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Ganiele MDLN, Weisbrot MA, Sian AM, Carosella Reboredo JM, Weisbrot MV, Grande Ratti MF. [Scope and limitations of teleconsultation during the covid-19 pandemic: accounts from primary healthcare professionals in the Autonomous City of Buenos Aires]. Salud Colect 2024; 20:e4579. [PMID: 38381119 DOI: 10.18294/sc.2024.4579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.
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Affiliation(s)
- María de Las Nieves Ganiele
- Médica, investigadora, docente, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariela Alejandra Weisbrot
- Magíster en Epidemiología, Gestión y Políticas de Salud. Investigadora, docente, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Andrea Melissa Sian
- Estudiante de Medicina, Instituto Universitario Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - María Victoria Weisbrot
- Socióloga. Investigadora, project manager, Instituto Universitario Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Florencia Grande Ratti
- Doctora en Ciencias de la Salud. Investigadora, Consejo Nacional de Investigaciones Científicas y Técnicas. Docente, Instituto Universitario Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Barbalho IMP, Fernandes F, Barros DMS, Paiva JC, Henriques J, Morais AHF, Coutinho KD, Coelho Neto GC, Chioro A, Valentim RAM. Electronic health records in Brazil: Prospects and technological challenges. Front Public Health 2022; 10:963841. [PMID: 36408021 PMCID: PMC9669479 DOI: 10.3389/fpubh.2022.963841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Electronic Health Records (EHR) are critical tools for advancing digital health worldwide. In Brazil, EHR development must follow specific standards, laws, and guidelines that contribute to implementing beneficial resources for population health monitoring. This paper presents an audit of the main approaches used for EHR development in Brazil, thus highlighting prospects, challenges, and existing gaps in the field. We applied a systematic review protocol to search for articles published from 2011 to 2021 in seven databases (Science Direct, Web of Science, PubMed, Springer, IEEE Xplore, ACM Digital Library, and SciELO). Subsequently, we analyzed 14 articles that met the inclusion and quality criteria and answered our research questions. According to this analysis, 78.58% (11) of the articles state that interoperability between systems is essential for improving patient care. Moreover, many resources are being designed and deployed to achieve this communication between EHRs and other healthcare systems in the Brazilian landscape. Besides interoperability, the articles report other considerable elements: (i) the need for increased security with the deployment of permission resources for viewing patient data, (ii) the absence of accurate data for testing EHRs, and (iii) the relevance of defining a methodology for EHR development. Our review provides an overview of EHR development in Brazil and discusses current gaps, innovative approaches, and technological solutions that could potentially address the related challenges. Lastly, our study also addresses primary elements that could contribute to relevant components of EHR development in the context of Brazil's public health system. Systematic review registration: PROSPERO, identifier CRD42021233219, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021233219.
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Affiliation(s)
- Ingridy M. P. Barbalho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Daniele M. S. Barros
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Jailton C. Paiva
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Jorge Henriques
- Department of Informatics Engineering, Center for Informatics and Systems of the University of Coimbra, Universidade de Coimbra, Coimbra, Portugal
| | - Antônio H. F. Morais
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Karilany D. Coutinho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Giliate C. Coelho Neto
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Arthur Chioro
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
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