TELEHEALTH AND TELEMEDICINE IN BRAZIL: OPPORTUNITIES ...

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INTRODUCTION BY INNOVATION CENTRE DENMARK IN SAO PAULO

A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK

TELEHEALTH AND TELEMEDICINE IN BRAZIL:

OPPORTUNITIES AND CHALLENGES

DECEMBER 2015


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BRAZILIAN TELEMEDICINE SECTOR


Telemedicine and home care

practices are expected to

grow due to prioritization by

the government of telecom

and health sectors.

Brazil is considered to be one of

the most advanced countries in

the field of telemedicine in Latin

America and the Caribbean.

Focus on democratization of

access, expansion of supply

and quality improvement of

healthcare services.


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BRAZILIAN TELEMEDICINE SECTOR


Source: CONASS (National Council

of Health Secretariats) 2014

Plus, 40% of Brazilians suffer from

non-communicable chronic diseases,

which accounts for over 70% of

causes of death.

Demographic changes

and the epidemiological

pattern in Brazil require

Telemedicine solutions.


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TELEMEDICINE AND TELEHEALTH NETWORKS AND RESOURCES IN BRAZIL


Source: RUTE (Telemedicine

University Network) 2015

Responsible for

structuring telemedicine

as a discipline, which

fostered the private

medical-hospital sector.

Aims at integrating all public,

university hospitals, formally

establishing telemedicine

centres, supporting

videoconferences, performing

diagnostics analysis, and

providing permanent education


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MODALITIES OF TELEMEDICINE IN BRAZIL


Telemonitoring

Remote monitoring of the patient's vital signs, whose records are

continuously sent to the doctor for analysis, interpretation and

warning.

Tele-diagnostics Remote transmission of data such as medical imaging, laboratory data

and other information to obtain some diagnosis.

Teleradiology

Transmission of radiological images between health care

establishments (Estabelecimento Assistencial a Saúde - EAS) for

remote consultation and medical interpretation.

Tele-education Implementation of medical distance learning courses aiming to guide

doctors, students and patients in distant and remote areas.

Tele-homecare Monitoring and assessment of the health status of patients being

treated in their own homes through ICT.

Source: Silver Consulting 2015


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APPLICATION OF TELEMEDICINE IN BRAZIL




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Percentage of total number of establishments

that have used the Internet in 2014.

PROPORTION OF HEALTHCARE FACILITIES PER AVAILABLE TELEMEDICINE AND TELEHEALTH SERVICES

Source: CGIBR (Internet

Management Committee) 2014


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PUBLIC AND PRIVATE SECTORS EXPENDITURE IN

COUNTRIES WITH UNIVERSAL HEALTH SYSTEM

Source: WHO, 2014 and CFM, 2014


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MODALITIES OF HOMECARE IN BRAZIL PRIV

ATE Home Care refers to a set of outpatient actions, planned and ongoing, performed at home.

Home

Hospitalization

refers to a set of activities provided at home to people that have a more

complex clinical condition, which requires full time care by a healthcare

professional and the need for specialized technology.

PU

BLIC

Home Care

type 1 (AD1)

intended for users with controlled health problems and physical difficulty or

unable to go to a healthcare facility; these users typically need health care

less often and have less need for healthcare resources.

Home Care

type 2 (AD2)


unable to go to a healthcare facility; these users typically require more

frequent care, health resources and continuous monitoring from different

healthcare network services.

Home Care

type 3 (AD3)


unable to go to a healthcare facility; these users typically need more frequent

care, health resources, continuous monitoring and use of equipment from

different healthcare network services.



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PLAYERS FROM THE HOMECARE SECTOR

Homecare in Brazil

Private institutions, who are service providers

Health insurance

companies, which

outsource the service

SUS (Universal Public

Health System) through

Programme Melhor em Casa

All players must meet the

requirements of decrees

and regulations set forth by

ANVISA (National Health

Surveillance System) and

CFM (Federal

Council of Medicine)


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LEGISLATION AND REGULATION OF THE

TELEHEALTH AND HOMECARE MARKETS

• The National Health Surveillance

System (Anvisa), regulatory

agency linked to the Ministry of

Health, controlls the market of

healthcare products.

• No medical device (local or

imported) can be industrialized,

sold of delivered to consumers in

Brazil without the registration at

the Ministry of Health.

Anvisa


• The Federal Council of Medicine,

responsible for the fiscalization and

regulations of the medical practice.

• The council defends the corporate

interests of the category of doctors

and is responsible for the

professional registration and the

Code of Medical Ethics.

CFM

CRM: Regional Council of

Medicine, subordinated to

the CFM and present in

each Brazilian state.


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Anvisa

According to Anvisa:

health-monitoring software serve as

tools for prevention, diagnosis, treatment,

rehabilitation, or contraception.

• Software of medical devices: products that do not need

"hardware" (classified as a health product) in order to be

operated, i.e. executed in a single computer by default;

• Software (or accessory), part of a medical device;

software that requires a connected "hardware" in order to

function, i.e. patient cardiac monitor, infusion pump, blood

pressure measurement, gas monitor, etc.;

• Software that is not a medical device; does not fit into

the above definitions, i.e. software used only for training

healthcare professionals and others.

3 groups


Anvisa regulates medical

equipment and healthcare

software. Software and medical

equipment are also classified

according to their associated risks:

• Class I – low risk

• Class II – medium risk

• Class III – high risk

• Class IV – maximum risk

and purpose: invasive,

non-invasive, active

and special rules.


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The Federal Council of Medicine (CFM)

defines Telemedicine as the practice of

medical services at a distance through

the use of interactive methodologies,

such as data communication and

audiovisual intended for care, education

and research in the field of health.

Telemedicine The applications of technology in

healthcare are provided through

the Law of Computing (Lei da

Informática), which allowed the

use of information in digital form.

Legislation on telemedicine and information technology

in the healthcare field is regulated by CFM or CRM.


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INDUSTRIAL POLICY AND RESEARCH,

DEVELOPMENT & INNOVATION

Telemedicine

Research

Development

Innovation

Industry

PDP (Productive Development Policy)

fosters the industry, strengthens

competitiveness, focusing on

productive systems with export

potential and able to generate chain

reaction effects in the industry.

FINEP (Funding Agency of

Studies and Projects),

BNDES (Brazilian

Development Bank) and

other funding agencies

foster research,

technological development,

and innovation, which has

contributed to the increase

in activities of P, D & I

performed by Brazilian

companies and research

institutions.


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impact


THE MARKET OF ICT AND MEDICAL EQUIPMENT THE IMPACT OF ICT AND EMHO ON THE BRAZILIAN TELEMEDICINE AND HOME CARE MARKET

Source: Teleco 2015

Information and

Communication Technology

Medical, hospital, dental and

laboratory equipment

EMHO sector

Telemedicine

Telecom sector


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FORECASTS FOR ICT IN HEALTHCARE

Source: Teleco 2015

Telecom sector

• A small proportion of hospitals will start to prepare personalized treatments plans for their patients.

• Automation of more than 50% of the operating routine, with increased innovations and management

systems to reduce maintenance problems and people’s dependency, will last until 2018.

• There will be digital strategy development due to rising healthcare costs combined with operation innefficiency.

• Companies and service providers will share the caring responsbility and financial results due to increased

external partnerships (currently na uncommon practice).

• Cloud computing will be dominant in the healthcare sector. By 2020, more than half of

healthcare sector institutions will be using this kind of technology or will have at least

started the migration of data servers for cloud computing.

• In order to improve the customer experience, more than half of the transactions made between patients

and hospitals will be done with mobile technologies by 2018. The institutions will need to prepare

themselves and adapts their services to meet their targets.

• A large part of healthcare organizations will invest the next three years in technologies, such as

wearable devices, remote monitoring of patients’ health and virtual care.

• Half of health institutions will suffer from 1 to 5 cyber attacks, which requires

investment to prevent interruptions and lealage of sensitive information.

• By 2020, most personal information is estimated to be available on the web

unprotected. As a result, healthcare organizations are likely to invest in data security.


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TECHNOLOGICAL TRENDS OF HEALTHCARE-

RELATED ICT

Source: Teleco 2015

Telecom sector


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INNOVATION IN MEDICAL EQUIPMENT FORECAST BY 2020

Source: Teleco 2015

Telecom sector

http://www.google.dk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://lydiaquintiliano.blogspot.com/2014/09/a-era-da-informatica.html&ei=o9QmVdrYKIqdsAH-64DwBw&bvm=bv.90491159,d.ZWU&psig=AFQjCNHFGIoZbld__zb6cENyeXeWrd96XQ&ust=1428694551320926


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FINAL CONSIDERATIONS AND

RECOMMENDATIONS

Source: Teleco 2015

Telecom sector

The healthcare sector in Brazil is

facing a growing demand for

diagnostic and expensive

therapeutic resources. This is due

to a more aged population that

requires more medical attention

and the current healthcare

situation that leaves a large portion

of the population with inaccessible

and/or unaffordable health care.

• Introduce portable equipment associated with information

systems that monitor pregnant women, especially those

who experience a high-risk pregnancy;

• Propose the use of custom electronic medical records for

home care that integrate with electronic medical records

used in hospitals/clinics and allow the patient to keep and

access the health record at any time or place;

• Offer portable equipment or technological platforms that

promote health care to indigenous people or people who

live remotely from urban centres. Prioritize solutions that

reduce rates of neglected and non-communicable diseases;

• Introduce 3D virtual platforms as health professionals

training resources, healthcare workers (for home care),

and learning resources for preventive medicine and/or

proper use of medical devices;

• Offer portable and monitoring solutions for the clinical

status of patients on home oxygen therapy programs

and/or mechanical ventilation;

• Introduce warning systems in several home care areas,

i.e. falls, equipment stops, and ambulances;

• Introduce data security solutions for healthcare

information management systems.


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http://icdk.um.dk/

+55 11 21 27 07 50

+55 11 30 68 98 67

[email protected]

INNOVATION CENTRE DENMARK

São Paulo, Brazil

http://www.google.dk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://toemvancouver.blogspot.com/2013/06/tirando-algumas-duvidas-dos-leitores.html&ei=qigkVbnkIYS4sQGGh4LAAQ&bvm=bv.89947451,d.ZWU&psig=AFQjCNEnDdLgD7kMjiI7g0dYpufkjQX_9w&ust=1428519451409454

http://icdk.um.dk/

mailto:[email protected]

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