The Use of Teleconsultations by Nurses in Primary Care in Minas Gerais, Brazil: the Experience of the Telehealth Network of Minas Gerais

  • Julia PA Santos Medical School, Universidade Federal de Minas Gerais, Brazil
  • Maria Beatriz M Alkmim Telehealth Center, University Hospital, Universidade Federal de Minas Gerais; Telehealth Network of Minas Gerais, Brazil
  • Izabella O Antunes Telehealth Network of Minas Gerais, Brazil
  • Camila G Ferreira Telehealth Network of Minas Gerais, Brazil
  • Milena Soriano Marcolino Medical School, Universidade Federal de Minas Gerais; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais; Telehealth Network of Minas Gerais, Brazil
Keywords: telemedicine, nursing, primary care, teleconsultation, Brazil

Abstract

Primary care is the doorway into the Brazilian public health system. On that level of care, nurses have a main role. As such, they can benefit from telehealth initiatives that bring them closer to specialists of other levels of care. This study aims to evaluate the use, by nurses, of a large scale Brazilian teleconsultation service. Methods: Teleconsultations requested by nurses from April 2007 to February 2014 were analysed to identify: the time of the day they were sent; the specialties they were directed to; and the main socioeconomic features of the cities from which they originated. In addition, a sample of teleconsultations from January to February 2014 was examined for the most common types of queries. Results: A total of 30,258 teleconsultations were analysed. They were mainly directed to medical subspecialties (76.5%). Nursing categories received 20.7% of the queries. Of all teleconsultations, 66.5% were performed during the working hours of the Primary Care units (8 am to 5 pm Monday to Friday). Most of the 632 cities that sent queries during this period had worse socioeconomic indices than the state’s average. Concerning teleconsultations performed from January to February 2014, most queries were about aetiology (29.0%) and pharmacological treatment (18.5%). Conclusion: This study from a large scale Brazilian teleconsultation service showed that nurses direct their requests mostly to medical subspecialties. The cities from where most teleconsultations were originated are notably more underserved. The main queries were about aetiology and pharmacological treatment.

Author Biographies

Julia PA Santos, Medical School, Universidade Federal de Minas Gerais, Brazil
Medical student, Universidade Federal de Minas Gerais, Brazil
Maria Beatriz M Alkmim, Telehealth Center, University Hospital, Universidade Federal de Minas Gerais; Telehealth Network of Minas Gerais, Brazil
Coordinator at the Telehealth Center, University Hospital, Universidade Federal de Minas Gerais; Telehealth Network of Minas Gerais, Brazil
Izabella O Antunes, Telehealth Network of Minas Gerais, Brazil
Research Nurse, Telehealth Network of Minas Gerais, Brazil
Camila G Ferreira, Telehealth Network of Minas Gerais, Brazil
Research Nurse, Telehealth Network of Minas Gerais, Brazil
Milena Soriano Marcolino, Medical School, Universidade Federal de Minas Gerais; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais; Telehealth Network of Minas Gerais, Brazil
Professor at the Internal Medicine Departament, Medical School, Universidade Federal de Minas Gerais, Brazil. Coordinator of the Scientific Division of the Telehealth Network of Minas Gerais

References

BRAZIL. Constitution (1988). Constitution of the Federative Republic of Brazil. Brasília, DF: Federal Senate: Graphic Centre, 1988.

Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet 2011;377(9779):1778-1797.

Quinellato LV. A Diretriz de Hierarquização do SUS: mudando a antiga perspectiva do modelo me?dico- assistencial privatista. Rio de Janeiro: FGV / EBAPE - Fundação Getúlio Vargas Escola Brasileira de Administração Pública e de Empresas; 2009.

Costa MBdS, Lima CBd, Oliveira CPd. Atuação do enfermeiro no programa saúde da família (PSF) no estado da Paraíba. Rev Bras Enfer 2000;53:149-152.

Alkmim MB, Figueira RM, Marcolino MSea. Improving patient access to specialized health care: the Telehealth Network of Minas Gerais, Brazil. Bull World Health Org 2012;90(5):373-378.

Oliveira FPd, Vanni T, Pinto HA, et al. Mais Médicos: um programa brasileiro em uma perspectiva internacional. Interface Butucatu 2015;19:623-634.

PNUD. (2010). Atlas do Desenvolvimento Humano no Brasil. Available at: http://atlasbrasil.org.br/2013/pt/consulta/ accessed 25 March 2015.

Marcolino MS, Alkmim, MBM, Assis TGP et al. The Telecare Network of Minas Gerais and its contributions to achieve the principles of universality, equity and integrity of SUS - experience report. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Icict/Fiocruz); 2013.

Wood J, Mulrennan S, Hill K, Cecins N, Morey S, Jenkins S. Telehealth clinics increase access to care for adults with cystic fibrosis living in rural and remote Western Australia. J Telemed Telecare 2016 Jul 20:1357633X16660646.

Chu S, Boxer R, Madison P, et al. Veterans Affairs Telemedicine: Bringing Urologic Care to Remote Clinics. Urology 2015;86(2):255-60.

Humphreys JS. Key considerations in delivering appropriate and accessible health care for rural and remote populations: discussant overview. Austr J Rural Health 2009;17(1):34-38.

Charles BL. Telemedicine can lower costs and improve access. Healthc Financ Manage 2000;54(4):66-69.

Brazilian Institute of Geography and Statistics (IBGE). (2014) Brazilian territorial area. Available at http://www.ibge.gov.br/home/geociencias/areaterritorial/principal.shtm. accessed 12 July 2015.

Medicine Federal Board (CFM). (2013). CREMESP: Demografia Médica no Brasil. Cenários e indicadores de distribuição. Available at http://www.cremesp.org.br/pdfs/DemografiaMedicaBrasilVol2.pdf accessed 24 August 2015.

Dias VP, Witt RR, Silveira DT, et al. Telenursing in primary health care: report of experience in southern Brazil. Stud Health Technol Inform 2009;146:202-206.

Sanches LM, Alves DS, Lopes MH, Novaes MA. The practice of telehealth by nurses: an experience in primary healthcare in Brazil. Telemedi J e-Health2012;18(9):679-683.

Gagnon MP, Breton E, Courcy F, Quirion S, Cote J, Pare G. The influence of a wound care teleassistance service on nursing practice: a case study in Quebec. Telemed J e-Health 2014;20(6):593-600.

Published
2016-09-28
How to Cite
Santos, J., Alkmim, M. B., Antunes, I., Ferreira, C., & Marcolino, M. (2016). The Use of Teleconsultations by Nurses in Primary Care in Minas Gerais, Brazil: the Experience of the Telehealth Network of Minas Gerais. Journal of the International Society for Telemedicine and EHealth, 4, e18 (1-8). Retrieved from https://journals.ukzn.ac.za/index.php/JISfTeH/article/view/166
Section
Special Theme: Telehealth in Brazil