Strategies to improve communication in telementoring in acute care coordination: a scoping review

Technology-driven innovative model for integrating mental healthcare into primary care: Example from Chhattisgarh, India

INTRODUCTION

Despite the expansion of India's National Mental Health Program and the District Mental Health Program (DMHP), Chhattisgarh continues to face a significant shortage of specialist mental health professionals. To address this gap, two hybrid task-shifting initiatives-Chhattisgarh Community Mental Health Care Tele-Mentoring Program (CHaMP) and Tele-mentoring for Rural Health Organisers of Chhattisgarh (TORENT)-were launched. This paper describes these programs and evaluates their preliminary impact.

METHODOLOGY

CHaMP targeted Primary Care Doctors, while TORENT focused on non-medical personnel, including Community Health Officers and Rural Health Organizers. The aim was to enable these frontline workers to screen, identify, manage, and follow up on common psychiatric disorders. Training was delivered using a standardized curriculum and validated clinical tools, emphasizing adult learning principles, peer learning, and a collaborative approach. Ongoing video-based consultations provided continuous mentoring and supervision. The programs' impact was assessed based on service coverage, workforce trained, and the number of individuals screened, referred, diagnosed, and treated annually.

RESULTS

From August 2019 to January 2024, >11,000 healthcare professionals were trained under CHaMP and TORENT. During this period, Community and Rural Health Organizers screened 1169,520 people. Of these, 105,070 individuals (approximately 9 %) screened positive and were referred for further assessment. Primary Care Doctors diagnosed and treated 1002,136 individuals. These efforts resulted in the establishment of a decentralized, end-to-end mental health care delivery network across the state.

CONCLUSION

CHaMP and TORENT represent an innovative and scalable strategy for integrating mental health into primary care. Their success offers a replicable model for integrating mental health into primary care across similar regions globally.

Consultation Processes With Helicopter Emergency Medical Service Physicians in Finnish Prehospital Emergency Care: The Paramedics' Perspective

OBJECTIVE

The Finnish emergency medical services operates mainly with highly educated paramedic-staffed units. Helicopter emergency medical services (HEMS) physicians alongside other physicians provide consultations to paramedics on the scene without the physician physically participating in the mission. We examined the Finnish paramedics' views regarding the consultation processes involving HEMS physicians.

METHODS

This was a cross-sectional survey study among paramedics (n = 200). Assessments of the performance of HEMS physicians and other physicians in the consultation process were analyzed descriptively. The effect of the physician being expressly part of the HEMS was analyzed with inductive content analysis.

RESULTS

Overall, consultations with the HEMS physician were well received among paramedics, and the HEMS physicians received higher assessments than other physicians. The familiarity with the prehospital environment, limitations, and local possibilities was valued. Expertise is particularly valuable in challenging emergency medical services missions but unnecessary in many nonurgent missions. There is scope for improvement in the attitudes and technical fluency of the consultation processes of HEMS physicians.

CONCLUSION

Using HEMS physicians in prehospital consultations could be recommended. Further studies are still needed to ensure the efficacy and efficiency of the consultation process and explore the integration of video connections into current consultation practices.

The use of drones for the delivery of diagnostic test kits and medical supplies to remote First Nations communities during Covid-19

BACKGROUND

Health care inequity in remote and rural Indigenous communities often involves difficulty accessing health care services and supplies. Remotely Piloted Aircraft Systems, or drones, offer a potentially cost-effective method for reducing inequity by removing geographic barriers, increasing timeliness, and improving accessibility of supplies, equipment, and remote care.

METHODS

We assessed the feasibility of drones for delivery of supplies, medical equipment, and medical treatment across multiple platforms, including drone fleet development and testing; payload system integration (custom fixed-mount, winch, and parachute); and medical delivery simulations (COVID-19 test kit delivery and return, delivery of personal protective equipment, and remote ultrasound delivery and testing).

RESULTS

Drone operational development has led to a finalized, scalable fleet of small to large drones with functional standard operating procedures across a range of scenarios, and custom payload systems including a fixed-mount, winch-based and parachute-based system. Simulation scenarios were successful, with COVID-19 test swabs returned to the lab with no signal degradation and a remote ultrasound successfully delivered and remotely guided in the field.

DISCUSSION/CONCLUSIONS

Drone-based medical delivery models offer an innovative approach to addressing longstanding issues of health care access and equity and are particularly relevant in the context of SARS-CoV-2.