Technology is moving fast and is changing our daily lives and everything around us. In the health field is no different. Every year new devices appear that facilitate diagnosis, and technologies that provide more aggressive treatments, and in doing so, we discover a new way to practice medicine in a more decentralized and democratic way. The impacts are enormous when we talk about expanding care and access to the health system as a whole.
According to the latest PNAD – National Sample Household Survey, conducted by IBGE, it shows that 84.72% of the population lives in urban areas. Although SUS is very effective, this focus places a significant burden on the public health system in large cities. Not to mention that in the country there are 115 isolated people who do not have direct access to health care.
Brazil is a silo for training senior health professionals. There are more than 500,000 trained physicians, about 64% of whom hold the title of specialist. For 2030, the expectations are even greater: this figure is expected to exceed 800,000. This is indicated by the study conducted by the CFM – Federal Council of Medicine, in partnership with the University of São Paulo. In 2021 alone, during the height of COVID-19, more than 24,000 new doctors graduated.
Specifically in the medical field, there are more career opportunities than doctors available. Brazil currently has 2.4 professionals per thousand inhabitants, which is higher than the population of, for example, Japan, and close to countries such as the United States (2.6), Canada (2.7) and the United Kingdom (2.8). In many countries that are considered developed, this figure is within 4 per thousand inhabitants.
The big challenge is how to take the burden off the system and ensure more people are served. How to democratize health services and ensure access to them for the entire population?
Telemedicine is a starting point and has also proven effective in this regard.
Now, the decision regulating the use of telemedicine, has clear rules and was included in the Official Gazette of the Federation, and is already in force in the country.
This method has been approved on an emergency basis during the pandemic and its regulation will mark a milestone in the country’s medical field.
Like we said before, this is a great tool for reaching people who don’t have access to healthcare. Today, for example, it is possible to perform and report an image examination through teleradiology. Only with qualified technicians and good software, radiologists located elsewhere can analyze reports and improve diagnoses.
We have also made major advances in telemedicine where it is possible to perform ECG, exercise tests, Holter and ABPM in remote locations which must be commended by qualified professionals. Not to mention other devices that perform physical examinations of otoscopy (a tool for visualizing the internal structures of the auditory meatus and eardrum), which analyze a throat infection. In addition, it enables and implements listening to the heart and lungs, and may identify many diseases, such as a possible acute heart attack. These technologies are also important for monitoring patients with chronic diseases, not to mention that they provide convenience for those who can undergo a consultation by video call.
A recent survey conducted by the telemedicine platform showed that Brazilians approve of the method. Of the 5,961 people interviewed, 81% considered remote service to be a good option. From the health professional’s point of view, in addition to the savings made, in terms of resources and time, there is the potential to serve more people. In terms of digital medical education, we follow the same logic. Through the Internet, professionals not close to reference centers can access quality education. Enhancing knowledge and training new professionals across the country, thus, democratizing medical care and reaching more patients.
Evolution of science and breaking taboos
Returning specifically to developments in the specialty of cardiology, the first trials with telemedicine began in Brazil in the mid-1990s. And in 1995, InCor – Instituto do Coração de SP, ECG-FAX, which provided the analyzes conducted by the entity’s physicians and the tests were, in turn, sent by fax to other cities. In 1996, the foundation made it possible to monitor patients at home, through a system called ECG-Home.
Digital teaching is a path of no return. It is true that this type of learning is still partially resisted, but it is necessary to emphasize that distance education is regulated by the MEC, in order to increase the education offer in the country specifically.
Institutions recognized by the Ministry of Education follow a series of requirements to ensure the training of qualified professionals and are under constant monitoring to maintain quality.
We need to let technology break down barriers. Health and knowledge are essential to the formation of an equal and balanced nation. We still have a long way to go, but good solutions are emerging to make virtual care as effective and assertive as face-to-face care, with a direct impact on the health care of the population.
* Marcos Vinicius Tatageba is CEO and founder of Educar Mais, the educational group that runs the Brazilian School of Medicine (EBRAMED)
* Leonardo Jorge Cordero de Paula is a cardiologist and Academic Director of the Brazilian School of Medicine (EBRAMED). He specializes in health administration and education, and is currently a Clinical Physician at Incor – Instituto do Coração
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