Telehealth in Brazil: evaluating the risks and a major shift in accessibility on the health system

Telehealth has been incorporated around the world, revolutionising health systems in many countries. This technology has also been developing in Brazil, where it has been integrated into the clinical practice. The country’s Federal Medical Council recognized the role of Telehealth in 2002 through Resolution No. 1.643, in specific scenarios as for purposes of research, clinical assistance, health education or support to diagnostic and therapeutic emergencies.

The initiative allowed the Brazilian population greater access to the public health system. In 2006, the Ministry of Health created the Telessaúde Brasil, a pilot project comprised of nine core Telehealth centers established across the country and connected to 100 primary care units to offer teleconsultations for doctors and health care professionals.

Government data showed, in 2016, that over 480,000 general teleconsultations, 3 million telediagnostic consultations and around the same number of heath educational events had taken place. All of these directed to health care professionals from the public system, only nine years after project had been launched.

Last February, a new resolution (No. 2.227) was published, in an attempt to update the regulations governing the practice of Telehealth, covering remote consultations, surgeries and diagnostic procedures. However, soon after the publication, no less than 1,444 requests for changes were submitted to the Federal Medical Council. The updated version was, then, annulled and the 2002 text went back into force.

Among the innovations foreseen in this second version of the resolution, the most controversial is the teleconsultation, which allows remote consultations without the presence of the physician where the patient is. In countries such as Canada, the United States, England, Portugal, the Netherlands, China, and the Nordic countries, this is already a reality – remote care is allowed, not requiring a medical professional on site.

Doctors in Brazil share diverse opinions on the matter. Some believe that this new regulation could represent danger to the population. Others have an opposite view, considering it is a major shift to provide increased access to the national health system, especially in outlying areas. According to a survey conducted by the Institute of Applied Economic Research (Ipea, acronym in Portuguese), with 2,773 users of the public system, the lack of doctors is the main problem faced by 58% of Brazilians. In a country with about 400,000 trained doctors, the reality in 700 municipalities is the total lack of available health professionals.

To dig deeper into all these issues, Portal Health Connections invited recognized specialists to share their experiences and insights on the current and future Brazilian scenario regarding the practice of Telemedicine. The first is neurologist Jefferson Fernandes, PhD. He is a qualified professor associated to Fundação Getúlio Vargas-RJ, IBCMED-SP and FIAP and the current chairman of the Board of Trustees of the Global Summit Telemedicine & Digital Health of the São Paulo Medical Association. The physician points out that Telemedicine’s main benefits have already been proven by scientific publications around the world. It is a “cost-effective” technology and with a great potential to help expand access to the national health system, “performed in a safer manner and complying with high-level quality standards”.

For those interested in investigating the topic, Jefferson highlights the next Global Summit Telemedicine & Digital Health, in 2020, with previous discussion events throughout the country – the next will take place in Rio de Janeiro, with the participation of local professionals involved in the practice and in building experiences in Telehealth.

Watch the first video of the series below (in Portuguese) and stay tuned for the next.

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