The Federal Council of Medicine (CFM) released, this Thursday (4), a new resolution that regulates the exercise of telemedicine in Brazil. The measure seeks to establish how medical services can be offered remotely and securely across the country.
It is worth remembering that telemedicine was only released in Brazil with the arrival of the covid-19 pandemic. In this scenario, the federal government instituted the state of public health emergency, which allowed different measures to be adopted, such as the practice of medicine remotely.
With the end of the state of emergency, it was necessary to regulate telemedicine so that this type of service could continue to occur, as the CFM did. Despite the release, the council recalls the importance of face-to-face consultation for patient analysis and possible diagnosis.
“The face-to-face medical consultation remains the gold standard, that is, a reference in patient care. But the pandemic has shown that telemedicine can be an important complementary act to medical care, allowing access to thousands of patients”, explained Donizetti Giamberardino, rapporteur of the standard, in a statement.
Limits of telemedicine in Brazil
The CFM recalls that medicine aims at the well-being of the patient, and can benefit from new technological and digital means. However, it will be up to the doctor to assess whether telemedicine is the most appropriate method for the patient’s needs in each situation, such as a consultation with a dermatologist or orthopedist, for example.
“The physician who uses telemedicine, aware of his legal responsibility, must assess whether the information received is qualified, within strict digital security protocols and sufficient for the proposed purpose”, details the standard. This is because “telemedicine does not replace face-to-face care”, as the document points out.
In addition, recurring patients must undergo face-to-face consultations at least every six months. “In the care of chronic diseases or diseases that require long-term follow-up, a face-to-face consultation with the patient’s physician must be carried out at intervals not exceeding 180 days”, the resolution points out.
Despite these limitations, the doctor who works remotely will be able to issue reports, certificates and prescriptions for the patient. The document must include:
- Physician identification, including name, CRM, professional address;
- Patient identification and data (address and place informed of the service);
- Signature with digital certification of the doctor in the ICP-Brasil standard or another legally accepted standard;
- Signaling that the query was remote.
How should medical data be stored?
An important issue is the security of patient data. According to the new standard, “personal and clinical data from medical telecare must follow the definitions of the LGPD and other legal provisions, regarding the primary purposes of the data”. The patient may request a copy, in digital or printed media, of all the data in his/her record.
In addition, companies providing telemedicine services, communication platforms and data archiving must have their headquarters established in Brazilian territory and be registered in the CRM of the state where they are based. The same goes for doctors.
It should be explained that, according to the resolution, “the complete record of the consultation, with audio, images and video is not mandatory in face-to-face consultations, the same principle must be adopted in telemedicine”.
What are the remote service modalities?
The current CFM resolution defines seven types of distance procedures that can be performed in Brazil. Next, check what they are:
- teleconsultation: it is the classic medical consultation, but that takes place remotely, by digital means;
- Teleinterconsultation: this occurs when two doctors talk remotely and discuss professional issues of a diagnosis, without the patient’s presence;
- Telediagnosis: is the use of the internet to transmit reports and analyze medical examinations;
- Telemonitoring: the modality refers to the remote monitoring of the evolution of a patient’s clinical condition;
- Teletriage: outpatient or hospital triage of the patient, such as analysis of symptoms, is done remotely and the result of this will direct the individual to the best care;
- telesurgery: is the performance of a surgical procedure at a distance, using robotic equipment;
- Teleconsulting: is a consultation made between health professionals to establish protocols and procedures.
Resolution No. 2,314/2022, which regulates the remote practice of medicine in the country, can be accessed, in full, in the Official Journal of the Union (DOU) this Thursday. The established measures are already in place.
Source: CFM and DOU