Clinical Quality Control of a Large-Scale Teleconsultation Service.

The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that assists 722 municipalities in the state of Minas Gerais. As a large-scale teleconsultation service, it was important to implement clinical quality control to guarantee the quality of the service. Our aim is to describe the audit of the teleconsultation responses performed by TNMG. A random sample was selected from teleconsultations performed by the specialists from the TNMG between January and February 2014. The responses were evaluated regarding size, objectivity, quality, ethics, courtesy and grammar. A total of 640 teleconsultation responses were assessed, and the mean scores were ≥2.45. Objectivity and quality had the lowest scores in the different specialities. The methodology was useful for evaluating the teleconsultation service and for identifying the areas to improve.

Audit of primary care electrocardiograms sent as emergency to a telehealth service - the Telehealth Network of Minas Gerais, Brazil.

The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that has performed electrocardiogram (ECG) analysis since 2005. From February to March 2014, 28% of ECGs were classified as "emergency" by the primary care tele-health sites. This quasi-experimental study aimed to investigate the reasons behind the high number of emergency ECGs being sent in, the implementation of corrective actions, and an assessment of the impact of these actions. In the 1st phase, primary care units that sent >70% of ECGs as emergency from February to March 2014 were selected. The 2nd phase consisted of the intervention. In the 3rd phase, the proportion of ECGs sent as an emergency during the 1st and 2nd months post intervention were assessed. Of the 63 cities selected during the 1st phase, 50% of the practitioners did not know the proper definition of emergency. After the intervention, 67% of the cities had a significant reduction in the proportion of ECGs sent as an emergency during the 1st month, and 17% had a significant reduction during the 2nd month.