RESUMO
INTRODUCTION: The Belo Horizonte Telehealth program, a pioneer in telemedicine within the Brazilian National Health System (Sistema Único de Sauùde in Portuguese), was implemented by the Belo Horizonte City Health Department (SMSA-BH) in 2004. The purpose of the present study is to analyze opinions on the obstacles, difficulties, and suggestions on the use of teleconsultations. METHODS: Semi-structured interviews were conducted among primary healthcare professionals and health managers. Content analysis for the latter was carried out using NVIVO® software to categorize responses. Simple descriptive quantitative aspects were analyzed to verify the use of the system over the years by the primary care unit (PCU) professionals. RESULTS: The difficulties encountered were related to the use of the system, inadequate response to teleconsultation requests, infrastructure problems, lack of practicality for the use of the program, difficulty in incorporating the program into the organizational culture, and lack of managerial support. Changes in management organization over the years have interfered with the use of the teleconsultation system. The most requested specialties were neurology, cardiology, endocrinology, and angiology. DISCUSSION: The main suggestions for increasing the number of teleconsultations requests included dissemination of information and prioritization by the management; improvement of the infrastructure; organization of the time and the agenda of the PCU professional; training the professionals for its use; and preconditioning the referrals to secondary level care to a previous teleconsultation. CONCLUSION: Teleconsultations need to be incorporated in the daily routine of PCUs by both managers and health professionals to assure its usage and improve the quality of care.
Assuntos
Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/estatística & dados numéricos , Consulta Remota/organização & administração , Consulta Remota/estatística & dados numéricos , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Brasil , Humanos , Consulta Remota/métodosRESUMO
INTRODUCTION: Telemedicine is the provision of health services by professionals who use information and communications technology in the exchange of information for the diagnosis, treatment, and prevention of diseases. Since 2004, the Municipal Department of Health of Belo Horizonte, MG, Brazil, has been implementing telehealth initiatives with the goal of increasing the ability of primary care providers to resolve problems by providing them with clinical support and with continuing education using information and communications technologies. This study characterized the primary care physicians who used the Belo Horizonte telehealth store-and-forward teleconsultation. MATERIALS AND METHODS: A descriptive study was conducted of the frequency of use of store-and-forward teleconsultation and characteristics of physician users. RESULTS: We analyzed 737 store-and-forward teleconsultations in the period 2006-2010. The number of store-and-forward teleconsultations grew from 2006 to 2009, and 85 physicians used the tool. The physician users were predominantly women, specialists in family and community medicine, those employed under a stable contract, and older and with more time in the profession and in public service. The adoption rate was 6.0%, 4.8%, and 1.2% in 2008, 2009, and 2010, respectively. CONCLUSIONS: Context variables and individual variables may be influencing the adoption of store-and-forward teleconsultation in Belo Horizonte. It would be useful to further study the factors that constitute barriers to using teleconsultations and to improve the training in use of the tool.