Presentation Brazilian Telehealth Program made for ICarnegie at the MOH August 2010

1. Brazil Telehealth

3. Brazil Population: 190,000,000 States: 26 + 1 Federal District Municipalities: 5,563 40% in metropolitan areas 220 native ethnicities (0,2% of the population) 185 languages

6. Family Health Strategy 1998 5% coverage FHT/Community Workers/Oral Health FHT/Community Workers Community Workers Without any kind

7. Family Health Strategy 2009 90% coverage FHT/Community Workers/Oral Health FHT/Community Workers Community Workers Without any kind

8. Brazilian Telehealth Strategy Brazil Telehealth Program - remote assistance and permanent education Pilot Project: 9 states and 900 points www.telessaudebrasil.org.br Open University of Unified Health System - provides in-service training for thousands of health care providers www.universidadeabertadosus.org.br Telemedicine University Network - RUTE, initially about 80 University Hospitals in collaborative research and education across all federal states – http://rute.rnp.br

10. Brazil Telehealth Program Coverage: 9 states centers implementing telehealth in 900 e-health points supporting about 2,700 FHT, covering 11 M inhabitants

11. Brazil Telehealth Program 9 states centers implementing telehealth in 900 e-health points supporting about 2,700 FHT, covering 11 M inhabitants Expansion states (3 + Federal District) Priority: Northeast region and Brazilian Amazon Coverage:

15. Number of State Centers Total: 1209 points (Primary Health Care Units) AM 42 CE 102 GO 151 MG 132 PE 99 RJ 105 RS 199 SC 160 SP 219

16. Brazilian Telehealth Figures

20. Health Ministry investments in Telehealth 1º Phase 2007 – 2008 2º Phase 2009 – 2010 R$ 14.831.778,35 US$ 7 M R$ 21.830.720,00 US$ 11 M Total: R$ 36.662.498,35 (±US$ 18,400,000)

21. Implementation A Telehealth Center R$ 200.000,00 ( (± US$100,000) A Telehealth point of care R$ 2.800,00 (± US$1,400)

23. Maintenance costs Maintenance of teleconsultants of a center/month for 100 points of Telehealth R$ 31.560,00 ( ± US$15,500) Maintenance costs of Human Resources by center/month for 100 points of Telehelth R$ 29.560,00 ( ± US$15,000)

25. Professional Fixation Minas Gerais – Clinical Hospital: survey with 105 professionals of PHT from 32 municipalities: 67% of the respondents felt that access to training at the workplace was a major factor in to stay in their hometowns Important 67% Medium 27% Low importance 2% No important 4%

26. Rio Grande do Sul Patient Referral (December 2007 – September 2009) Avoided 70% It was not avoided for other reasons 2% didn’t know 1% Referral required 3% Referral decided after teleconsultation 14%

30. PC Health Informatics, Mirror Committee of TC 215 – Health Informatics, Brazil

32. ISO TC 215 Organization

37. National Program