A survey released last April, by the Regional Center for Studies on the Development of the Information Society (Cetic), showed that 74% of Brazilians over 16 years of age and Internet users had not used a telemedicine service or with another health professional in the last 12 months. Among other reasons, 58% of survey respondents said they are concerned about the security of personal data. The study “Covid-19 ICT Panel: An Online Survey with Internet Users in Brazil” heard 5,500 people across the country.
Resolution 2314/2022, issued this month by the Federal Council of Medicine (CFM), states that the patient, or his legal representative, must authorize the service by telemedicine and transmit his images and data by term. the agreement. The standard also specifies that in the case of remote issuance of a report, it must contain the identity of the doctor, patient data, as well as the date, time and signature of the doctor with a digital certificate in the ICP-Brazil standard or other accepted standard.
These requirements are intended to comply with the General Personal Data Protection Act (LGPD). In this sense, the legislation prohibits the communication or joint use of sensitive personal data processing agents relating to health with the aim of obtaining an economic advantage, and does not allow operators of private healthcare plans to access the data in order to exercise choice. Contracting risks, as well as in contracting and excluding beneficiaries, for example.
Defined as the practice of medicine mediated by digital, information and communication technologies (DICTs), for the purposes of assistance, education, research, disease and injury prevention, management and promotion of health, telemedicine has expanded due to the high demand for telecalling, as a result of social distancing recommendations imposed by the COVID-19 pandemic, which is Today it is considered one of the major transformations in the sector. At the same time, it has proven effective in providing assistance to inner cities and a challenge for professionals who need to adapt to this new model of care.
Waiting rooms can now be directly in front of a computer or cell phone screen, and medical care is made possible through technology. We are talking, for example, about telecommunication, online consultations, remote diagnosis, remote monitoring and even remote surgeries, which are performed with the help of robots.
The demand for these services, which was already on the rise, tends to continue to grow significantly. This is indicated by recent studies by Global Market Insights, according to which telemedicine should move 131 billion US dollars by 2025.
In Brazil, research by the Regional Center for Studies on the Development of the Information Society (Cetic) indicates that at least half of Brazilians over 16 years of age who use the Internet have provided health services online in the past 12 months, between appointments, exams and teleconsultations View exam results online. Telemedicine was the most used among high-income people, groups A and B, responsible for 42% of teleconsultations and 51% of other services.
The importance of organization
Despite the acceleration of the use of telehealth services due to the health crisis, Resolution No. 2314/2022 is the result of a discussion that the medical profession has had since 2018. This is due to the need to demonstrate its efficacy and equivalence with direct care.
However, its practice requires knowledge beyond handling a device to make video calls. That is why, according to the head of the Regional Council of Medicine in Sergipe (Crimes), Gilvan Pinto Monteiro, the regulation aims to prevent “violations that do harm, especially to the patient.”
According to the new regulation, the doctor needs to know the specific ethical aspects of this type of consultation, such as storing digital data, registering in the medical record, and sending the summary form to patients. Telemedicine also requires a more aggressive application of the knowledge the professional already has regarding the anamnesis, the interview in which the clinician is able to identify the patient’s needs and then formulate a diagnosis.
However, it may not suit all specialties or clinical situations. That’s reported by GP and working physician, Sheila Amorim, who began doing teleconsultations during the pandemic, initially, to meet with family and friends who had difficulty getting emergency and emergency care. He quotes: “Face-to-face counseling is necessary, for example, when pulmonary auscultation, skin examination, and abdominal palpation, among other physical examinations, are necessary.”
Face-to-face consultation is the gold standard of reference and complementary telemedicine, as regulated by the Council of Foreign Ministers. In the case of clinical follow-up of chronic or serious diseases, the use of telemedicine is allowed, but face-to-face consultations should be carried out at intervals not exceeding 180 days.
Telemedicine in medical colleges
In Brazil, information technology began to appear in the curricula of medical schools in 1986. As discussions about methodology progressed, disciplines dealing with telemedicine, formerly electives, began to form educational programs at the undergraduate and graduate levels, medical residency and extension courses.
The training of physicians working in this field has acquired more and more important features. In 2006, the then Ministry of Science and Technology established the University Network for Telemedicine, with the aim of promoting the improvement of telemedicine projects and providing infrastructure, information technology and communication equipment for research groups in universities in all regions of the country, and promoting their integration and knowledge exchange.
“Although it has been a trend that has been reinforced in recent years, there have been medical schools working with telemedicine since the late 1990s. At that time, the methodology did not flourish precisely because of a lack of regulation, but in the current context it is a bridge to humanization and safety Attendance, health connected without distance. The key point is not to lose sight of the fact that professional practice must continue to take responsibility and focus on caring for people,” says Melhores Escolas Médicas Portal Coordinator, Evelyn Silva.