Implementing an Electrocardiography Telediagnostic Service in Pernambuco, Brazil
In Brazil, cardiovascular diseases account for more than 10% of hospital admissions, and are considered a significant contributor to healthcare costs. One of the most frequently ordered diagnostic tests in the investigation of cardiovascular diseases is the 12-lead electrocardiogram (ECG). Cardiologists are not widely available to provide reports in small municipalities in Brazil, and eHealth services can be a feasible alternative to low resource environments. The use of tele-electrocardiography (Tele-ECG) can improve the management of patients and support decision making regarding referral to advanced medical centres. This study describes the implementation of a telediagnostic service for Tele-ECG in the state of Pernambuco, Brazil. The service was provided as a campaign in each community and was conducted by a team composed of a nurse and a technician from the university telehealth unit using a telehealth platform HealthNet, a laptop and a mobile digital electrocardiograph. In 2016, 34 visits were held to municipalities in Pernambuco, with 6,138 ECGs performed on patients from waiting lists, 63.5% of whom had never had an ECG, with 39.6%of the tests showing evidences of abnormal clinical situations and 0.1%) showing artefacts. The field interventions highlighted the contribution of telehealth as a feasible strategy to enhance access to care and reducing time to ECG reports, the need for patient transportation and costs for the Brazilian healthcare system, the Unified Health System. Considering the restricted budgets of the municipalities to acquire digital devices to perform ECGs and the shortage of specialised medical staff, the success of this field intervention increased the interest of public managers for telediagnostic services.
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