The abstracts received by the 10 Congress Of the International Society of nd. Telemedicine and e-health, the 2 Congress of the Brazilian Council of nd

Transcrição

1

2 Dear Colleague, th The abstracts received by the 10 Congress Of the International Society of nd Telemedicine and e-health, the 2 Congress of the Brazilian Council of nd Telemedicine and e-health and the 2 Meeting of the Latin-American and Caribbean Chapter of the American Telemedicine Association are edited in this CD-ROM. They are published as they were sent; only a uniform layout was given. An alphabetic sequence using the surname of the first author was followed. Abstracts written in Portuguese and English were not separated; whenever a choice was given the English version was used, as it is the international language of Science. Whether it was a poster or oral presentation is not indicated. An index was elaborated with all authors linked to their contributions which we sincerely appreciated. The Organizing Committee São Paulo, October 23, 2005 Prezado Colega, Os resumos dos trabalhos enviados para o 10º Congresso da Sociedade Internacional de Telemedicina e Telessaúde, o 2º Congresso Brasileiro de Telemedicina e Telessaúde e o 2º Encontro do Capítulo Latino Americano e Caribenho da Associação Americana de Telemedicina estão reunidos neste CD-ROM. Estamos publicando tal como foram recebidos, apenas uniformizando o formato geral. A seqüência é alfabética sempre considerando o sobrenome do primeiro autor. Não houve separação dos resumos encaminhados em português e inglês; sempre que tivemos opção usamos a versão inglesa por ser a língua internacional da ciência. O tipo de apresentação, se pôster ou oral, não é indicado. Procuramos elaborar um índice com todos os autores vinculados às suas contribuições que, sinceramente, agradecemos. A Comissão Organizadora São Paulo, 23 de outubro de 2005

3 Abreu, I.M. Ajzen, S. Alencar, A. Alkmim, M.B. Artigo 2 Artigo 3 Almeida, A.L. Almeida, M.E.B.T.M.P. Alves, L.C. Alves, R.H.K. Alvin, F.B. Andrade, V.G. Artigo 2 Andreazzi, D.B. Atta, M.T. Azevedo, D.F.G. Azevedo, R. Barsottini, C.G.N. Artigo 2 Artigo 3 Artigo 4 Batiz, M.G. Artigo 2 Bedi, B.S. Bekteshi, F. Bento, R.F. Artigo 2 Artigo 3 Artigo 4 Bhaskaranarayana, A. Böhm, G.M. Borges, C.L. Artigo 2 Artigo 3 Borghi, G. Bossi, G.A. Artigo 2 Bossi, G.A.M. Brady, F. Brady, P. Campelo, V.E.S. Artigo 2 Artigo 3 Artigo 4 Carniglia, L. Carvalho, I.M.M. Artigo 2 Carvalho, M.L.M. Carvalho, R.S. Cassetti, I. Castilio, D. Cavalcanti, S. Chao, LW Artigo 2 Artigo 3 Artigo 4 Artigo 5 Artigo 6 Artigo 7 Artigo 8 Artigo Chiari, J.P. Cogo, A.L.P.

4 Conrado, M.A. Corrêa, F.G.C. Dalpino, N. R. S. Daré Junior, S. Debbag, R. De-Lorme, P. Diniz, C.G.P. Domingues, L.A. Eisenstein, E. Enrique S. Fernandes G.C.V.R. Ferreira E.G.P. Ferreira S.R.G. Ferreira, W.S. Festa C.N. Artigo 2 Figueiredo, L Artigo 2 Filgueiras, T. Fonseca, L.M. Fortuin, J.B. Fregonara, M. Artigo 2 Freitas, M.A.V. García, F. Garcia, G.B. Gimenez, R.S.S. Gismondi, R.C. Artigo 2 Godoy, I. Godoy, S. Godoy, S.C.B. Grottone, G. Guerra, I. M. Guimarães, E.M.P. Gundim, R.S. Artigo 2 Gutierrez, M.A. Guzovsky, P.A. Hammes, E. Holcomb, M. Hovenga, J.S. Johnson, P. Jakobi, H.R. Jordanova, M. Judkins, D. Juliani, M.C.M Artigo 2 Junior, M.J. Kachienga, M.A. Kashiabara, J.A. Kelmer, S. Kiefer, S. Kurcgant, P. Latifi, R. Artigo 2 Artigo 3

5 Legramandi, D.B. Leite, M.M.J. Lievens, F. Lombroso, F. Lopes, P.R.L. Artigo 2 Artigo 3 Artigo 4 Artigo 5 Machado, H.R. Maia, C.C.A. Malmström, M.F.V. Mancini, F. Mário Jr., M.J. Marta, S.N. Artigo 2 Medeiros, R. Artigo 2 Melare, D. Melo, M.C. Mendes,I.A.C. Merrell, R.C. Messina, L.A. Miot, H.A. Molefi, M. Molefi, M.L. Monteiro, A. Monteiro, A.M.V. Artigo Artigo 2 3 Mortara, A.M. Moshela, M. Muja, S.H. Múnera, L.E.S. Murthy, R.L.N. Nason, A.M. Navarro Newball, A.A. Artigo 2 Artigo 3 Neto, J.R.N Nobre, L.F. Artigo 2 Artigo 3 Nogueira, M.S. Nunes, A.A. Ohl, R. Olurunju, S. Paixão, M.P. Pegoraro, C.N. Peixoto, F.C. Artigo 2 Pereira, A. J. Peres, H.H.C. Petitet, A. Pinheiro Neto, C.D. Artigo 2 Artigo 3 Pinto, V.C. Pires, F.S.

6 Pisa, I.T. Artigo 2 Artigo 3 Artigo 4 Artigo 5 Ponokowski, P. Porter, J. Porter, J.M. Prudent, L. Reis, M.C.S. Ribeiro, M.A.C. Richardson, R.J. Ricur, G. Artigo 2 Rocha, G.Z. Roque, A.C. Rosa, V.T.A. Rossi, F. Russomano, T. Artigo 2 Artigo 3 Sachpazidis, I Artigo 2 Sakas, G. Salas, L.C. Salvatore, P. Santos, A.A.S Artigo 2 Santos, A.F. Artigo 2 Artigo 3 Santos, D.T. Santos, S.F. Artigo 2 Artigo 3 Artigo 4 Sakuno, T. Sarkis, C. Satyamurthy, L.S. Schaun, T.R. Schor, P. Artigo 2 Scott, R.E. Sequeira, E. Artigo 2 Artigo 3 Artigo 4 Artigo 5 Artigo 6 Sgavioli, C.A.P.P. Artigo 2 Artigo 3 Artigo 4 Sigulem, D. Artigo 2 Artigo 3 Silva, A.P.S.S. Silva, I.M. Artigo 2 Artigo 3 Soares, E.R. Soares, R.C.F.R. Artigo 2 Soares, S Artigo 2 Sousa, R.M. Souza, C. Artigo 2 Artigo 3 Souza, C.A.

7 Sparenberg, A.L.F. Artigo 2 Artigo 3 Spiri, W.C. Sproule, K. Stamboulian, D. Szabo, C.A. Szomorovszky, S.V. Tachinardi, U.A.S. Thornby, D. Vujacich, C. Young, E. Wainer, J. Artigo 2 Wangenheim, A. Weinstein, R. Whalen, E. Williams, M.D. Zaldivar, R. Artigo 2 Timm, R. Togashi, G.B. Trindade, M.A.B. Artigo 2 Vazquez, L. Vélez Beltrán, J.A. Artigo 2 Artigo 3 Veronezi, M.C. Artigo 2 Artigo 3 Voegels, R.L.

8 A DINÂMICA DE ENFERMAGEM EM SERVIÇO DE URGÊNCIAS COM SISTEMA DE TELE-ECG DIGITAL NO SUL DO BRASIL Soares, E. R.; Schaun, T.R.; Russomano, T.; Sparenberg, A. Laboratório de Microgravidade/IPCT-Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil. Associação Médica de São Lourenço do Sul, RS, Brasil INTRODUÇÃO. Pequenas cidades e áreas rurais no Brasil são carentes de cardiologistas, o que prejudica a análise de Eletrocardiogramas (ECGs), especialmente os exames emergenciais. A transmissão em tempo real (on-line) de ECGs permite o rápido estabelecimento de diagnósticos cardiológicos. MATERIAL E MÉTODOS. À partir de janeiro de 2000, a sala de urgências do Hospital Santa Casa de Misericórdia de São Lourenço do Sul (HSCM-SLS), RS, adotou um Sistema de Tele-ECG Digital (SED), o qual permite o registro, a transmissão e análise em tempo real e o armazenamento dos dados eletrocardiográficos. O SED inclui uma aparelho digital de ECG, computadores, software de comunicação (pcanywhere, versão 10.5, Symantec), modem ligado à linha fixa de telefonia e telefone celular remoto (9600 bits/s). A equipe de enfermagem, a quem compete orientar e treinar a realização dos exames, é composta por uma coordenação geral, enfermeiras supervisoras de turno e técnicos e auxiliares de enfermagem. RESULTADOS. No período de 17/11/2003 à 16/11/2004 foram analisados 604 exames, com tempo médio de transmissão e análise de 8,05 min (DP 1,6). A média etária foi de 58,7 anos. Na amostra, 321 (53.15%) pacientes foram do sexo feminino e 283 (46.85%) do sexo masculino, incluindo 176 (29.14%) exames normais e 428 (70.86%) com diagnósticos eletrocardiográficos patológicos. CONCLUSÃO. O SED constitui-se em método de baixo custo e que permite o diagnóstico precoce de urgências cardiológicas, trazendo grande benefício para a dinâmica do Serviço de Enfermagem, ao ser empregado em cidade de pequeno porte. adolfosparenberg@hotmail.com trussomano@hotmail.com

9 A MODEL OF TELEHEALTH BETWEEN UNIVERSITY HOSPITAL AND PRIMARY CARE SECTOR OF THE MUNICIPAL HEALTH SYSTEM OF BELO HORIZONTE Santos, A.F.; Alkmim, M.B.; Silva, I.M.; Souza, C.; Santos, S.F.; Peixoto, F.C.; Bossi, G.A.; Alves, L.C.. Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, Minas Gerais, Brasil; Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil; Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brasil; PRODABEL - Empresa de Informática e Informação do Município de Belo Horizonte, Belo Horizonte, Minas Gerais, Brasil. The BH TELEMED project is a Telemedicine and Telehealth project for primary care, made for the family health teams in the city of Belo Horizonte and financed by line of the European Union and the Ministry of Health. It interconnects the " Hospital das Clínicas"(HC) of the Federal University of Minas Gerais(UFMG) and the Health Centers of the Municipal Health Department through a long distance consulting system with teleconsultations and specific theme discussions. Its objective is to promote permanent in-service training and to improve the effectiveness of the primary health network. The project is composed of Telemedicine, Telenursing and Teleodontology activities. The body of Teleconsultants is made up of 50 doctors, 10 nurses and 2 dentists of the UFMG. The defined model is to carry out teleconsultations scheduled according to spontaneous demand, discuss themes based on clinical cases and themes programmed according to statistical data of specialised consultations. The technology used is simple and not expensive (computers and webcams) allowing a simultaneous on-line access of all the participating units, with image, voice and/or chat interaction. In the first 15 months of the project there was a gradual implementation of the system in 17 health centers, development of the on-line module of the Teleconsulting Management software, the interconnection of the network and the stabilisation of the system. In the period 103 events were carried out (86 teleconsultations, 3 medical theme discussions, 4 telenursing sessions, 1 teleodontology session and 7 international videoconferences) with the participation of 772 health professionals. The implemented model of Telehealth showed itself effective in reducing the necessity of relocating patients to only 24% of discussed cases, improving the resolution potential of the public health system. Simultaneously it has been observed a progressive rise in the participation of professionals in the clinical telesessions.

10 (1) A MULTI-DIMENSION METHODOLOGY FOR ASSESSING, EVALUATING AND COMPARING THE TELEHEALTH PROJECTS (1) (2) Fregonara, M. ; Borghi, G. Azienda Sanitaria Locale Provincia di Milano 3, Monza (Milan), Italy (2) Health General Direction - Lombardy Region, Milan, Italy The telehealth projects receive mainly public funding, therefore government agencies make careful economic assessment and impact analysis of the investment expenditures and results. The Cost/Benefit Analysis (CBA) investigates all the possible resources and estimated effects derived by the introduction of technological innovations. The comparison between resources (costs) and results (benefits) is used for estimating the impact of telehealth projects, in order to choice the project offering more net benefits among different solutions. The main goal of the proposed method, based on six steps, is to overcome the CBA limits enlarging its analysis parameters with a multi-dimensions approach of assessing, evaluating, selecting and comparing the costs, benefits and social impacts of telehealth projects in order to take a decision about its outputs, resources and outcome. The first step identifies and classifies all the information on the main assessment parameters for the project analysis: costs, profits and impacts. The second step splits all the resources within the project implementation phases: design, realisation, activation, utilisation and divestment. The third step collects the data within the aggregated macro-items in order to obtain an abstraction level, but keeping a sufficient detail. The fourth step combines and classifies the aggregated macro-items into the different project phases to obtain a better ranking of the assessment parameters. The fifth step estimates the balance of all the amount (costs and profits) and the outcomes (impacts) for each project phases, in order to allow a specific or global evaluation. The last step defines the metrics to support the decision about financing the project, based on the previous steps. This approach aims at estimating the global increase of health state through the value of all the resources, costs, benefits and outcomes, because all the main actors (patients, their family, physicians and service organisations) attribute different values to these parameters. The methodology is also focused on the project impact, measured through the evaluation of costs and benefits, the assessment of possible effects, included the intangible or social benefits for people and the direct/indirect influences on the National Health Service budget.

11 The method acquires all the information needed to inquire into all the complex impacts of telehealth projects from different perspectives: patients' quality of life; care cost saving; modification of treatments; equipment and supply costs; time of actors; improper admissions or examinations. The method compares telehealth projects in order to both ex ante (economic feasibility and realisation costs) and ex post (benefits and general costs) or both traditional and telematics processes, evaluates different workflows or solutions, analyses among alternatives with potentially diverse global benefits, assesses different organisation and management of health centres. The method, tested in telecare, will fit also in different sectors of health: teleeducation, telenursing, etc. Up to now, we are developing a software tool for the evaluation of telehealth projects through the proposed methodology, acquiring all the information needed to analyse a project from all the different perspectives.

12 A SLIGHT SIGHT ON FRENCH TELEMEDICINE ADVENTURE : TWO CONCRETE TELEMEDECINE APPLICATIONS Petitet, A. - MD (AP) CATEL, ISfTeH board member, CardioGap - Le Thor - France th FOREWORDS. On august, 13, 2004 a very important event took place in France: for the first time, the word: telemedicine was legaly inscribed in a french law. That's means from now, telemedicine actions move from "hunting stories" to pragmatic application tracks. This communication reports two applications : - 1. an international acute cardiac ischemia rescue network (before the law) an emergency network in a whole french district (after the law). - An international acute cardiac ischemia rescue network. In 1998, sanitary evacuations statistics showned to a french oil company medical department for expatried workers the second place of suspected acute myocardial infarction. The head of this medical departement decided to improve the real documentation on time to better know the severity and the potential level of emergency. It was decided to equip each site for exploitation and/or prospection with a ECG recorder-transmitter all over the world. 40 devices were active. The reception medical station for reading, analysis and decision was first a North America call center, then a french emergency hospital station. The network was working during 7 years. There were 35 "medical" calls : in 17, ECG electric changes were in favor of acute myocardial infarction or early ischemia ; in 18, no real proof of electric cardiac disorders. So the conclusion was:(1) in 17, the quick decision to treat then to transport patients to a well equiped hospital concerning cardiac emergencies improve dramatically the quality of care and first of all, the recovering,(2) avoidance of unusufull sanitary evacuation in 18 with a decreasing financial charge for this post. Today, after this positive experience, the company initiate local and regional connections by telemedecine between its workers groups and agreed hospital and clinics. - An emergency network in a whole french district. The french emergency organisation is one of the best worlwide. It is based on SAMU/SMUR on one hand, Firemen on the other hand. The main principle is to have a medical inside the emergency car. But,

13 several factors and also a large new pannel of types of transport have changed the today conditions. In addition, more and more, the medical teams out and in hospital need to work closely together and to use for that the same objective documentation in real time. There are 98 administrative french districts. One of them, an average one, Vaucluse was chosen to be equiped by a multiparametric monitor able to transmit continously data from the emergency car to the hospital station. 14 emergency cars are equiped. The device is able to collect biomedical parameters as ECG 12, Sp0²,NIBP,Respiration, Capno and also to provide a very complete electronic and evolutive patient dossier all over the transportation. The sensor module and the tablet PC inside the car are linked by bluetooth (no cables). The tablet PC,where all the data are collected with e-pr, is linked with the hospital station by GPRS. Inside hospital, the regulation station might be connected with a terminal in the CCU for instance. All the screens of this netwoork show the same documentation on the same time. More, there is a two ways messagerie for exchanges between the mobil team and the hospital one. Numerous advantages are done (1) no delay to drive the patient to the well adapted hospital reception,(2) interoperability between mobil emergency team and hospital medical team, (3)help to the primary first aid or para-medics team to improve the care under the medical management,(4) costs effectivity by avoidance of wrong transportations,(5) better and more accurate hospital reception,(6) electronic objective documentation to be stored for forward expectation, (7) a perfect common transmission tool between SAMU/SMUR and Firemen. This is a pure concrete demonstration of role of telemedicine in a daily sensible practice.

14 A SOCIAL PERSPECTIVE APPROACH ON TELEMEDICINE FOR LAND MINES VICTIMS IN COLOMBIA Vélez Beltrán, J.A. and Navarro Newball, A.A. Colombian Telemedicine Centre, Cali-Colombia KEYWORDS. Telemedicine, Land mines, Rehabilitation, Emergency, Evacuation, BACKGROUND. The Colombian territory has been seeded with more than land mines and, accidents and incidents and victims had been registered in 94% of the territory. OBJECTIVE. The objective of this work is to create and to validate a set of web-based interactive tools to support assistance of land mines' victims and health care professionals in Colombia. METHODS. The Web-based environment for land mines' victims support follows an interdisciplinary and inter-institutional work and an object oriented software methodology. Actually, the prototype of the environment is under a technical validation which includes performance tests and surveys. RESULTS. At the moment there are three prototype web environments. The emergency attention environment facilitates the communication between health personnel attending the victim and specialists in trauma. The rehabilitation environment allows the remote supervision of the patient during the healing process, decreasing the number of required displacements. The characterisation environment allows the search and selection of trauma specialist. Also, a preliminary validation took place. DISCUSSION. Even though the web based interactive tools show a high level of interactivity, they must be enhanced in order to make them friendlier. The access to the land mine victim's support environment is easy as long as there is an Internet connection. An educational cycle including a web based expert decision support system (WEDS), a planning instrument, a video transmission and a simulator can be extended in order to complement the tools. The deployment of the proposed environment will cause a great social impact. javelez@colombiantelemed.org aannewball@colombiantelemed.org

15 A TELERADIOLOGIA SEM O PACS. O PROJETO INTERINSTITUCIONAL ENTRE CENTRO DE ENSINO NACIONAIS EM RADIOLOGIA PEDIÁTRICA. Monteiro, A. Faculdade de Ciências Médicas da UERJ. A Faculdade de Ciências Médicas, entre os Projetos em Telemedicina, tem desenvolvido Projetos de Teleintegração com outros centros de ensino, nacionais e internacionais, com o objetivo de aperfeiçoamento, ensino, pesquisa e assistência. Neste âmbito acadêmico destaca-se o Projeto Interinstitucional em Radiologia Pediátrica pelo seu pioneirimo nesta linha de pesquisa e assistência e, pela sua relevância no atendimento desta população de crianças. Utilizando sistemas de videoconferências, com conexões pela Rede de Internet via RNP, e também por ISDN, o Projeto já agrega, até o presente, cinco pontos no nosso país. Na metodologia de troca e envio de imagens têm-se adotado sistemas simples, tais como o digitalizador de imagens, o progama Microsoft PowerPoint e o próprio uso do negatoscópio, online. O propóstito desta forma simplificada de troca de imagens pode ser resumido como um facilitador do processo de inclusão entre diferentes centros de ensino. O público alvo tem sido de alunos da graduação e da pós-graduação, lato e stricto-senso, além de médicos e professores. O objetivo pricipal deste projeto é capacitar, de forma atualizada, o médico-radiologista, e permitir a integração em projetos de pesquisa multicêntricos. Experiência do INCOR no desenvolvimento, implantação e manutenção do PACS Gutierrez, M.A. Serviço de Informática, Insituto do Coração do Hospital das Clínicas da Faculdade de Medicina da USP. O Instituto do Coração (InCor) tem envidado esforços para integrar todas as informações clínicas dentro da Instituição. Nos últimos anos o InCor implementou com sucesso um sistema para transmissão, arquivamento, recuperação, processamento e visualização de Imagens 3 Médicas (PACS-InCor) e um Sistema de Informações Hospitalares (SI ) que armazena as informações administrativas e clínicas. A integração desses subsistemas forma o Prontuário Eletrônico do Paciente (PEP).Institutos é também uma questão muito relevante.

16 ACTIVITIES OF THE TELEDENTISTRY CENTER AT SACRED HEART UNIVERSITY Sgavioli, C.A.P.P. ; Veronezi, M.C..; Marta, S.N. ; Carvalho, I.M.M. ; Soares, S. ; Melare, D. ; Sequeira, E. ; Chao L.W. (1) Sacred Heart University, Bauru, São Paulo, Brazil. (2) Discipline of Telemedicine, Medical School, University of São Paulo, São Paulo, Brazil. The presence of new technologies requires new positions in the process of learning and teaching. Attempting to transform regular classes in a continuous process of information, communication and investigation, where the knowledge can be built through the balance of individual and group work, between professor coordinator supporter and the active participation of students, in this way Teledentistry was introduced at USC. The current data available from ENADE on the students' access to technology and number of professionals registered in the Federal Dental Council, as well as the amount of dental courses existing in Brazil, show the possibility of an increase in the activities of Teledentistry, increasing the space and time in the access to permanent formation and education of all. This opens the possibility of the University to assist dental professionals working in places distant from the learning institutions and searching for professional upgrade or a second professional opinion in diagnosis and treatment planning. The Dental Course of USC keeps a technical-scientific accord with the Discipline of Telemedicine of FMUSP for utilization of the website Medical Digital Station ( Online courses by the Cybertutor Teleeducation environment; the Virtual Ambulatory for Dentistry and also the creation of Cd-Roms within the Virtual Man Project were developed. Undergraduate and graduate dental students are using the whole material produced so fat in the learning activities. The Teledentistry at USC was developed because of the ability of the group of people involved to make plans real, starting with ambitious dreams, claiming to reach the entire community interested in the growth and education in Dentistry.

17 ANALYSIS OF PARAMETERS OF MANAGEMENT IN THE PROFESSIONAL QUALIFICATION DIRECTED TO THE TECHNOLOGICAL INNOVATION IN HEALTH THROUGH THE USE OF THE TELEMEDICINE Borges, C. L. Digital Radiology Observer - ORD São Paulo / SP - Brazil INTRODUCTION. The objective of this work is the analysis of management parameters to be used in the professional qualification directed to the technological innovation in Health through the use of resources of Telemedicine. This exercise resulted in the construction of a pilot course aiming to the specialized formation in area of administrative and operational management of projects that involve digital technology in departments of Radiology, to be offered by the Radiology Institute / USP in partnership with the Radiology Department / UPenn, counting on the contribution in services of Telemedicine Discipline / School of Medicine / USP. METHODOLOGY. The study consists of the analysis of the relevancy and interrelation of values listed as necessary to the elaboration and implementation of the course, as much in the basic infrastructure for remote communication as in the logical sequence of knowledge absorption directed to the formation specialized in this sector. Functional and administrative infrastructure aspects will be analyzed in the use of resources of Telemedicine for remote communication with different types of data (text, image and voice) guided to the professional qualification. In the question of systematization of the knowledge absorption directed to the technological innovation, parameters of efficiency will be evaluated through use of relationary practical of the study divided in 06 sequential discipline modules elaborated. RESULTS AND CONCLUSION. The waited results of the analysis, when the course on field, suggest the construction of a basic model of management for use of Telemedicine in professional qualification directed to technological innovation in Health.

18 APRENDIZAGEM AUXILIADA POR COMPUTADOR EM OFTALMOLOGIA PARA PROFISSIONAIS DA SAÚDE NÃO- ESPECIALIZADOS Grottone, G., Pisa, I.T., Lopes, P.R.L., Barsottini, C.G.N., Schor, P., Sigulem, D. Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil INTRODUÇÃO. A oftalmologia é uma especialidade de difícil aprendizado para outros profissionais de saúde fora o médico-oftalmologista. Novos métodos de ensino, baseados em auxílio informatizado, podem produzir melhores resultados nesta tarefa. OBJETIVO. O objetivo deste trabalho é desenvolver e validar um novo protocolo direcionado à consulta oftalmológica por profissionais da saúde, utilizando elementos computacionais e multimídia para auxiliar no ensino. MÉTODOS. Baseado em uma lista de sinais e sintomas em oftalmologia, um novo protocolo foi desenvolvido tomando como base a experiência obtida através de 10 alunos de medicina, que utilizaram diretrizes oftalmológicas préestabelecidas, testando suas dificuldades de aprendizagem. Antes do atendimento com pacientes, foram reunidos e instruídos por um supervisor quanto ao funcionamento de cada instrumento a ser utilizado na consulta bem como seus possíveis resultados. Para cada bloco de informações, uma nota entre 1 e 10 foi atribuída ao grau de dificuldade para fazer o exame e interpretar os resultados gerados. RESULTADOS. Ao final de dois meses, o protocolo final foi apresentado demonstrando suficiente informação para o profissional de saúde ter uma ferramenta para decidir quais os pacientes que necessitavam de atenção imediata de um especialista em oftalmologia. CONCLUSÃO. Este é o primeiro passo para produzir um programa de computador com a meta de poupar recurso em saúde, distribuindo conhecimentos básicos e habilidades sobre cada especialidade médica. Isso é de extrema importância quando pensamos em países em desenvolvimento, onde o acesso ao médico especialista frequentemente é dificultado por barreiras sócio-econômicas e geográficas. Apresentação como POSTER

19 ASSESSMENT OF VIDEOCONFERENCE QUALITY FOR HEALTH DISCUSSIONS BETWEEN LONG DISTANCE HOSPITALS Campelo, VES; Pinheiro Neto, CD; Bento, RF; Wen, CL Faculty of Medicine, University of Sao Paulo INTRODUTION: The telemedicine system is a new way of medical practice. It provides tools for patients' data retrieval and image data communication between long distance hospitals on the information highway. Information technology is now becoming the most popular technology every fields should consider. To make telemedicine an effective medical practice it is essential to become an easy technology and principally to show good quality for data exchange. OBJECTIVES: to assess the quality of videoconference in case discussions. METHODS: a short questionnaire was administered to 20 otolaryngologists (15 males/5 females) after two videoconferences between University of Sao Paulo and Rio de Janeiro State University at a IP (internet protocol) 384Kbps conection. There were 13 ENT residents, 5 post-graduating students and 2 Phd. RESULTS: 65% of the interviewees considered that the images were good and 70% answered that the audio was good. 75% said that image quality didn t hinde case comprehension. 65% considered that videoconference is the best way to exchange experience between distant health groups, and 75% agree that it s use will increase. 25% didn t know that videoconferences could be done using internet. CONCLUSIONS: This telemedicine system showed its ability to improve the way of patient information presentation and to access patient medical records with good quality of image data communication.

20 AVALIAÇÃO DO PROGRAMA INTER-INSTITUCIONAL DE TELEMEDICINA DA PÓS-GRADUAÇÃO DE RADIOLOGIA DA UNIFESP, UFF, UERJ, USP Lopes, P.R.L. 1 ; Pisa, I.T. 1 ; Ajzen, S. 1 ; Santos, A.A.S 2 ; Gismondi, R.C Monteiro, A.M.V. ; Machado, H.R. ; Ferreira, W.S. ; Borges, C. L. ; 1 Sigulem, D. 1 2 Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil; Faculdade de Medicina - Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ, Brasil; 3 Faculdade de Ciências Médicas - Universidade Estadual do Rio de Janeiro 4 (UERJ), Rio de Janeiro, RJ, Brasil; Faculdade de Medicina de Ribeirão Preto 5 - Universidade de São Paulo (USP), Ribeirão Preto, SP, Brasil; Observatório de Radiologia Digital (ORD), São Paulo, SP, Brasil INTRODUÇÃO. Programas de telemedicina inter-institucional podem acelerar a colaboração entre grupos afins se em seu planejamento são considerados aspectos sobre o objetivo dos parceiros, atividades práticas a serem realizadas e parâmetros de avaliação pré-estabelecidos, entre outros. OBJETIVO. Este trabalho tem como objetivo descrever um modelo de parametrização para avaliação na colaboração médica em programas de telemedicina inter-institucionais. METODOLOGIA. Considera-se o uso dos recursos de comunicação remota na participação quinzenal de estudos de caso e qualificações de tese entre os setores de pós-graduação das instituições supra citadas. Pretende-se implementar uma métrica de avaliação para levantar resultados relevantes sobre a qualidade da colaboração médica realizada, considerando efetividade, segurança, praticidade e utilidade. Para seguridade serão avaliados aspectos sobre a qualidade da imagem e câmera, resolução espacial e cores, compressão, imagens necessárias no processo, largura de banda e treinamento adequados. Para praticidade serão avaliados aspectos sobre a organização do serviço, disponibilidade dos equipamentos, competência para operação, financiamento e aspectos legais. Quanto à utilidade serão considerados a melhoria da qualidade do serviço, melhoria do bem-estar da população e custo-efetividade do programa proposto. RESULTADOS. Os resultados preliminares demonstram a importância de realizar uma avaliação crítica da conectividade dos parceiros antes de estabelecer os recursos que serão efetivamente empregados no programa.