1) The document describes NIMHANS ECHO, an innovative tele-mentoring model developed by NIMHANS, Bangalore to build skilled capacity for addiction and mental health in the community. 2) Through weekly live video conferences and asynchronous e-learning modules, NIMHANS ECHO connects experts at NIMHANS with community health professionals to provide training, mentoring, and share best practices. 3) Over two years, NIMHANS ECHO has connected with nearly 1000 community partners, delivered over 170 hours of training, and seen positive impact including improved clinical practices and patient satisfaction with care.

1. 1
Virtual Knowledge Network
NIMHANS ECHO
INNOVATIVE TELE-MENTORING MODEL FOR SKILLED CAPACITY
BUILDING IN ADDICTION & MENTAL HEALTH
Arun K, Jayant M, Mallikarjun R, Manjula S, Lakshmanan S, Lakshmi K, Kubenthiran, Vivek Benegal,
Pratima Murthy, Miriam Komaromy*, Sanjeev Arora*
NIMHANS, Bangalore, India and *UNM Health Science Centre, Albuquerque, USA
Prabhat Chand, MD, DNB, MNAMS
Addiction Psychiatrist

2. VKN: Capacity building with Co-ordinated
Care
• Mental, neurological, and
substance abuse (MNS) disorders:
increasing global burden of disease
(WHO 2014)
• Available resources to tackle the
huge burden are insufficient,
inequitably distributed, and
inefficiently used.
• Large majority of people with
these disorders receiving no
(quality) care at all (mhGAP,WHO)
National Institute of Mental Health and Neurosciences,
Bangalore a public funded government academic medical centre
of excellence on mental health and neurosciences

3. SKILLED CAPACITY BUILDING
QUALITY CARE
Is it possible to provide QUALITY CARE
LIKE NIMHANS in the Community, the
places where the patient/people stay ?
3

4. Virtual Knowledge Network
NIMHANS ECHO: Bridging the GAP
Demonopolize
knowledge and Amplify
the Capacity to provide
Best Practice Care in
Addiction Mental Health
in Community by
leveraging technology
VKN: Capacity building with Co-ordinated
Care

5. NIMHANSECHO (hub and spoke) model
improves training CAPACITY and ACCESS to
best practice in the Community
PMC
Multidisciplinary
NIMHANS
Counsellor
General
Practitioner
Medical
college
School
Educator
Resident
Psychiatry
Private
Psychologist
Public
health
NGO
VKN NIMHANS ECHO: Capacity building
with Co-ordinated Care
5

6. Objectives
Connecting NIMHANS, an academic center to
Community Health Professionals
 “Capacity building” with “Quality Care”
 Reduce the “variations” in standard of care.
 Sharing of “best practice” models.
 Sharing of “wisdom” along with “clinical
practice guidelines”.
 Continued training “Handholding” and
developing a “Learning loop” rather than a
single or few sessions.
DEMOCRITIZING KNOWLWDGE
VKN NIMHANS ECHO: Capacity building
with Co-ordinated Care
6

7. Every Tuesday 2-4PM LIVE session
VKN: Capacity building with Co-ordinated
Care
Easy to access anywhere:
No cost to participants
Secured, encrypted,
HIPAA compliant

8. NIMHANS ECHO(Combination of Synchronous (LIVE) and Asynchronous (e-
learning)
Synchronous (LIVE)
Clinical Case Presentation
• Clarification, Suggestion on Management
• Tentative follow up presentation
• Learning from the case
Didactic
• Presentation of relevant topic by Experts
• Sharing of latest knowledge
Community health
professionals also present
complex clinical cases in
the weekly tele-health
Sessions and get input for
best practice from CAM
NIMHANS Team and also
from the Peers
VKN: Capacity building with Co-ordinated
Care

9. E-learning Certificate module :
Anytime
Didactic Module
1 – Alcohol*
2 - Opioid Use Disorders and Management
3 - Addiction and Co morbidity
4 - Cannabis Use Disorders*
5 - Psychosocial Assessment and Intervention
6 - Addiction Pharmacology*
7 - Helping People : Quit Tobacco*
8 - Stress and Resilience
9 - Behavioural Addiction
10 - Adolescent and Addiction
11 - Substance Use in Special Population
12 - Clinical Challenges
13 - Evidence Based Practice : Alcohol
14 - Substance Induced Psychotic Disorders
15 - Biological Functions
16 - Forensic Aspects of Addiction
17. Psychological Management
VKN: Capacity building with Co-ordinated
Care
Recorded Videos are uploaded Currently Running

10. VKN NIMHANS ECHO : two years after
and ongoing…..
• 968 partner Spoke
• 86 tele-ECHO clinics
• 172 session hours
• 20 monthly module
Registration
• 1206 health
professionals
• 2860 instances of
participation
Tele-ECHO
Participation • 440 Credits Points
• 101 E-Module
completer
• 473 Feedback
(39.22%)
Certification and
Credits
VKN: Capacity building with Co-ordinated
Care

11. 2 2 8 2 5 2
33 33
58
32 36
24
373 373
342
374 367
382
0
50
100
150
200
250
300
350
400
450
Objectives Balanced Interactive Organization Communicate Relevence
Chart Title
poor/average Good V.good/Excellent
VKN: Capacity building with Co-ordinated
Care
Feedback: Healthcare perspective
(n=408)

12. Commercial Bias (N=408)
Yes
7%
No
93%
Commercial Bias
Yes No
12

13. Will you like to Change in your Clinical
Practice? (n=408)
Yes
98%
No
2%
Practice Change
Yes No
13

14. Benefits to Participant Spoke
VKN: Capacity building with Co-ordinated
Care
Learning by Doing
Affiliation and
mentoring
Professional
interaction
Up-to-Date and best
practice
Benefit to
Participants

15. 15
Patient perspective: One
Spoke
Reduction in their
expenses
No Need of Travel
 Easy accessibility
Regular and frequent
Follow-ups
Better Language
communication
0
1
2
3
4
5
6
7
8
9
10
Confidence Satisfaction
CAM Vs VKN mentored Health care
Provider (n=22)
NIMHANS SPOKE
Overall satisfaction is 9.2(SPOKE) out of 10(NIMHANS)

16. 16
Current status
Addiction &
Mental Health
Complex case
Weekly Tuesday
April 2014
Road to
Recovery
R2R
Psychiatric
Rehab
Monthly 4th
Friday June
2015
Motherhood and
Mental Health
Perinatal Psychiatry
Monthly 3rd Friday
September 2015
9 Districts of Bihar
Alcohol Addiction
2nd and 4th Wednesday
March 2016
Training ECHO

17. Copyright 2014 Project ECHO®
• Technology
• Force Multiplication
• Demonopolizing Knowledge
• Knowledge Expansion
Task Sharing
Interprofessional
Consultation
Guided
Practice
Mentor/Mentee
Relationship
Community of Practice
(Social Network)
Joy of
Work
Movement Building
vs.
Organization Building
Lesson learnt?
Identifying
champions

18. Conclusion
Strength
• May not be suitable for all
disorders
Weakness
•Preventive, promotive and
curative
• Complex Clinical Care
Opportunities

19. VKN in News
“First Prize at International
Telemedicine Congress 2015”
“Mental Health Innovation
Network”
“Funding to train and handhold
doctors/counsellors from State
Health Society Bihar”
“Innovative, replicable, public
health practices” by National
Health Mission (NHM) India
VKN: Capacity building with Co-ordinated
Care

20. Moving Knowledge: Instead of Patients
“Virtual” Knowledge Network
vlc.nimhans.ac.in
VKN: Capacity building with Co-ordinated
Care