Telemedicine and telehealth: a success story in SUS – 08/24/2021 – Opinion

Among the impacts of the digital disruption caused by the pandemic is the understanding of the potential of telehealth. The Federal Deputy Adriana Ventura’s (Novo-SP) bill, which regulates telemedicine, is being processed at the Chamber’s Social Security and Family Committee. Although the temporary regulation of teleconsultation only occurred with the enactment of law 13,989/2020, the history of telehealth in the SUS began in 2007, in line with the resolution of the World Health Organization.

The first Telehealth Center was inaugurated by the Ministry of Health (MS) at the State University of Amazonas, and the first telehealth point, in Parintins (AM). The 60 municipalities in the state were gradually included in the telehealth network. The aerial image of the Amazon region and its hydrographic basin, the care gaps and isolated populations illustrate what this meant.

Inserted in the SUS permanent education policy, the Telehealth Brazil Program aimed, through teleconsultations, to offer the Family Health Strategy teams a second opinion. The model was gradually extended to the entire country. Challenges with connectivity, development of digital platforms and standards were faced. Published studies and the monitoring of the Telehealth Brazil Program demonstrated that, for every two teleconsultations offered, the referral of a patient to another service was avoided. On average, 60% of teleconsultations led to a change in conduct, resulting in greater resolvability and cost reduction.

The incorporation of telehealth in telescreening reduced waiting lines for specialties. In addition to qualifying the services, it became a strategy for strengthening the performance in a network, supporting the referral and counter-referral of patients and the expansion of access to humanized care. The MS regulation, updated in 2011, established concepts and standards for teleconsultations and articulation with SUS regulation, including the registration of Telehealth Centers in the National Registration System for Health Establishments (SCNES).

The Telehealth Brazil Program was linked to the Telemedicine University Network (Rute/RNP) and a budgetary unit was created in the MS, extending the broadband infrastructure to strategic teaching hospitals in the national health policy. In 2011, the Pan American Health Organization recognized the program’s success, considering it a model for other countries in Latin America.

A new chapter opens with the authorization of teleconsultation, a reality in several countries long before the pandemic. There is a need to establish introductory protocols in different specialties, meeting the LGPD (General Data Protection Law) and the Code of Medical Ethics and other health professions. However, comprehensive, humanized and resolute care is unique and can be achieved through hybrid care, where telehealth —combined with face-to-face consultation and not in opposition to it— expands access, supports care management and strengthens the care network the health.

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