{"id":8304,"date":"2021-07-30T17:31:13","date_gmt":"2021-07-30T20:31:13","guid":{"rendered":"https:\/\/saudedigitalbrasil.com.br\/?p=8304"},"modified":"2024-09-01T13:32:42","modified_gmt":"2024-09-01T16:32:42","slug":"future-health-impedir-a-primeira-consulta-via-telemedicina-pode-prejudicar-o-futuro-da-saude","status":"publish","type":"post","link":"https:\/\/saudedigitalbrasil.com.br\/en_us\/future-health-impedir-a-primeira-consulta-via-telemedicina-pode-prejudicar-o-futuro-da-saude\/","title":{"rendered":"Future Health: Preventing the first consultation via telemedicine could harm the future of healthcare"},"content":{"rendered":"<div class=\"dati1w0a f10w8fjw hv4rvrfc discj3wi\">\n<div>\n<div class=\"a8nywdso j7796vcc rz4wbd8a l29c1vbm\"><span class=\"d2edcug0 hpfvmrgz qv66sw1b c1et5uql lr9zc1uh a8c37x1j keod5gw0 nxhoafnm aigsh9s9 d3f4x2em fe6kdd0r mau55g9w c8b282yb iv3no6db jq4qci2q a3bd9o3v b1v8xokw oo9gr5id\" dir=\"auto\">In an article published in Future Health, Eduardo Cordioli, president of\u00a0<a class=\"oajrlxb2 g5ia77u1 qu0x051f esr5mh6w e9989ue4 r7d6kgcz rq0escxv nhd2j8a9 nc684nl6 p7hjln8o kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x jb3vyjys rz4wbd8a qt6c0cv9 a8nywdso i1ao9s8h esuyzwwr f1sip0of lzcic4wl oo9gr5id gpro0wi8 lrazzd5p\" tabindex=\"0\" role=\"link\" href=\"https:\/\/www.facebook.com\/hashtag\/sa%C3%BAdedigitalbrasil?__eep__=6&amp;__tn__=*NK*F\" target=\"_blank\" rel=\"noopener\">#Sa\u00fadeDigitalBrazil<\/a>, addresses the two main obstacles to the proposal for\u00a0<a class=\"oajrlxb2 g5ia77u1 qu0x051f esr5mh6w e9989ue4 r7d6kgcz rq0escxv nhd2j8a9 nc684nl6 p7hjln8o kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x jb3vyjys rz4wbd8a qt6c0cv9 a8nywdso i1ao9s8h esuyzwwr f1sip0of lzcic4wl oo9gr5id gpro0wi8 lrazzd5p\" tabindex=\"0\" role=\"link\" href=\"https:\/\/www.facebook.com\/hashtag\/regulamenta%C3%A7%C3%A3o?__eep__=6&amp;__tn__=*NK*F\" target=\"_blank\" rel=\"noopener\">#regulation<\/a>\u00a0from the\u00a0<a class=\"oajrlxb2 g5ia77u1 qu0x051f esr5mh6w e9989ue4 r7d6kgcz rq0escxv nhd2j8a9 nc684nl6 p7hjln8o kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x jb3vyjys rz4wbd8a qt6c0cv9 a8nywdso i1ao9s8h esuyzwwr f1sip0of lzcic4wl oo9gr5id gpro0wi8 lrazzd5p\" tabindex=\"0\" role=\"link\" href=\"https:\/\/www.facebook.com\/hashtag\/telemedicina?__eep__=6&amp;__tn__=*NK*F\" target=\"_blank\" rel=\"noopener\">#telemedicine<\/a>\u00a0in Brazil. The prohibition of the first online consultation and territoriality can harm and interrupt the advancement of the quality of\u00a0<a class=\"oajrlxb2 g5ia77u1 qu0x051f esr5mh6w e9989ue4 r7d6kgcz rq0escxv nhd2j8a9 nc684nl6 p7hjln8o kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x jb3vyjys rz4wbd8a qt6c0cv9 a8nywdso i1ao9s8h esuyzwwr f1sip0of lzcic4wl oo9gr5id gpro0wi8 lrazzd5p\" tabindex=\"0\" role=\"link\" href=\"https:\/\/www.facebook.com\/hashtag\/sa%C3%BAde?__eep__=6&amp;__tn__=*NK*F\" target=\"_blank\" rel=\"noopener\">#health<\/a>\u00a0in Brazil. Check out the full text:\u00a0<a class=\"oajrlxb2 g5ia77u1 qu0x051f esr5mh6w e9989ue4 r7d6kgcz rq0escxv nhd2j8a9 nc684nl6 p7hjln8o kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x jb3vyjys rz4wbd8a qt6c0cv9 a8nywdso i1ao9s8h esuyzwwr f1sip0of lzcic4wl py34i1dx gpro0wi8\" tabindex=\"0\" role=\"link\" href=\"https:\/\/bit.ly\/2WNoyDx?fbclid=IwAR0vCEFhtw7DVpTJjqRXH5qFIO9emmBgP5-m4vHAIROGkFBYWKt9HN0ve-k\" target=\"_blank\" rel=\"nofollow noopener\">https:\/\/bit.ly\/2WNoyDx<\/a><\/span><\/div>\n<\/div>\n<div class=\"j83agx80\">\n<div class=\"pq6dq46d\">\n<div class=\"oajrlxb2 g5ia77u1 qu0x051f esr5mh6w e9989ue4 r7d6kgcz rq0escxv nhd2j8a9 pq6dq46d p7hjln8o kvgmc6g5 cxmmr5t8 oygrvhab hcukyx3x jb3vyjys rz4wbd8a qt6c0cv9 a8nywdso i1ao9s8h esuyzwwr f1sip0of lzcic4wl n00je7tq arfg74bv qs9ysxi8 k77z8yql l9j0dhe7 abiwlrkh p8dawk7l cbu4d94t taijpn5t k4urcfbm\" tabindex=\"0\" role=\"button\" aria-label=\"Edit\">\n<div class=\"rq0escxv l9j0dhe7 du4w35lb j83agx80 pfnyh3mw taijpn5t bp9cbjyn owycx6da btwxx1t3 kt9q3ron ak7q8e6j isp2s0ed ri5dt5u2 rt8b4zig n8ej3o3l agehan2d sk4xxmp2 d1544ag0 tw6a2znq tdjehn4e tv7at329\">\n<div class=\"bp9cbjyn j83agx80 taijpn5t c4xchbtz by2jbhx6 a0jftqn4\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"kb5gq1qc pfnyh3mw c0wkt4kp\"><\/div>\n<div>\n<p>The advancement of remote service, in any service, is something irreversible in the world: from banking, education, retail and now in healthcare. This is digital transformation.<\/p>\n<p>&nbsp;<\/p>\n<p>The physical and digital have never been so close, creating what we can call \u201cphygital\u201d. In medicine, it is no different. Telemedicine emerges to brilliantly and efficiently unite these two worlds. But how can this be done if there are still barriers to its full potential in the post-pandemic period?<\/p>\n<p>&nbsp;<\/p>\n<p>With the definitive regulation of telehealth imminent, two central points are in question, raised by the Regional Medical Council (CRM).<\/p>\n<p>&nbsp;<\/p>\n<p>Brazil, unlike what happens in the rest of the world, intends to maintain a limit on the first consultation and require that it be exclusively in person.<\/p>\n<p>&nbsp;<\/p>\n<p>Countries in Europe, the United States, India, Canada, South Africa, Mexico and Argentina allow the first consultation to be carried out remotely. They set the limits in order to give the doctor and the patient the autonomy to decide whether that initial consultation can, in fact, be carried out remotely.<\/p>\n<p>&nbsp;<\/p>\n<p>The NHS, the British healthcare system that served as an example for the creation of our SUS, advocates exactly the opposite and advises that the first consultation should preferably be digital.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>This is because it recognizes that telemedicine has the property of placing the right patient in the right place, avoiding waste, improving the patient experience and accelerating diagnosis, making more assertive interventions in shorter times and avoiding delays.<\/p>\n<p>&nbsp;<\/p>\n<p>Another point is the issue of territoriality, which has no legal support in the country.<\/p>\n<p>&nbsp;<\/p>\n<p>What defines this aspect today from the point of view of medicine in Brazil is a law from 1957, which establishes that, when a doctor moves from one state and goes to another to provide care, he must inform the CRM that he is providing care in that state and the location.<\/p>\n<p>&nbsp;<\/p>\n<p>However, considering that in telemedicine the professional remains at his\/her address and receives the patient remotely, this does not change the fact that the service is provided in the location where the doctor&#039;s office is established.<\/p>\n<p>&nbsp;<\/p>\n<p>Not surprisingly, Complementary Law 116\/2003 determines that the place where remote services are provided is the place where the provider is located.<\/p>\n<p>&nbsp;<\/p>\n<p>THE PATIENT AND THE DOCTOR DETERMINE<\/p>\n<p>It turns out that, in my view, both questions make no sense at all. As a telehealth specialist, I affirm that it is not the first consultation, the follow-up consultation or any other consultation that should or should not be done via telemedicine.<\/p>\n<p>&nbsp;<\/p>\n<p>The person who determines this is the patient, first and foremost, followed by the doctor, using the available technology and scientific knowledge.<\/p>\n<p>&nbsp;<\/p>\n<p>Not to mention that telemedicine can be even broader and the platforms can be used not only during remote consultations but also in person, face to face with the patient. In this case, the doctor can contact a specialist, seek support for his\/her clinical decision, etc.<\/p>\n<p>&nbsp;<\/p>\n<p>It can bring people closer together and humanize them. Yes, that&#039;s right: it doesn&#039;t push them away or dehumanize them.<\/p>\n<p>&nbsp;<\/p>\n<p>After all, what is more humane, treating a patient via telemedicine or forcing them to go in person and travel ten days to see a specialist? That is the time, for example, it takes for a person who lives in S\u00e3o Gabriel da Cachoeira to travel to Manaus to see a specialist, using a boat as a means of transport.<\/p>\n<p>&nbsp;<\/p>\n<p>Furthermore, I have countless reports of people who have been waiting for three years for a neuropediatric appointment and today the waiting time for an appointment is three days. And telemedicine has changed this scenario.<\/p>\n<p>&nbsp;<\/p>\n<p>This is just one example of the advantages. But it is a fact that if we limit medical practice in telemedicine by territory, we will keep different categories of citizens in our public health system, going against what everyone in this country wants to change. This is not equity and cannot be an egalitarian public policy.<\/p>\n<p>&nbsp;<\/p>\n<p>Therefore, we cannot allow Brazil to continue to lag behind. Technological advances in telemedicine in our country have been stagnant for about 20 years, given that the last regulation was in 2002.<\/p>\n<p>&nbsp;<\/p>\n<p>Until then, there was no clear determination of what could or could not be done, causing legal uncertainty. And, without legal certainty, there is no technological development or training of professionals.<\/p>\n<p>&nbsp;<\/p>\n<p>We believe in comprehensive telehealth and its vital role in achieving our goals and ensuring dignified, quality, yet agile, efficient and rational care for all Brazilians.<\/p>\n<p>&nbsp;<\/p>\n<p>It is up to each patient to decide whether or not to have remote care, and it is up to the doctor to assess whether or not the consultation carried out remotely using technology is appropriate.<\/p>\n<p>&nbsp;<\/p>\n<p>It is this autonomy of choice that should guide the act of caring for people. We, as Brazilians, cannot allow this right to choose to be usurped from us.<\/p>\n<p>&nbsp;<\/p>\n<p>We need to once and for all be clear about the idea that the future of medicine and telehealth are one and the same \u2013 after all, the world we live in today is already \u201cphygital\u201d.<\/p>\n<p>&nbsp;<\/p>\n<p>The issue is not just about the future. If we maintain the restrictions, we will be condemned to live in the past, with no prospect of improvement for the current present.<\/p>\n<p>**<\/p>\n<p>Gynecologist Eduardo Cordioli is the medical manager of Telemedicine at Hospital Israelita Albert Einstein and president of Sa\u00fade Digital Brasil (Brazilian Association of Telemedicine and Digital Health Companies), an entity whose goal is to expand patients&#039; access to doctors through the use of technology.<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Em artigo publicado na Future Health, Eduardo Cordioli, presidente da\u00a0#Sa\u00fadeDigitalBrasil, aborda os dois principais pontos de entrave na proposta de\u00a0#regulamenta\u00e7\u00e3o\u00a0da\u00a0#telemedicina\u00a0no Brasil. A proibi\u00e7\u00e3o da primeira consulta online e a territorialidade [&hellip;]<\/p>","protected":false},"author":9,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[41],"tags":[],"class_list":["post-8304","post","type-post","status-publish","format-standard","hentry","category-sdb-na-midia"],"_links":{"self":[{"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/posts\/8304","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/comments?post=8304"}],"version-history":[{"count":1,"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/posts\/8304\/revisions"}],"predecessor-version":[{"id":8305,"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/posts\/8304\/revisions\/8305"}],"wp:attachment":[{"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/media?parent=8304"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/categories?post=8304"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/saudedigitalbrasil.com.br\/en_us\/wp-json\/wp\/v2\/tags?post=8304"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}