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BACKGROUND: The number and specificities of telehealth service units that expanded their services and diversified with the COVID-19 pandemic in Brazil need to be discovered. The objective of this manuscript is to present a methodology for the diagnostic evaluation of 19 telehealth units from different regions of the country for federal governmental decision-making. METHODS: A cross-sectional quantitative and qualitative study was carried out in the form of a census based on administrative records with an online survey and in-depth interviews with local telehealth managers. RESULTS: Despite the discontinuity of regular funding, the results point to a diversity of initiatives and advances. Citizenship, sustainability, security, and budget management are recurring themes in the maturity analysis of telehealth services after the advent of the pandemic. CONCLUSION: It is necessary for Brazil to build a resilient model of the maturity of telehealth services that contemplates the different regional scenarios.
Assuntos
COVID-19 , Telemedicina , Humanos , Brasil/epidemiologia , Pandemias , Estudos Transversais , COVID-19/epidemiologia , Teste para COVID-19RESUMO
With millions of people in the world in situations of physical distancing because of COVID-19, information and communication technology (ICT) has become as one of the principal means of interaction and collaboration. The following advantages of ICT have been cited since the start of the new millennium: increased access to information and service delivery, educational strengthening, quality control of screening programs, and reduction of health care costs. In the case of telemedicine, however, a number of barriers-especially technological, human and social, psychosocial, anthropological, economic, and governance-related-have stood in the way of its adoption. The past 20 years have seen an increase in the availability of resources and technical capacity, improvements in digital education, empowerment of patients regarding their treatment, and increased public interest in this area. Successes have included the use of interdisciplinary teams, academic and professional networking, and virtual medical consultations. After reviewing the state of telemedicine in the Region of the Americas, the authors recommend the urgent adoption of measures aimed at implementing national telemedicine policies and programs, including a regulatory framework and adequate funding. Implementation of the measures should be integrated and interoperable and include the support of academic networks and the collaboration of specialized institutions. The policies should generate an enabling context that ensures sustainability of the progress achieved, bearing in mind the possible barriers mentioned.
Com milhões de pessoas no mundo em situação de distanciamento físico devido à COVID-19, as tecnologias da informação e comunicação (TICs) se enquadraram como um dos meios principais de interação e colaboração. Já no início deste milênio, começaram a ser mencionadas as seguintes vantagens: maior acesso à informação e à prestação de serviços; fortalecimento da educação; controle de qualidade dos programas de detecção e redução dos custos na atenção à saúde. No entanto, entre as principais barreiras de adoção da telemedicina se encontram as de caráter: tecnológico; humano e social; psicossocial e antropológico; de governança e econômico. Nestes 20 anos, houve um aumento nos recursos e na capacidade técnica, uma melhora na educação digital, um empoderamento do paciente em seu tratamento e um maior interesse público nessa área. Em especial, são consideradas bem-sucedidas a constituição de equipes interdisciplinares e as redes acadêmicas e profissionais, e as consultas médicas virtuais. Após revisar o estado da telemedicina na Região das Américas, os autores recomendam a adoção de medidas urgentes para implementar políticas e programas nacionais de telemedicina, incluindo o marco normativo e o orçamento necessário. Essa implementação deve ser realizada de maneira integral e interoperável e sustentada por redes acadêmicas, de parceria e instituições especializadas. Tais políticas devem gerar um contexto favorável, dando sustentabilidade ao avanço obtido e considerando os aspectos mencionados nas possíveis barreiras.
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BACKGROUND: In recent decades, advances in information technology have given new momentum to telemedicine research. These advances in telemedicine range from individual to population levels, allowing the exchange of patient information for diagnosis and management of health problems, primary care prevention, and education of physicians via distance learning. OBJECTIVE: This scientometric investigation aims to examine collaborative research networks, dominant research themes and disciplines, and seminal research studies that have contributed most to the field of telemedicine. This information is vital for scientists, institutions, and policy stakeholders to evaluate research areas where more infrastructural or scholarly contributions are required. METHODS: For analyses, we used CiteSpace (version 4.0 R5; Drexel University), which is a Java-based software that allows scientometric analysis, especially visualization of collaborative networks and research themes in a specific field. RESULTS: We found that scholarly activity has experienced a significant increase in the last decade. Most important works were conducted by institutions located in high-income countries. A discipline-specific shift from radiology to telestroke, teledermatology, telepsychiatry, and primary care was observed. The most important innovations that yielded a collaborative influence were reported in the following medical disciplines, in descending order: public environmental and occupational health, psychiatry, pediatrics, health policy and services, nursing, rehabilitation, radiology, pharmacology, surgery, respiratory medicine, neurosciences, obstetrics, and geriatrics. CONCLUSIONS: Despite a continuous rise in scholarly activity in telemedicine, we noticed several gaps in the literature. For instance, all the primary and secondary research central to telemedicine was conducted in the context of high-income countries, including the evidence synthesis approaches that pertained to implementation aspects of telemedicine. Furthermore, the research landscape and implementation of telemedicine infrastructure are expected to see exponential progress during and after the COVID-19 era.
Assuntos
Bibliometria , Pesquisa , Telemedicina , Betacoronavirus , COVID-19 , Infecções por Coronavirus , Atenção à Saúde , Educação a Distância , Saúde Ambiental , Política de Saúde , Humanos , Enfermagem , Saúde Ocupacional , Pandemias , Médicos , Pneumonia Viral , Atenção Primária à Saúde , Psiquiatria , Publicações , Radiologia , SARS-CoV-2 , TelerreabilitaçãoRESUMO
Background and Introduction: In Brazil, the Telemedicine University Network (RUTE) initiative promotes collaboration between university hospitals, teaching hospitals, health professionals, and students using information and communication technology infrastructure to support special interest groups (SIGs) in health care. Health professionals in institutions belonging to RUTE plan a program of video conferences and/or web conferences to discuss specific themes. This article presents the results of an analysis of collaboration in these SIGs. Materials and Methods: This study uses descriptive statistical analysis and visualization of data contained in management reports provided by RUTE national coordinators for the period between 2007 and 2016 to evaluate the extent of participation in SIGs between institutions associated with RUTE. In this data visualization, we employ concepts from social network theory. Results: The analysis identified the most influential institutions as measured by social network theory metrics. A small number of institutions were found to have many participating SIGs, but most had only a few participating institutions (more than 130 institutions have only one participating SIG). Over the study period, a significant quantitative growth in collaboration occurred, increasing from 21 institutions and 92 participating SIGs in 2007 to 380 institutions and 1,912 participating SIGs in 2016. Conclusion: The growth in collaboration within the network indicates increasing interest and participation in telehealth initiatives in Brazil.
Assuntos
Comportamento Cooperativo , Rede Social , Telemedicina , Universidades , Brasil , Bases de Dados Factuais , Humanos , Opinião PúblicaRESUMO
This article aimed to systematize the views on telehealth in Latin America and to present the experience of building an instrument for monitoring the development of telehealth initiatives based on the reality of this region. A group was structured to coordinate telehealth efforts in Latin America, with members appointed by the ministries of health of 16 countries. Five thematic groups were also set up. Based on international experiences and focusing on the reality of telehealth in the continent, an instrument was created to monitor the development of telehealth in Latin America. Several countries have national telehealth projects: Brazil, Colombia, Ecuador, Mexico, Panama. Others are in the process of development and early deployment: Bolivia, Costa Rica, Cuba, El Salvador, Guatemala, Peru, Venezuela. The instrument described in the article, which is still being tested, proposes a characterization of countries according to their telehealth development stage: nonexistent, nascent, intermediate, advanced, and exemplary. Currently, important telehealth initiatives are already underway in Latin America.
Assuntos
Política de Saúde , Telemedicina , Humanos , América Latina , Telemedicina/organização & administraçãoRESUMO
OBJECTIVE: To report the experience of the Brazilian Program of Pediatric Teleradiology in combining teleconferencing and a virtual learning environment for services integration, collaborative research, and continuing education in pediatric radiology. MATERIALS AND METHODS: We performed virtual meetings from March 2005 to October 2010 on pediatric radiology-related themes, using a combination of videoconferences and Web conferences, which were recorded and made available in an open-source software (Moodle) for reuse. RESULTS: We performed 58 virtual sessions: 29 anatomical-clinical-radiological sessions, 28 on upgrading themes, and 1 virtual symposium. The average of connected points was 12 by videoconference and 39 by Web conference, and of 450 participants per event. At the time of this writing, 318 physicians and students are registered in the virtual learning environment, with a total of 14,678 accesses. CONCLUSIONS: Telemedicine is being included in pediatric radiology practice, as a means for distance education, training, and continuing integration between groups.
Assuntos
Aprendizagem , Pediatria/educação , Radiologia/educação , Ensino/métodos , Telemedicina/instrumentação , Brasil , Competência Clínica , Comunicação , Estudos de Viabilidade , Humanos , Internet , Pediatria/instrumentação , Pediatria/tendências , Radiologia/instrumentação , Radiologia/tendências , Telecomunicações/instrumentação , Telecomunicações/tendências , Telemedicina/tendências , Interface Usuário-ComputadorRESUMO
PURPOSE OF THE REVIEW: The purpose of the review is to describe the Brazilian Telemedicine University Network RUTE concerning the Special Interest Group of Children and Adolescents, the new SIG-COVID19-BR activities for continuing medical education, and to update relevant information regarding diagnosis and treatment, using digital technologies. RECENT FINDINGS: A total of 145 sessions of video and webconferences were held with the participation of 6575 health professionals, including medical students, interns, and residents. Major topics involved the healthcare of children and adolescents were combined with the emergence of a new pandemic plus the need to decrease the professional knowledge gaps in geographically distant hospitals. SUMMARY: Telemedicine is a cost-effective tool and a bridge to decrease health disparities access for proper care and assistance for any population. RUTE is a Brazilian model of telemedicine which has a positive impact attracting the participation of health professionals, and even more so, during the Covid-19 virus pandemic outbreak.
RESUMO
[RESUMEN]. Con millones de personas en el mundo en situación de distanciamiento físico por el COVID-19, las tecnologías de la información y comunicaciones (TICs) se han posicionado como uno de los medios principales de interacción y colaboración. Ya al inicio de este milenio se empezaban a mencionar las siguientes ventajas: mayor acceso a la información y a la prestación de servicios; fortalecimiento educativo; control de calidad de los programas de detección y reducción de los costos de la atención de en salud. Sin embargo, entre las principales barreras de adopción de la telemedicina se encuentran las de índole: tecnológicas; humanas y sociales; psicosociales y antropológicas; de Gobernanza y económicas. En estos 20 años se logró un aumento en los recursos y capacidad técnica, una mejora en la educación digital, un empoderamiento del paciente en su tratamiento y un mayor interés público en esta área. En especial se considera exitosa la conformación de equipos interdisciplinarios, las redes académicas y profesionales y las consultas médicas virtuales. Después de revisar el estado de la telemedicina en la Región de las Américas, los autores recomiendan adoptar medidas urgentes para poner en práctica políticas y programas nacionales de telemedicina, incluyendo el marco normativo y presupuesto necesario, cuya implementación se realice de manera integral e interoperable y que se sustente de redes académicas, de colaboración e instituciones especializadas. Dichas políticas deben generar un contexto habilitante que den sostenibilidad al avance logrado, considerando los aspectos mencionados en las posibles barreras.
[ABSTRACT]. With millions of people in the world in situations of physical distancing because of COVID-19, information and communication technology (ICT) has become as one of the principal means of interaction and collaboration. The following advantages of ICT have been cited since the start of the new millennium: increased access to information and service delivery, educational strengthening, quality control of screening programs, and reduction of health care costs. In the case of telemedicine, however, a number of barriers—especially technological, human and social, psychosocial, anthropological, economic, and governance-related—have stood in the way of its adoption. The past 20 years have seen an increase in the availability of resources and technical capacity, improvements in digital education, empowerment of patients regarding their treatment, and increased public interest in this area. Successes have included the use of interdisciplinary teams, academic and professional networking, and virtual medical consultations. After reviewing the state of telemedicine in the Region of the Americas, the authors recommend the urgent adoption of measures aimed at implementing national telemedicine policies and programs, including a regulatory framework and adequate funding. Implementation of the measures should be integrated and interoperable and include the support of academic networks and the collaboration of specialized institutions. The policies should generate an enabling context that ensures sustainability of the progress achieved, bearing in mind the possible barriers mentioned.
[RESUMO]. Com milhões de pessoas no mundo em situação de distanciamento físico devido à COVID-19, as tecnologias da informação e comunicação (TICs) se enquadraram como um dos meios principais de interação e colaboração. Já no início deste milênio, começaram a ser mencionadas as seguintes vantagens: maior acesso à informação e à prestação de serviços; fortalecimento da educação; controle de qualidade dos programas de detecção e redução dos custos na atenção à saúde. No entanto, entre as principais barreiras de adoção da telemedicina se encontram as de caráter: tecnológico; humano e social; psicossocial e antropológico; de governança e econômico. Nestes 20 anos, houve um aumento nos recursos e na capacidade técnica, uma melhora na educação digital, um empoderamento do paciente em seu tratamento e um maior interesse público nessa área. Em especial, são consideradas bem-sucedidas a constituição de equipes interdisciplinares e as redes acadêmicas e profissionais, e as consultas médicas virtuais. Após revisar o estado da telemedicina na Região das Américas, os autores recomendam a adoção de medidas urgentes para implementar políticas e programas nacionais de telemedicina, incluindo o marco normativo e o orçamento necessário. Essa implementação deve ser realizada de maneira integral e interoperável e sustentada por redes acadêmicas, de parceria e instituições especializadas. Tais políticas devem gerar um contexto favorável, dando sustentabilidade ao avanço obtido e considerando os aspectos mencionados nas possíveis barreiras.
Assuntos
Acesso à Informação , Desinformação , Prática de Saúde Pública , Saúde Pública , Planejamento em Saúde , Telemedicina , Acesso à Informação , Comunicação , Infodemia , Saúde Pública , Prática de Saúde Pública , Planejamento em Saúde , Telemedicina , Acesso à Informação , Desinformação , Saúde Pública , Prática de Saúde Pública , Planejamento em Saúde , COVID-19RESUMO
Con millones de personas en el mundo en situación de distanciamiento físico por el COVID-19, las tecnologías de la información y comunicaciones (TICs) se han posicionado como uno de los medios principales de interacción y colaboración. Ya al inicio de este milenio se empezaban a mencionar las siguientes ventajas: mayor acceso a la información y a la prestación de servicios; fortalecimiento educativo; control de calidad de los programas de detección y reducción de los costos de la atención de en salud. Sin embargo, entre las principales barreras de adopción de la telemedicina se encuentran las de índole: tecnológicas; humanas y sociales; psico-sociales y antropológicas; de Gobernanza y económicas. En estos 20 años se logró un aumento en los recursos y capacidad técnica, una mejora en la educación digital, un empoderamiento del paciente en su tratamiento y un mayor interés público en esta área. En especial se considera exitosa la conformación de equipos interdisciplinarios, las redes académicas y profesionales y las consultas médicas virtuales. Después de revisar el estado de la telemedicina en la Región de las Américas, los autores recomiendan adoptar medidas urgentes para poner en práctica políticas y programas nacionales de telemedicina, incluyendo el marco normativo y presupuesto necesario, cuya implementación se realice de manera integral e interoperable y que se sustente de redes académicas, de colaboración e instituciones especializadas. Dichas políticas deben generar un contexto habilitante que den sostenibilidad al avance logrado, considerando los aspectos mencionados en las posibles barreras
Assuntos
Telemedicina , Acesso à Informação , Planejamento em Saúde , Administração das Tecnologias da Informação , COVID-19 , Acessibilidade aos Serviços de SaúdeRESUMO
In Brazil the Telemedicine University Network (Rede Universitária de Telemedicina RUTE) is an initiative that among others promotes collaboration between university hospitals, universities, and health professionals through information technology infrastructure and special interest groups (SIGs) support. This paper presents results of analyses on collaboration during implementation and coordination activities of RUTE SIGs. This study is based on descriptive statistics and data visualization previously collected by RUTE national coordination relative to the status in July 2014. The analysis through collaboration graph identified the strongest collaboration RUTE units. The graph also highlights the collaborative relationship of RUTE units in form of communities, the most collaborative with each other in a communion in the same SIGs, and the less the collaborative units in the network. It should be stated that the most active units are also the oldest in the community.
Assuntos
Relações Interinstitucionais , Colaboração Intersetorial , Modelos Organizacionais , Telemedicina/organização & administração , Universidades/organização & administração , Comunicação por Videoconferência/organização & administração , Brasil , Disseminação de Informação/métodosRESUMO
Objetivo: No Brasil a Rede Universitária de Telemedicina (RUTE) é uma iniciativa que visa promover a integração em telemedicina e telessaúde de hospitais universitários, hospitais certificados de ensino, faculdades de medicina e demais cursos da área da saúde, através de infraestrutura de tecnologia da informação e comunicação e dos grupos de interesse especial (SIGs). Este artigo apresenta resultados da análise da colaboração e do crescimento existente nos SIGs RUTE. Métodos: O estudo se baseia em estatística descritiva de dados previamente coletados pela coordenação nacional RUTE relativos aos anos 2008-2013. Resultados: Resultados indicam uma colaboração e um crescimento de SIGs ativos, passando de 8 em 2008 para 55 em 2013, e de inscrições de unidades e instituições RUTE, passando de 96 para 1269 respectivamente. Foi possível notar que este salto quantitativo foi elevado nos dois anos iniciais do estudo, enquanto que, a partir do terceiro ano o crescimento continuou, porém sem fortes aumentos. Conclusão: O crescimento da colaboração verificado neste estudo foi significativo, apontando uma evolução positiva para os SIGs RUTE quanto ao interesse, participação e divulgação de ações em telessaúde no país.
Objective: In Brazil the Telemedicine University Network (Rede Universitária de Telemedicina RUTE) is an initiative to promote telemedicine integration of teaching hospital and health faculties through information and communication technology infrastructure and specials interest groups (SIGs) support. This paper presents results of the analysis of growth and collaboration in this SIGs RUTE. Methods: The study is based on descriptive statistics previously collected data for the national coordination RUTE for years 2008-2013. Results: Results indicate a quantitative improvement and a SIGs growth, from 8 in 2008 to 55 in 2013, and registered collaborating institutions, from 96 to 1269 respectively. We observed that this quantum leap was high in the first two years of the study, whereas, from the third year growth continued, but without strong increases. Conclusion: Therefore, the growth of collaboration found in this study was significant, indicating a positive trend for SIGs RUTE regarding interest, participation and reporting actions in telehealth in the country.
Objetivo: En Brasil, la Red Universitaria de Telemedicina (RUTE) es una iniciativa que tiene como objetivo promover la integración de la telemedicina y la telesalud entre hospitales universitarios, de enseñanza, facultades de medicina y otros cursos en el área de la salud a través de la infraestructura de tecnologia de la información y comunicación y los grupos de interes especial (SIGs). Este artículo presenta resultados del análisis del crecimiento y colaboración existente en SIGs RUTE. Métodos: El estudio se basa en la estadística descriptiva de datos recogidos previamente para la coordinación RUTE entre los años 2008-2013. Resultados: Los resultados indican un crescimento de los SIGs, de 8 en 2008 a 55 en 2013, y de registro de instituciones participantes, de 96 a 1.269, respectivamente. Observamos que este salto cuantitativo fue alto en los primeros dos años, mientras que, a partir del tercer año continuó el crecimiento, pero sin aumentos fuertes. Conclusión: Por lo tanto, el crecimiento de la colaboración encontrada en este estudio fue significativa, lo que indica una tendencia positiva para SIGs de RUTE en interés, participación y presentación de informes en las acciones de telesalud en el país.
Assuntos
Faculdades de Medicina , Telemedicina , Redes Comunitárias , Educação a Distância , Hospitais de EnsinoRESUMO
Este artigo pretendeu sistematizar a visão de telessaúde na América Latina e apresentar a experiência de elaboração de um instrumento para o monitoramento do desenvolvimento de ações de telessaúde a partir da realidade dessa região. Foi estruturada uma coordenação de telessaúde na América Latina, com membros indicados pelos ministérios da saúde de16 países, além de cinco grupos temáticos. Partindo das experiências internacionais e com foco na realidade de telessaúde do continente, foi elaborado um instrumento para acompanhar o desenvolvimento de telessaúde na América Latina. Vários países mantêm projetos nacionais de telessaúde: Brasil, Colômbia, Equador, México, Panamá. Estão em processo de elaboração e início de implantação: Bolívia, Costa Rica, Cuba, El Salvador, Guatemala, Peru, Venezuela. O instrumento descrito pelo artigo propõe a caracterização do grau de desenvolvimento da telessaúde nos países da América Latina como inexistente, incipiente, intermediário, avançado e exemplar, e ainda está em fase de teste. Atualmente, a América Latina já possui ações importantes na área de telessaúde.
This article aimed to systematize the views on telehealth in Latin America and to present the experience of building an instrument for monitoring the development of telehealth initiatives based on the reality of this region. A group was structured to coordinate telehealth efforts in Latin America, with members appointed by the ministries of health of 16 countries. Five thematic groups were also set up. Based on international experiences and focusing on the reality of telehealth in the continent, an instrument was created to monitor the development of telehealth in Latin America. Several countries have national telehealth projects: Brazil, Colombia, Ecuador, Mexico, Panama. Others are in the process of development and early deployment: Bolivia, Costa Rica, Cuba, El Salvador, Guatemala, Peru, Venezuela. The instrument described in the article, which is still being tested, proposes a characterization of countries according to their telehealth development stage: nonexistent, nascent, intermediate, advanced, and exemplary. Currently, important telehealth initiatives are already underway in Latin America.
Assuntos
Humanos , Política de Saúde , Telemedicina , América Latina , Telemedicina/organização & administraçãoRESUMO
The Brazilian eHealth initiative enables videoconferencing, diagnosis and formative second opinion, continuous and permanent education and web conferencing, by linking university and teaching hospitals via RNP (Rede Nacional de Ensino e Pesquisa), Brazil's national research and education R & E network. It operates two significant national projects: The Telemedicine University Network, RUTE (Rede Universitaria de TElemedicina www.rute.rnp.br) and the National eHealth Primary Care Program, Brazil Telehealth (www.telessaudebrasil.org.br); respectively from the Science and Technology Ministry MCT and Health Ministry MS. The municipal, state, national and international health institutions coordinate collaborative projects in research, innovation, development, management, education and assistance...