BRAZILIAN NATIONAL TELEHEALTH PROGRAM

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1 BRAZILIAN NATIONAL TELEHEALTH PROGRAM Ana Estela Haddad Beatriz Alckmin Chao Wen Sergio Roshke Francisco Campos Ministry of Health, Brazil Departamento de de Gestão Gestão da da Secretaria de de Gestão Gestão do do Trabalho Educação na na Saúde Saúde e da e da Educação na na Saúde Saúde da Saúde

Departamento de de Gestão Gestão da da Secretaria de de Gestão Gestão do

2 Brazil inhabitants 5563 cities in 88% of the cities the population varies from 2,000 to 50,000 inhabitants 40% of the population in metropolitan areas Departamento de de Gestão Gestão da da Secretaria de de Gestão Gestão do do Trabalho IBGE, 2000 Educação na na Saúde Saúde e da e da Educação na na Saúde Saúde da Saúde

to 50,000 inhabitants 40% of the population in metropolitan areas Departamento de

3 Some important information about National Health System (SUS): Universal, equitative and holistic system included in the Constitution. Decentralized and socially controlled system. Provides comprehensive and free medical care to the whole population. 82% coverage of influenza vaccination for elderly, rotavirus vaccination provided by SUS, improvemets in health outcomes. Is a global reference for STD/AIDS free public antiretroviral therapy 72,000 hearth surgeries 132 million high-complexity procedures 12,000 organ transplants e da

82% coverage of influenza vaccination for elderly, rotavirus vaccination provided by SUS, improvemets in health outcomes.

4 Family Health Program Created in 1994 to improve the access of all citizens to health care Teams: a physician a nurse auxiliary nurses health agents a dentist e da

5 Health of the Families Program (HFP) Working in 84% of municipalities teams (1 physician, 1 dentist 1nurse, 1-2 aux nurse, 6 health agents ) Coverage: 50% of the Brazilian population 86M people e da

6 The rate of change Actual % of population covered by the health family teams Brazil, * 0% Educação 0 a 25% na Saúde 25 a 50% 50 e a da 75% Educação 75 a na 100% Saúde FONTE: SIAB - Sistema de Informação da Atenção Básica

2005* 0% Educação 0 a 25% na Saúde 25 a 50% 50 e a da 75% Educação

7 Brazilian National Telehealth Program Telehealth Support for Primary Health Care in Brazil - Pilot Project Objectives: Improve quality of primary care Qualify professionals of family health teams e da

Project Objectives: Improve quality of primary

8 Telehealth National Pilot Project Promote integration between academy and primary care Improve tele-education Structure a tele-consultation and second opinion Creation of a Virtual Library for Primary Care (Bireme) e da

tele-education Structure a tele-consultation and

9 Telehealth National Pilot Project Promote the use of technology by the Family Health teams Decrease the number of patients sent to secondary level Evaluate different technologies, methodologies and cost-effectiveness e da

number of patients sent to secondary level Evaluate

10 Telehealth National Pilot Project Participant Institutions: Ministry of Health Ministry of Education Ministry of Science and Technology Ministry of Defense Ministry of Communication Civil House of the Federal Government Bireme/OPAS/WHO Brazilian Society of Community and Family Medicine e da

of Defense Ministry of Communication Civil House of the Federal

11 Telehealth National Pilot Project Participant Institutions : USP State University of São Paulo UFMG Federal University of Minas Gerais UERJ State University of Rio de Janeiro UFCE Federal University of Ceará UFAM/UEA Federal University of and State University of Amazonas UFRGS Federal University of Rio Grande do Sul UFPE Federal University of Pernambuco UFG Federal University of Goiás UFSC Federal University of Santa Catarina e da

Federal University of and State University of Amazonas UFRGS Federal University of Rio Grande do Sul UFPE

12 Telehealth National Pilot Project Coverage: Nine State Clusters implementing tele-health in 900 health units supporting about Health Family teams, covering inhabitants. e da

13 Selection criteria for 900 health units Mandatory Criteria: Letter of agreement from the Health Unit Responsible Municipalities with minimal infra structure in telecommunication (access to Internet) Municipalities with Health Family Strategy implemented e da

Municipalities with minimal infra structure in telecommunication

14 Selection criteria for 900 health units Priority Criteria: Municipalities with geographic access barriers Municipalities with population less or equal 100,000 habitants Municipalities with Health Family Strategy coverage equal or greater than 50% Municipalities with IDH less than The project coverage in different regions of the state should not be more than 20% in metropolitan areas and at least 80% in municipalities not belonging to metropolitan areas. e da

equal or greater than 50% Municipalities with IDH less than 0.

15 Equipments for University Centers videoconference server e da

16 Equipments for health units Low cost technology e da

17 III Agreement Ministry of Health and the National Research and Education Network National Research and Education Network (RNP/MCT) Established in 1989 by Ministry of Science and Technologies promotes innovative use of advanced networking in Brazil. Also called RNP2 backbone, this infrastructure connects 329 Brazilian institutions among them and with foreign institutes, making it possible for people and resources to interact through advanced applications. e da

18 III Agreement Ministry of Health and the National Research and Education Network National Research and Education Network (RNP/MCT) RNP is part of the Latin American Cooperation for Advanced Networks (Clara): Argentine, Brazil, Chile, Colombia, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Peru, Uruguay and Venezuela. Clara connection to Europe was funded by the European Commission e da

Argentine, Brazil, Chile, Colombia, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Peru,

19 Map Backbone RNP e da

20 Agreement Objectives: To promote the coming forward of Tele-health Clusters, in the States not participating in the National Tele-health Pilot Project, trough the implementation of two points of high speed Internet access and infra structure, recommending to be one at a university institution and one in a remote health unit with Family Health Strategy. e da

implementation of two points of high speed Internet access and infra structure,

21 Telemedicine University Network (RUTE) The Telemedicine University Network (RUTE) is a initiative to support the improvement of the infrastructure already existent in university hospitals and to promote integration between the participant institutions. RUTE is an initiative of the Ministry of Science and Technology and coordinated by the National Research and Education Network (RNP). e da

22 Points of Telehealth Telehealth points in Brazil for 2007 Participation of all Brazilian States e da Secretaria de Gestão do Trabalho e da

23 TELEHEALTH A REALITY IN BRAZIL Ministry of Health e da

24 Ministry of Health Secretariat of Management of Education and Work in Health Francisco Campos Ana Estela Haddad Departamento de de Gestão Gestão da da Secretaria de de Gestão Gestão do do Trabalho Educação na na Saúde Saúde e da e da Educação na na Saúde Saúde da Saúde

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Telehealth Support for Primary Health Care in Brazil - Pilot Project

Telehealth Support for Primary Health Care in Brazil - Pilot Project Francisco Campos Secretariat of Manegment of Work and Education in Health Ministry of Health - Brazil Ana Estela Haddad Director of