients in their homes. Las pautas han detallado la elegibilidad para practicar Telemedicina en India, los modos y tipos de teleconsultas, profundizado en la relacin mdicopaciente, consentimiento y protocolos de gestin, y tocado los aspectos de seguridad y privacidad de datos de Teleconsulta. These technologies could be integrated with telepsychiatry for enhanced psychiatric care delivery [39]. According to the guidelines, every consult, whether first or followup, shall be undertaken only after confirming the absence of any condition requiring emergency care (Board of Governors in supersession of the Medical Council of India,2020b). Similarly, in case of failure of RMP to recall the previous consultation context and treatment, it is not considered a followup consultation (Board of Governors in supersession of the Medical Council of India,2020a,2020b; Dinakaran et al.,2020). This review would initiate the discussion on the features of the guidelines, their limitations, and their significance in times of the COVID19 pandemic. Initially, the department developed a 45-min teleyoga program for stress management and the well-being of adults [41]. Hence the regulations of the state governments might be a potential hindrance in the practice of telemedicine. Menon J, Kannankulangara A. Available at: The Mental Health Care Act 2017. In keeping with our ethos of working as a multidisciplinary team, psychotherapeutic services and family interventions were also offered and conducted successfully over the telemedicine route. The https:// ensures that you are connecting to the . Bethesda, MD 20894, Web Policies , The areas and the context where it can be used have been spelled out (Ryu,2012). India has the second largest case load of COVID-19 cases in the world, with 32,512,366 cases until 25 August 2021 [1]. (2020). official website and that any information you provide is encrypted The pandemic has led to the expansion of telepsychiatry services in government and private medical institutes. TIMINGS: 8 am to 11.30 am (First contact as well as Follow-up patients) Days: Monday, Thursday and Friday (Except gazetted holidays) Location: G-13, Ground Floor, Main OPD, NIMHANS There are several ways you can consult the Department of Integrative Medicine (IMD), NIMHANS in the Outpatient facility. The links of IAP parenting handouts and webinars were shared with them (https://iapindia.org/guidelines-for-parents/). (2020). , & 2021;15. Department of Community Medicine & School of Public Health PGIMER, Jolly, T. Login for Appointment/ Health Record. The term Telemedicine coined in the 1970s means Healing at a distance literally (Strehle & Shabde,2006). Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. India, 2 Disaster Med Public Health Prep. The consultation has also been categorized as the first consult and follow up consult. Indian Space Research Organisation All India Institute of Medical Sciences, The synchronous, two-way, interactive telecommunication format is more popular, often in video teleconferencing (VTC). Province of BC Health Authorities Through this portal, a free telemedicine service called eSanjeevani can be accessed. Saraf, A. , Math SB, Manjunatha N, Kumar CN, et al. Before Thara R, John S, Rao K. Telepsychiatry in Chennai, India: the SCARF experience. But the current telemedicine guidelines leave it vague with a mention of proper mechanism to address the grievance or queries (Board of Governors in supersession of the Medical Council of India,2021). , It brought the specialty healthcare services to the doorsteps of rural and remote areas using technology. ElAmir, Z. Try these apps . The Telemedicine Practice Guidelines are included as Appendix 5 to the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. , He has a special interest in the intricacies of Biostatistics and Epidemiological study designs. Lahiri D, Mitra S. COVID-19 is accelerating the acceptance of telemedicine in India. 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. Use of telemedicine reduced the exposure of healthcare professionals and non-COVID patients to COVID infection by decreasing the footfall in hospitals. and transmitted securely. Participants affected by type 1 diabetes mellitus have been . This yoga module was of 50min in duration and involved fast- and slow-breathing techniques and meditation and relaxation techniques. Inclusion in an NLM database does not imply endorsement of, or agreement with, However, it is prudent to obtain permission from the parent for anyone below 18years, given the existing definition of minor in the Mental Health Care Act, 2017 [38]. All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards. HHS Vulnerability Disclosure, Help Manjunatha N, Kumar CN, Math SB. Telemedicine uses electronic communication and information technology (IT) to support the delivery of healthcare services and medical education to people at a distant site, i.e., to those who are not able to reach the healthcare provider in person (Sood et al.,2007). The guideline spells the responsibility of the platforms that facilitate telemedicine to ensure the authenticity and credentials of the RMP enlisted to provide the teleconsultation in their platform. Virtual reality adaptable devices and technology are already making inroads as supplementary treatment modalities in various psychiatric conditions like phobias, anxiety disorders, depressive disorders, ADHD, and even autistic spectrum disorders. The RMP must mention a diagnosis before the prescription in the teleconsultation (Ryu,2012). Zelis, C. B. R. . (2018). Sanjeeva Kumar, then Additional Secretary, Ministry of Health and Family Welfare, Government of India. Panda PK, Dawman L, Panda P, Sharawat IK. The .gov means its official. Hierfr stellen wir innovative IT- Dienstleistungen zur Verfgung. Harris, A. M. (2020a). Directly as a Walk-In Patient Telemedicine, in its current form, has a history from the later parts of the 19th century. Telescreening for COVID19 symptoms, based on which patients can be referred to COVID19 designated hospitals or other hospitals, is being recommended (Enabling Delivery of Essential Health Services during the COVID 19 Outbreak: Guidance note Background,2021). The https:// ensures that you are connecting to the Artificial intelligence and machine learning utilize big data collected from various sources, including medical records, wearables, and clients monitoring devices, and analyse the data using algorithms. government site. The modules included different yoga practices ranging from yogic games (krida yoga), physical postures (asanas), and breathing techniques (pranayama) to meditations. The project COVID19 National Teleconsultation Centre (CoNTeC) has been conceptualized by the Indian Ministry of Health and Family Welfare and has been implemented by the All India Institute of Medical Sciences (AIIMS), New Delhi (COVID19 National Teleconsultation Center & AIIMS New Delhi,2021). Guidelines have been prepared by the Board of Governors, created in a supersession to the Medical Council of India, in collaboration with NITI Aayog, the government think tank for planning and policymaking (Board of Governors in supersession of the Medical Council of India,2020b). In particular, the side effects such as behavioural activation with selective serotonin reuptake inhibitors, extrapyramidal side effects with antipsychotics, and blood pressure changes with clonidine should be watched. Telepsychiatry operational guidelines. . Ray A, Sharma S, Sadasivam B. Telephonic triage in times of COVID-19: experiences at a telemedicine center in India. The issue came to the forefront when the Bombay High Court delivered a verdict against a doctor couple in a case of criminal negligence, wherein the physician made a prescription without a diagnosis over the telephone (Deepa Sanjeev Pawaskar And Anr vs. Kichloo, A. Telemedicine is likely to become an integral part of healthcare services in the post pandemic era. , & Availability and easy accessibility of health services, especially in remote and rural areas, Health education for individuals and the community, Collaborative specialty care with primary care physician and village health worker, Technological issues: poor internet bandwidth, digital illiteracy, Missed/error in diagnosis due to inability of doing physical examination, Ineffective counselling due to poor online recognition of non-verbal and verbal cues, Prescription errors: inability to understand prescription due to illiteracy, Privacy, confidentiality, and distraction challenges, Health data prone to hacking and misuse. Local ophthalmological drops such as: ciprofloxacillin for conjunctivitis, etc. Fast and stable internet and broadband connections (ADSL, fiber optic, cable, 4G or similar; at least 1MB / 300kb) are recommended. The guidelines advise a detailed in-person face-to-face assessment before initiating teletherapy. The Consumer Protection Act (CPA) will be applicable for teleconsultation, as long as the consultation is charged by the RMP or the Institute (Board of Governors in supersession of the Medical Council of India,2021). , Hence, the guidelines' title could have been Teleconsultation Practice Guidelines as it aptly reflects the scope of the guideline rather than the Telemedicine Practice Guideline. It also specifies the jurisdiction of the guidelines as applicable only for services provided in India. Teleconsultation is defined as synchronous or asynchronous consultation using information and communication technology to omit geographical and functional distance. The services include but are not limited to teleradiology, teleophthalmology, telecardiology, telestroke, telepediatrics, teleconferencing, and teleclassroom. The clinical team at the Department of Child and Adolescent Psychiatry at NIMHANS was able to successfully initiate and sustain telepsychiatry services after the onset of COVID-19, although this was not the norm previously. For psychotherapy, the ethical and legal responsibilities and requirements laid down by the Indian telemedicine guidelines are similar to those for face-to-face therapy. , & Basavarajappa, C. Available from: Agarwal N, Jain P, Pathak R, Gupta R. Telemedicine in India: a tool for transforming health care in the era of COVID-19 pandemic. 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]. 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. This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. Another telepsychiatry project in India by Thara et al. As a library, NLM provides access to scientific literature. Countries have issued telemedicine practice as guidelines (Ministry of Health Singapore,2015), as well as statutory rules (Ateriya et al.,2018). , 10.1017/dmp.2021.126. The guidelines are with a restricted scope for providing medical consultation to patients, excluding other aspects of telemedicine such as research and evaluation and the continuing education of healthcare workers. The State of Maharashtra on 25 July 2018,2018). On June 11, 2020, the Insurance Regulatory and Development Authority of India (IRDAI) issued guidelines advising insurers to allow telemedicine wherever consultation with a medical practitioner is allowed in the conditions of the policy contract. This model of paediatric and adolescent telehealth in India can be replicated by other LMIC. FOIA A psychiatrist is entitled to provide teletherapy to patients from any part of India. Teleconsultation was seen as a reasonable alternative to referral, as patients and caregivers felt that it integrated the GP's knowledge of the patient and the cardiologist's subject expertise. 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. Telemedicine has also been used to deliver healthcare during mass religious gatherings like Maha Kumbh Mela. For example, among the antidepressants, escitalopram and fluoxetine may be prescribed during the initial consultation. For older children and adolescents, especially those above the age of 10years, individual psychotherapy online sessions were attempted as and when deemed feasible. During the lockdowns, the focus of healthcare establishments was on the care of COVID-affected patients. He is currently pursuing research cum academic career in the Department of Community Medicine & School of Public Health at Postgraduate Institute of Medical Education & Research, Chandigarh, since July 2019. Patients may feel that teleconsultation is inferior as it lacks physical human interaction. , As per guidelines, barring methylphenidate, which comes under schedule X class of drugs, other psychotropic medications can be prescribed to children through a teleconsultation by a qualified psychiatrist. However, the nonrelease of even a short course on telemedicine, along with the guidelines, is a point of contention. The crucial aspect of stakeholder consultation with the RMPs, patients, technical platforms, and the medical institutes that already provide telemedicine services remains unanswered. This breaks the boundaries by enabling doctors to provide services and patients to avail themselves of services in states other than their residential ones. 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. Promoting a natural environment may help improve patient perception on teleconsultation. Aljadah, M. ISRO has been spearheading telemedicine in India and has paved the way for its operationalization from just being a technology demonstration. The Personal Protection Bill, 2018, is yet to be made an Act, thus having gaps in privacy safeguards (Ministry of Health Singapore,2015). Unser Expertenwissen fr Ihre Geschftskommunikation. 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. Chawla D, Thukral A, Kumar P, Deorari A. Share This. 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]. in 2016 [36] had developed the Clinical Decision Support System for the diagnostic evaluation of adults and children. Singh M, Das RR. NIMHANS is the first institute in India to start a helpline inclusively for Psychosocial support and mental health services during disasters. Board of Governors in supersession of the Medical Council of India Also, the jurisdiction of state medical council on matters of professional misconduct and disciplinary action against the RMP in cases of interstate teleconsultation needs detailed clarifications. Singapore has comprehensive guidelines encompassing the details of organizational structure and equipment required to provide telemedicine, including instruments like the stethoscope, and technological support required while providing telemedicine services, which has not been included in Indian guidelines (Ministry of Health Singapore,2015). Apollo TeleHealth is one of the largest telemedicine networks in south Asia. The state of Alabama in the USA mandates special licenses for telemedicine from physicians (Telemedicine laws and developments: A statebystate analysis,2021). India. , The children and adolescents who participated in the sessions were evaluated on Strengths and Difficulty Questionnaire at the baseline and after 1month. Most children and their families found telemedicine acceptable, effective, and convenient. Feasibility and effectiveness of teleconsultation in children with epilepsy amidst the ongoing COVID-19 pandemic in a resource-limited country. There was closure of the outpatient services. List B drugs can be prescribed in telefollowup consultation only, while a prohibited list of drugs cannot be prescribed online. During the feasibility study, the teleyoga sessions were conducted six days/week between 10:00 AM and 11:00 AM. For the first time, the government of India released telemedicine practice guidelines for Registered Medical Practitioners on March 25, 2020, amid the COVID19 outbreak. The Indian telemedicine guidelines propose that the first consultation must be conducted face to face and hence must be a video consultation [12]. The elements and principles of ASUs and RHPs guidelines are almost the same as that of RMP guidelines, with the only difference being adherence to homeopathy and ASU regulations while practicing it. 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. There needs to be a way to address the issues arising out of private data leaks in public. An explicit consent in words understood by the patient must be obtained if the RMP initiates the consultation, and the same must be mentioned in patient records (Board of Governors in supersession of the Medical Council of India,2021). Community outreach activities of the centre like imparting parenting training and school health education also continued over the online mode. , Retrieved May 29, 2021, from. Implicit or implied consent is taken if the patient initiates the teleconsultation. ). (2014). The guidelines have elaborated on the eligibility for practicing Telemedicine in India, the modes and types of teleconsultations, delved into the doctorpatient relationship, consent, and management protocols, and touched upon the data security and privacy aspects of Teleconsultation. Telemedicine: Opportunities and developments in member states: Report on the Second Global Survey on eHealth 2009 (Global Observatory for eHealth Series, Volume 2). (2016). Paediatric and adolescent telemental health services would be discussed in the next section. Caregiver satisfaction and effectiveness of teleconsultation in children and adolescents with migraine during the ongoing COVID-19 pandemic. . (2021). National Teleconsultation Service. teleconsultation. Tlconsultation est un service de consultation par tlephone ou video avec des professionnels de la sant. Any violation of the norms by the firms may lead to their blacklisting (entities to be avoided or distrusted as being deemed unacceptable by the Medical Council of India or its successors (Board of Governors in supersession of the Medical Council of India,2021). The RMP enjoys the same discretion and accountability in diagnosing and prescribing medicines in teleconsultation as he does in the conventional inperson consultation. The prescription can be shared online with the patient. Pandey V, Srivastava V, Imran M, Mishra A. 4th Floor,Tele Medicine Centre, the nation. Subsequently, a centralized IVRS phone line was set up so that children and families could reach out and request a follow-up teleconsultation according to their convenience. In India, eapplications like Practo, 1mg and Lybrate have flourished. Some of these were when a child or adolescent had come into conflict with the law and required an assessment or if a sensitive issue like child sexual abuse was suspected, which according to Indian law needs to be mandatorily reported to child welfare/law enforcement agencies. 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. Later a set of Frequently Asked Questions and their answers were released by the council (Board of Governors in supersession of the Medical Council of India,2020a).
Verona Nj Certificate Of Occupancy,
Everman Isd Pay Scale 23-24,
Most Sexually Active States In Nigeria,
Articles T