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Establishing a Canada-Brazil Telehealth Partnership Establishing Canadian expertise and products and...

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Establishing a Canada- Brazil Telehealth Partnership Establishing Canadian expertise and products and helping Brazil to establish, expand and manage their own telehealth and telemedicine networks
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Establishing a Canada-Brazil Telehealth

Partnership

Establishing Canadian expertise and products

and helping Brazil

to establish, expand and manage

their own telehealth and telemedicine networks

Infotelmed and LCE

This presentation has been prepared by:

LCELCE Communications

Montreal . Canada

Infotelmed Communications Inc www.infotelmed.ca LCE Communications reg www.LCE.ca with the collaboration of the www.edumed.net

Edumed Institute, Sao Paulo, Brazil

Infotelmed and LCE

Brazil: a snapshot

• 182 million inhabitants

• 50% of Latin America’s output

• 8th world economy

• US$ 15 B Foreign Direct Investment

New socialist government prioritized health and education as main goals

• 7th largest world software market, US$ 10 B• among world’s 10 largest health sectors

Infotelmed and LCE

Brazil’s ICT sector

US$ 35 billion revenue, growth @ 10%

annual investment expected @ US$ 12 billion

6 fixed telephony providers

40 million telephony users, growth @ < 2%

18 cellular providers

40 million cellular subscribers, growth @ > 20%

20 million Internet users, 30 million by 2005

Infotelmed and LCE

Brazil’s health care sector 1

Overall Statistics• US$ 50 B industry yearly turnover (public+ private)• every citizen entitled to Unified Health System• 7 K hospitals, up to 3.33 beds/1,000 inhab. • 15 K clinics & labs, 54 K pharmacies, 145 health coops• 40% yearly growth (private)

Main trends for sector• home care, telemedicine• improved quality

Infotelmed and LCE

Brazil’s health care sector 2

Three largely separate systems

free public Unified Health System

(SUS) covers 75% of population,

paid by Brasilia’s budget

private health plan system covers

23% of population (40 million souls),

includes medical insurance, medical cooperatives, self-management health plans, community health plans

private medical care, covers 2% of the population, self-paid

Infotelmed and LCE

Brazil’s health care sector 3

Status of Health Care System

private medicine and university-based public medicine very advanced:

AIDS/HIV & infectious diseases, cardiology & cardiac surgery,

oncology, plastic surgery, reconstructive surgery, immunology

public health mostly in sorry state, low level of wages and per capita investment

improving in efficiency and coverage due to IT investments, education and training, managerial reform

Infotelmed and LCE

But Brazil, like Canada, has health care challenges: 1

Demographics, Brazil 2002

vast territory, 8 M sq.km (Canada at 9 M) 182 million inhabitants, median age 27 yrs 17 births/1,000 pop., annual growth 1.15% 86% literacy, 30% < 8 years of studies

Population Distribution north / west vast expanses (like Canada), densities < 1 per sq.km

high concentration coastline capitals (Rio at 291/sq.km) average 17 inhabitants per sq.km 76% urban, 24% rural, 89% < 50,000 inhabitants, 65% < 20,000

Infotelmed and LCE

But Brazil, like Canada, has health care challenges: 2

Distribution of Wealth min. wage for 15% in richest southern states, up to 59% northeast minimum wage at US$ 80 / month for 40% of working force income 20% richest = 27 times 20% poorest 29% below poverty level

Health Status life expectancy at birth: male: 67 years, female: 75 years infant mortality < 1 yr old: 10/1,000 born alive, northeast 18, south 6 chronic and degenerative diseases account for 57% to 65% deaths

Infotelmed and LCE

But Brazil, like Canada, has health care challenges: 3

Aboriginal Health National Indian Health Service public health service under construction, family health concepts barefoot community health agents (natives) disease profile still related to poverty, low immune defenses

Aboriginal Population large Indian reserves among poorest of poor 8 million inhabitants (1500’s) today < 600,000

Infotelmed and LCE

But Brazil, like Canada, has health care challenges: 4

Health Care Professionals, 2002

360K physicians (208/100,000), 170K dentists (96/100,000) 90K registered nurses (52/100,000), 500K nurse assistants

(289/100,000), 170K other allied health total at about 1.3 million professionals

Large Regional Disparities 65 to 554 physicians per 100,000; São Paulo state alone accounts for

95,000 physicians (26,5%) 160 counties with 93% of physicians,

3,400 remaining with 7% 43% counties < 10 resident physicians, 38% have none

Infotelmed and LCE

Opportunities for Canadian telehealth (TH) expertise and products

Telehealth Status

just starting: pioneers are large and rich private hospitals, excellence centres in public universities

telehealth yet to be adopted by public health sector

few succesful experiments underway, growing fast potential is enormous:

size of country, very large distances highly unequal resource distribution and service provision absolute lack of services in so many areas attention to Canadian leadership, achievements

Infotelmed and LCE

Infotelmed: who we are

Federally incorporated research and consulting company established since 1998, www.infotelmed.ca

Focus: telehealth, health care telematics, telemedicine, e-health Under contract, federal & provincial governments, diverse organizations:

Evaluation of telehealth networks and projects, more than 50 urban, rural and isolated communities for Health Canada, resulting in substantial reports

Reports: telehealth industry competitiveness, profile and capability in Canada (Industry Canada) - final reports available online

Needs assessments and analyses Development, Strategic & Operational plans - implementation of telehealth

Member, The Keston Group, www.keston.com international group of consultants & researchers medical imaging, medical physics and telehealth

Infotelmed and LCE

Who is involved at Infotelmed

Jocelyne Picot, BA, MA, PhD, President of Infotelmed

Author of several reports and articles and frequent speaker on the subject of telehealth

Adjunct Professor at McGill University Experienced consultant and researcher in the field of telehealth and

telemedicine: developed and implemented unique tools and mixed qualitative-

quantitative approach to needs assessments and evaluation of telehealth Consultant to the largest French-speaking hospital in Canada -

recognized as a Canadian expert in the field of telehealth Founding member of the Canadian Society of Telehealth (CST)

Infotelmed and LCE

LCE Communications: who we are

LCE carries mandates with Brazilian institutions technical & scientific partnerships, technology transfer & distribution

Edumed Institute mandate: to mediate and negotiate projects with governmental entities &

private institutions - aim: financing, grants, donations to establish technical and scientific partnerships:

health care, telemedicine, telehealth, computer-mediated education

LCELCE Communications

Montreal . Canada

Consulting & engineering office, since 1990 services in telecom and telehealth systems worldwide contracts, Brazil as niche market mandates cover:

telemedicine applications, telehealth programs, telecom technologies

Infotelmed and LCE

Who is involved at LCE

Luiz C. Esteves, P.Eng., M.Sc.

principal consultant and director of LCE Communications consultant to TIW, Telus, SRT, medium / large corporations consultant to Brazilian companies manager at space programs, telecom projects, R&D assistant professor at Catholic University, Rio

Author, McGraw-Hill book company, 1981

in the works - telehealth

Infotelmed and LCE

The Edumed Institute – the Brazilian partner

not-for-profit NGO organization (2000) 21 staff members and associates

develops and partner with telehealth and educational projects

headquartered in Campinas, Brazil’s foremost technological

area with representations countrywide coordinates consortium of 25 public/private institutions

work relies on partnerships with: universities, hospitals, government, private sectors

R&D in IT and digital communications applications development of distance health education and training

Infotelmed and LCE

Who is involved at Edumed

Dr. Renato E.M. Sabbatini, Ph.D.

Post-doctoral fellow, Max Planck Institute, Neurobiology, Germany Ph.D. (Physiology), School of Medicine, Sao Paulo University Founder, director of The EduMed Institute President, Latin American and Caribean Federation, International

Medical Informatics Association (IMIA – LAC) Member, Internet Commission of the American Medical Informatics

Association (AMIA) Dr. Sabbatini is a visionary and enthusiastic adopter and promoter

of telehealth and CME programs in Brazil

Infotelmed and LCE

Edumed: projects which need Canadian expertise*

* products & content

Amazon Telehealth Project telemedicine services, indigenous people

Pediatric Oncology Network Project videoconferencing and Internet network

of specialized hospitals for cancer treatment

Brazilian Telecardiology Network videoconference and telemedicine initiative via hi-speed network,

protocols and clinical directives for cardiovascular health services

Telemedicine for Family Health wireless IP distance education network for municipal health secretariats

UNIMED health cooperative telemedicine / distance education project, neuroradiology subproject

Infotelmed and LCE

Project One – first steps which

have already been taken

Initial efforts have been: Health Canada - Amazon Telehealth Project highlights CIDA - submission of Amazon Telehealth Project highlights Industry Canada –preliminary discussions and meetings

Already happening with Edumed: case conferences set up with CHUM in Montreal supply, satellite-based, home care, portable wireless VC products translation & certification proposal, cardiac triage software participation of Dr. Picot, International Telehealth Seminar, May, Brazil participation of Dr. Sabbatini, CST Quebec conference, October

Infotelmed and LCE

Next steps: bilateral visits and feasibility study

Feasibility study aimed at information and intelligence gathering visits to Edumed Institute by the Canadian consultants

interviews and information gathering in the region served by Edumed in-depth study of relevant documentation from:

CIDA, Health Canada, WHO, the IADB and International Trade complete needs assessment report, obstacles, recommendations target: selection / definition of appropriate Canada-Brazil joint project

Bilateral visits Field visit by LCE and ICI to undertake study Dr Sabattini’s visit to various telehealth sites in Canada, attendance

at CST conference in Quebec city, October 2004

Infotelmed and LCE

Involvement of other partners

AudiSoft portable wireless narrowband videoconference & telemedicine unit

Colabnet user-controlled satellite bandwidth allocation software & home

care wireless support solutions (Smart Labrador partner)

March Networks home care wideband support solutions

Smart Labrador, MUN Faculty of Medicine telemedicine and CME/CHE content support (IC ’s Smart Communities)

Infotelmed and LCE

Thank you!

We appreciate you giving us your time

to participate in this presentation And now we need to know:

what further steps do you propose we take? what can Industry Canada do to help move

this joint project forward?

contact information: [email protected] [email protected]

company information: www.LCE.ca www.infotelmed.ca


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