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Objectives: Telehealth implementation is a complex systems-based endeavour. This paper compares telehealth responses to (COrona VIrus Disease 2019) COVID-19 across ten countries to identify lessons learned about the complexity of telehealth during critical response such as in response to a global pandemic. Our overall objective is to develop a health systems-based framework for telehealth implementation to support critical response. Methods: We sought responses from the members of the International Medical Informatics Association (IMIA) Telehealth Working Group (WG) on their practices and perception of telehealth practices during the times of COVID-19 pandemic in their respective countries. We then analysed their responses to identify six emerging themes that we mapped to the World Health Organization (WHO) model of health systems. Results: Our analysis identified six emergent themes. (1) Government, legal or regulatory aspects of telehealth; (2) Increase in telehealth capacity and delivery; (3) Regulated and unregulated telehealth; (4) Changes in the uptake and perception of telemedicine; (5) Public engagement in telehealth responses to COVID-19; and (6) Implications for training and education. We discuss these themes and then use them to develop a systems framework for telehealth support in critical response. Conclusion: COVID-19 has introduced new challenges for telehealth support in times of critical response. Our themes and systems framework extend the WHO systems model and highlight that telemedicine usage in response to the COVID-19 pandemic is complex and multidimensional. Our systems-based framework provides guidance for telehealth implementation as part of health systems response to a global pandemic such as COVID-19.

Resumo A Rede de Núcleos de Telessaúde (RedeNutes) integra o Programa Telessaúde Brasil e desenvolve ações para Estratégia Saúde da Família, por meio dos serviços de teleassistência e tele- educação. O objetivo foi avaliar o grau de implantação da RedeNutes em seis municípios de Pernambuco. Tratou-se de pesquisa avaliativa, tipo análise da implantação no segundo componente, referente à análise da influência do grau de implantação sobre os efeitos observados, apoiada na estratégia estudo de casos múltiplos. A análise envolveu as dimensões gestora, municipal, global e seus componentes: planejamento, desenvolvimento, portal, teleassistência e tele-educação. Na dimensão Gestora, o grau de implantação foi considerado implantado; nas dimensões Municipal e Global, parcialmente implantado; entretanto o componente Teleassistência encontra-se não implantado. Concluiu-se que a Telessaúde pode contribuir com a melhoria do cuidado integral à saúde da população assistida, porém necessita de superar os problemas de adesão à intervenção, sobretudo em relação à Teleassistência.

The adherence to antihypertensive drugs and low salt diet improved after the CEP. Preliminarily, this telehealth strategy suggests a positive impact on hypertensive patients.

This paper presents the basis of the Agile Governance in Information and Communication Technology (ICT), which is based on Agile Software Engineering Methodologies principles and values. Its development was done through a systematic review process, supported by Bibliometrics and Scientometrics methods and techniques, where the Critical Success Factors (CSF) of ICT Governance projects and the principles of the Agile Manifesto were analyzed. Next, through an inductive approach, focused on the convergence between the concepts involved, it was analyzed how agile principles could help to minimize the gap between ICT and business. Evidences of their occurrence were taken through a Conceptual Survey Research. As a result, the foundations and concepts of Luna, A. J. H. de O., Agile Governance in ICT were defined and, finally, the development of a reference model was proposed as a future work.

Estudos demonstram que são escassas as ações relacionadas à saúde mental na Estratégia da Saúde da Família, requerendo sensibilização e capacitação dos profissionais. A Telessaúde assume um papel importante, pois favorece a criação de serviços colaborativos entre profissionais de saúde e especialistas trabalhando remotamente. Este artigo apresenta as estratégias para a implementação e a avaliação dos Seminários por Webconferência em Saúde Mental, oferecidos pela RedeNUTES para as equipes de saúde da família de Pernambuco, Brasil. Os seminários síncronos têm frequência semanal e são apresentados por teleconsultores da rede assistencial ou de ensino. As sessões são gravadas e disponibilizadas para consulta na Biblioteca Virtual. Em 2009, ocorreram 39 seminários. A avaliação geral dos seminários, o grau de compreensão dos temas abordados, o material didático utilizado e o tempo de duração tiveram bons resultados. Conclui-se que esse serviço oportuniza um bom espaço para educação continuada em saúde mental.

Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

We evaluated a tele-education programme for primary care staff in Pernambuco State, Brazil. During 2008 and 2009, tele-education sessions occurred four times each week for one hour per day. The topics included public health, child and adolescent health, mental health and nursing. After each session, participants completed an evaluation questionnaire. A total of 73 municipalities and 141 health centres participated in the programme. There were 254 tele-education sessions scheduled during the 20-month study period; of these, 224 sessions were successfully performed and 30 were cancelled. We collected 3504 responses from the satisfaction survey. There was high acceptance of the programme: 97% rated it as excellent or good.