SUMMARY

The coronavirus pandemic (COVID-19) brought up discussions about improvements in both primary healthcare and hospital care in Brasil. In addition, the use of information and communication technology tools has become more prominent in the transmission of health information to patients remotely. Through content dissemination actions for professionals and direct guidance to users, remote telehealth/telemedicine services offer qualified actions that can reduce unnecessary referrals and decrease the flow of patients in health units. Information and communication technologies are allies in the fight against COVID-19.

KEYWORDS:
Telemedicine; Coronavirus Infections; Primary Health Care; Brasil

Dear Editor,

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its rapid spread have caused important changes in health services worldwide. Although the focus of care is on the treatment of severe cases in hospitals, primary health care (PHC) services have also been impacted by the coronavirus disease 2019 (COVID-19) pandemic. In Brasil, due to the spread of COVID-19 throughout the territory, PHC has undergone important changes in the work process and in the way care is provided. Family health teams have had to reorganize their demands to provide essential evidence-based care, as well as secure information on protective measures against the new coronavirus¹1. Souza CDF, Gois-Santos VT, Correia DS, Martins-Filho PR, Santos VS. The need to strengthen Primary Health Care in Brasil in the context of the COVID-19 pandemic. Braz Oral Res. 2020;34:e047.. In view of the current epidemiological scenario, in which social distance is recommended to avoid agglomerations and the spread of SARS-CoV-2, an old tool has gained substantial importance – telemedicine and telehealth.

The Brazilian Telehealth Networks, created in 2011 and currently implemented throughout Brasil through State Centers, is an important tool to promote training for PHC professionals and to enable enhancements in healthcare assistance, ensuring agility in decision making. In this sense, unnecessary referrals to specialized services are reduced.

The activities promoted by the Telehealth Program were already part of the daily lives of the teams that make up the Family Health Strategy (ESF, acronyms in Portuguese) even before the pandemic. The program offers actions such as teleconsulting (among professionals), teleregulation, telemonitoring, web lectures, and the publication of Second Training Opinions (content published in the Virtual Health Library, based on good evidence related to PHC priority problems)¹1. Souza CDF, Gois-Santos VT, Correia DS, Martins-Filho PR, Santos VS. The need to strengthen Primary Health Care in Brasil in the context of the COVID-19 pandemic. Braz Oral Res. 2020;34:e047.

2. BRASIL. Ministério da Saúde. Portaria GM/MS N° 2.546, de 27 de outubro de 2011. Redefine e amplia o Programa Telessaúde Brasil, que passa a ser denominado Programa Nacional Telessaúde Brasil Redes (Telessaúde Brasil Redes). Diário Oficial União; 28 out. 2011. Brasília: Ministério da Saúde; 2011. [cited 2020 Jul 1]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2011/prt2546_27_10_2011.html
https://bvsms.saude.gov.br/bvs/saudelegi...

3. Bavaresco CS, Hauser L, Haddad AE, Harzheim E. Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brasil Networks Programme. Braz Oral Res. 2020;34:e011.^-44. Caetano R, Silva AB, Guedes ACCM, Paiva CCN, Ribeiro GR, Santos DL, et al. Challenges and opportunities for telehealth during the COVID-19 pandemic: ideas on spaces and initiatives in the Brazilian context. Cad Saude Publica. 2020;36(5):e00088920..

In face of the new challenge introduced by the COVID-19 pandemic, the Brazilian Ministry of Health published an ordinance on an exceptional and temporary basis, which allows remote interaction actions (between professionals and patients) to carry out pre-clinical care, care support, medical visits, treatment monitoring, and diagnosis⁵5. BRASIL. Ministério da Saúde. Portaria GM/MS N° 467, de 20 de março de 2020. Dispõe, em caráter excepcional e temporário, sobre as ações de Telemedicina, com o objetivo de regulamentar e operacionalizar as medidas de enfrentamento da emergência de saúde pública de importância internacional previstas no art. 3° da Lei n° 13.979, de 6 de fevereiro de 2020, decorrente da epidemia de COVID-19. Diário Oficial União; 23 mar 2020. Brasília: Ministério da Saúde; 2020. [cited 2020 Jul 1]. Available from: http://www.in.gov.br/en/web/dou/-/portaria-n-467-de-20-de-marco-de-2020-249312996
http://www.in.gov.br/en/web/dou/-/portar... .

Recently, the teleconsultation procedure in primary care started to be included in the SUS procedure table (June 24, 2020, through Ordinance No. 526/2020)⁶6. BRASIL. Ministério da Saúde. Portaria GM/MS N° 526, de 24 de junho 2020. Inclui, altera e exclui procedimentos da Tabela de Procedimentos, Medicamentos, Órteses, Próteses e Materiais Especiais do SUS. Diário Oficial da União; 02 jul 2020. Brasília: Ministério da Saúde; 2020. [cited 2020 Jul 1]. Available from: http://www.in.gov.br/en/web/dou/-/portaria-n-526-de-24-de-junho-de-2020-264666631
http://www.in.gov.br/en/web/dou/-/portar... .

Additionally, the Brazilian Ministry of Health has implemented other free communication channels to provide information on COVID-19, such as a phone number (136) and a smartphone app (Coronavirus SUS)⁷7. BRASIL. Agência Saúde. Ministério da Saúde. Aplicativo Coronavírus SUS. 2020. Brasília: Ministério da Saúde; 2020. [cited 2020 Jul 1]. Available from: https://www.saude.gov.br/noticias/agencia-saude/46628-aplicativo-coronavirus-sus-agora-envia-mensagens-de-alertas-aos-usuarios
https://www.saude.gov.br/noticias/agenci... . With the purpose of monitoring suspected and/or confirmed cases of COVID-19 in self-isolation, the states from Northeast Brasil have implemented an exclusive communication channel. Through it, SARS-CoV-2-infected people are monitored daily via remote assistance (text messages or phone calls) by healthcare professionals. These measures allow information at a distance, avoiding unnecessary agglomerations and queues at health units⁸8. Consórcio Nordeste. Aplicativo monitora COVID-19. Google Play. 2020. [cited 2020 Jul 1]. Available from: https://play.google.com/store/apps/details?id=br.com.novetech.monitoracorona
https://play.google.com/store/apps/detai... .

Since the World Health Organization's pandemic announcement in March 2020, the Telehealth Center of the State of Sergipe also has promoted remote education activities (web lectures, teleconsulting, and folders) to family health teams working in all 75 municipalities of Sergipe state⁹9. OPAS/BRASIL. OMS afirma que COVID-19 é agora caracterizada como pandemia. Brasília: Organização Pan-Americana de Saúde; 2020. [cited 2020 Jul 1]. Available from: https://www.paho.org/bra/index.php?option=com_content&view=article&id=6120:oms-afirma-que-COVID-19-e-agora-caracterizada-como-pandemia&Itemid=812
https://www.paho.org/bra/index.php?optio... . From March to June 2020, 18 web lectures were held, with an average of 93 participants, ranging from 19 to 427 participants by web lecture, resulting in a total of 1,670 listeners. During this period, issues related to COVID-19 were the most discussed topic. Thus, the framework of Information Technology and Health Communication (ITHC) services have also been adapted to the current demand generated by the COVID-19 pandemic¹1. Souza CDF, Gois-Santos VT, Correia DS, Martins-Filho PR, Santos VS. The need to strengthen Primary Health Care in Brasil in the context of the COVID-19 pandemic. Braz Oral Res. 2020;34:e047..

Since information technologies contribute to the qualification of health professionals, resulting in evidence-based care, more financial resources are needed to expand telehealth activities. It is necessary to have a financial source for the permanent qualification of teleconsultancy professionals, to expand the number of computers with internet access in primary care services, and improve ITHC devices³3. Bavaresco CS, Hauser L, Haddad AE, Harzheim E. Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brasil Networks Programme. Braz Oral Res. 2020;34:e011.. These investments on telehealth should occur both during the pandemic and in the post-pandemic period.

The transmission of health information, with updated scientific evidence, through telehealth, promotes a reduction in the circulation of individuals in health services, guarantees services that can be provided at a distance to users with comorbidities, thus reducing the risks of dissemination and contamination by COVID-19⁴4. Caetano R, Silva AB, Guedes ACCM, Paiva CCN, Ribeiro GR, Santos DL, et al. Challenges and opportunities for telehealth during the COVID-19 pandemic: ideas on spaces and initiatives in the Brazilian context. Cad Saude Publica. 2020;36(5):e00088920.^,1010. Lurie N, Carr BG. The role of telehealth in the medical response to disasters. JAMA Intern Med. 2018;178(6):745-6..

REFERENCES

Publication Dates

History