Title: Telehealth and Teleradiology BRAZIL
1Telehealth and Teleradiology BRAZIL
Alexandra Monteiro. MD.PhD. Member of Brazilian
Committee of Telehealth. MINISTRY OF
HEALTH. Coordinator of Teleradiology Committee.
BRAZILIAN COLLEGE OF RADIOLOGY. Adjunct Professor
of Radiology and Coordinator of the Telehealth
Center STATE UNIVERSITY OF RIO DE JANEIRO (UERJ).
e-mail alexandra_at_uerj.br
2BRAZIL is a continental country with assimetric
geographic distribution of the municipalities
- Brazil is a federal republic
- formed by a Federal District, 26 States and 5564
Municipalities - with a population of over 190 million people
- 83 of the population lives in urban areas.
- - Human Development Index (HDI) of 0.80
3Brazilian Health System
- The Unified Health System (SUS) is exclusively
responsible for providing health care to 78.8 of
Brazilian population, and it is the primary
network of public health institutions that
provide, support, and manage health services - The remaining 21.2 of the population, which are
covered by the Supplementary System, is also
entitled to access the health services provided
by SUS - In addition to these functions, SUS is also
responsible for health surveillance, disease
control, and regulation of the health sector.
Brazils challenges Support for the political
and technical processes needed to ensure the
country achieving the Millennium Development
Goals (MDGs) Support and improvement ongoing
federal projects in telemedicine and telehealth.
4Brazil Distribution of large bandwidth
Brazil has a fairly advanced (but poorly
distributed) ICT infrastructure, largely a
result of the telecommunications privatisation
process started in 1998
Ministry of Communication, 2006
municipalities
5 Improvements in large bandwidthImplementation
of DEDICATED NETWORKS to research, education
and e-health services.
Brazilian National Research and Education Network
(RNP)IPÊ national backbone
Funded by the Ministry of Science and Technology
6Brazilian RNP provide national with
international connections in dedicated
networksto research, education and e-health
services
7Ongoing national e-health projects RUTE
(Telemedicine University Network) connecting
the University Hospitals around all the Brazilian
states. RUTE SIGs pediatric radiology,
neuroradiology, thoracic radioloy, abdominal
radiology, education in radiology and
technologies researchs for teleradiology.
Brazilian Telehealth Program connecting
University Hospitals in 9 states to provide
e-education and teleconsultation (including
teleradiology) for primary health professionals
in the municipalities, that covers almost 11
million people.
8Brazilian College of Radiology (CBR)
Distribution of radiologists (2010)
n 82
9CBR-Teleradiology Committee
- Goals
- Ethical Standards in Teleradiology
- Resolution in Teleradiology (2009) - Federal
Council of Medicine (CFM) - - only physicians would ask for second
opinion, - - general physicians would ask
teleconsultation only for general X-Ray, - - radiologists from anywhere would ask
for teleconsultation, - - Teleradiologists may attend
teleconsultation only for - two states
in Brazil (Federal Council of Medicine) - Integration among radiologists (teleducation)
- DICOM protocols CBR, Brazilian Standards
Association (ABNT), Federal Council of Medicine
(CFM) and Brazilian Health Informatics Society
(SBIS) - DICOM legislation- National Agency of Sanitary
Vigilance (ANVISA)
- Interamerican College of Radiology (CIR)
- Brazilian Teleradiology Committee has been
contributing to CIR Ethical Standards in
Teleradiology - Ethics legislation were approved in october
2010.
10Distribution of digital radiology equipment
Brazilian Registry of Health Facilities (CNES)
11Goals - Stimulate educational activities related
to Health Informatics (HI) - Stimulate
scientific research and technical development in
HI - Contribute to the definition of health and
health care policies - Promote HI as a means to
reduce costs and improve the quality of health
services.
Partnerships CFM - Federal Council of
Medicine DATASUS - Department of Health
Informatics and Information ANS - National
Agency for Supplementary Health ABNT - Brazilian
Association of Technical Standards ISO TC215
Mirror Committee International Organization for
Standardization HL7 Brazil- Brazilian Affiliate
to Health Level Seven Organization IMIA-LAC-
Latin American and Caribbean Federation of Health
Informatics IMIA- International Medical
Informatics Association
12- ISO 13131 QUALITY CRITERIA FOR TELEHEALTH
- STANDARDS FOR TELEHEALTH
- The Brazilian Standards Association (ABNT) has
worked towards adopting and developing standards
to support TeleHealth - One of the most important standards in
discussion in the ISO world now, is the ISO 13131
Quality Criteria for Services and Systems for
TeleHealth. The standard is in the Committee
Draft stage, which means it still can get plenty
of contribution from members - DICOM is part of the Joint Initiative Council
which means that DICOM members can take part in
ISO meetings.
www.abnt.org.br
13Welcome to Brazil a virtual tour to the various
regions!!!