Resumo: A COVID-19 tem representado um desafio global aos sistemas de saúde, expandindo em velocidade crescente de óbitos, de pacientes críticos com pneumonia e necessidade de suporte respiratório. Métodos alternativos para controlar a propagação da doença, como o isolamento social, medidas extremas de quarentena e o rastreio dos contactantes dos casos têm sido utilizados no mundo. Contudo, essas medidas podem não ser totalmente eficazes para combater a escalada da COVID-19 em compasso às preparações nacionais necessárias às novas demandas de cuidado. Ampla gama de tecnologias digitais pode ser usada para aprimorar essas estratégias de saúde pública, e a pandemia gerou um frenesi relacionado à telessaúde. No Brasil, esse campo tem crescido acentuadamente nos últimos anos. Todavia, a despeito da intensa proliferação de normativas, ainda inexistia, até a epidemia, um marco regulatório plenamente consolidado no país. O surgimento da COVID-19 marca um momento profícuo de expansão das aplicações e usos da telessaúde, como forma de melhorar a resposta do sistema de saúde à crise em curso. O artigo discute a contribuição da telessaúde para o enfrentamento da COVID-19 e as iniciativas recentes desencadeadas no país, como oportunidades para a consolidação da telemedicina e de aperfeiçoamento do Sistema Único de Saúde. Concluiu-se que a telessaúde oferece capacidades para triagem, cuidado e tratamento remotos, auxilia o monitoramento, vigilância, detecção e prevenção, e para a mitigação dos impactos aos cuidados de saúde indiretamente relacionados a COVID-19. As iniciativas desencadeadas nesse processo podem reconfigurar o espaço futuro da telemedicina na prática dos serviços no território.
Resumo: estudo de abordagem qualitativa sobre a concepção da política de telessaúde no Brasil baseado em modelos de avaliação em saúde e na análise de políticas públicas, mais especificamente na proposta analítica de múltiplos fluxos e no modelo lógico de avaliação de programas em saúde. as fontes de dados consistiram em documentos relacionados à criação da Rede universitária de telemedicina (Rute), artigos disponíveis na literatura sobre telessaúde e avaliação em saúde, atas e participações em reuniões de variados fóruns. o modelo de múltiplos fluxos se concentra nas fases iniciais do ciclo da política pública: a construção da agenda governamental e a escolha de alternativas de políticas. Buscou-se delinear a composição da Rute e responder quais condicionantes levaram os gestores federais de diversos setores a reconhecer a qualidade do sistema como problema na saúde pública e a escolha da implantação de programas de telessaúde como uma das alternativas para a solução. os processos analisados demonstraram que, na convergência do fluxo de problemas com ambiente político favorável, abriu-se uma janela de oportunidade para a implantação da telessaúde como alternativa vir a ascender como política na agenda de decisão governamental. Porém, para isso, urge a necessidade de inclusão digital no território e identificar as tecnologias da informação e comunicação como inovação para o sus. Palavras-chave: telessaúde; política pública; avaliação.
This study characterized the evolution of Brazilian public telemedicine policy in the Brazilian Unified Health System for 30 years from 1988 to 2019 by analyzing its legal framework. We identified 79 telemedicine-related legislations from the federal government (laws, decrees, and ordinances) and 31 regulations of federal councils of health professionals. Three historical phases were established according to the public policy cycle, and material was classified according to the purpose of the normative documents. The content analysis was based on the advocacy coalition framework model. Of the federal legislations, 8.9% were for the Formulation/Decision-Making phase, 43% for the Organization/Implementation phase, and 48.1% for the Expansion/Maturation phase of telemedicine policy in Brazil. The Federal Council of Medicine was the most active in standardizing telemedicine and was responsible for 21 (67.7%) regulations. The first legislations were passed in 2000; however, the coalitions discussed topics related to telemedicine and created their belief systems from the 1990’s. The time cycle which included formulation and decision making for Brazilian telemedicine policy, extended until 2007 with the creation of several technical working groups. The expansion and maturation of telemedicine services began in 2011 with the decentralization of telemedicine policy actions across the country. Telemedicine centers which performed telediagnosis influenced the computerization of primary health care units. We conclude that Brazilian telemedicine field has greatly grown and changed in recent years. However, despite the proliferation of legislations and regulations in the period studied, there is still no fully consolidated process for setting up a wholly defined regulatory framework for telemedicine in Brazil.
Since 2004, educational videoconferences have been held in Brazil for paediatric radiologists in training. The RUTE network has been used, a high-speed national research and education network. Twelve videoconferences were recorded by the Health Channel and transformed into TV programmes, both for conventional broadcast and for access via the Internet. Between October 2007 and December 2009 the Health Channel website registered 2378 hits. Our experience suggests that for successful recording of multipoint videoconferences, four areas are important: (1) a pre-planned script is required, for both physicians and film-makers; (2) particular care is necessary when editing the audiovisual material; (3) the audio and video equipment requires careful adjustment to preserve clinical discussions and the quality of radiology images; (4) to produce a product suitable for both TV sets and computer devices, the master tape needs to be encoded in low resolution digital video formats for Internet media (wmv and rm format for streaming, and compressed zip files for downloading) and MPEG format for DVDs.
Objectives: to describe the adaptation process of the Zero Mothers Die app, developed in Europe, is to combat maternal mortality, was brought into the Brazilian context with an individualized auscultation methodology for pregnant women and mothers who attended a high complexity referred teaching hospital. Methods: the research consisted of two parts: the participant observation technique was used by health professionals to translate the platform; with an approach in the service with online forms for pregnant women, and the content analysis was performed by grounded theory of the data. During five months, 109 pregnant women and mothers installed the app, but only 17 completed the questionnaire. Results: the women and health professionals pointed out questions such as interactivity, application interface, content, pregnancy and childcare clinical management, which contributed for the Brazilian version. Conclusions: the participatory medicine and e-pregnant woman are new premises of a humanization policy for women and childcare. The insertion of an app with information based on the best evidence in the prenatal routine in the health establishments with teaching activities that can provide new dialogue connections with the pregnant women and chances to update the professional in training.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.