PDF herunterladen
CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2021; 79(07): 658-664
DOI: 10.1590/0004-282X-ANP-2020-0488
Brazilian Academy of Neurology

Telemedicine use among neurologists before and during COVID-19 pandemic

Uso da telemedicina pelos neurologistas antes e durante a pandemia de COVID-19
Emanuelle Roberta da Silva Aquino 
1   Academia Brasileira de Neurologia, Comissão Aberta de Telemedicina, São Paulo SP, Brazil.
5   Universidade de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil.
7   Hospital Sírio Libanês, Telemedicina, São Paulo SP, Brazil.
,
Renan Barros Domingues 
1   Academia Brasileira de Neurologia, Comissão Aberta de Telemedicina, São Paulo SP, Brazil.
6   Santa Casa de Misericórdia, Departamento de Neurologia, São Paulo SP, Brazil.
,
Carlos Eduardo Mantese 
1   Academia Brasileira de Neurologia, Comissão Aberta de Telemedicina, São Paulo SP, Brazil.
7   Hospital Sírio Libanês, Telemedicina, São Paulo SP, Brazil.
8   Hospital Mãe de Deus, Porto Alegre RS, Brazil.
,
Francisca Goreth Malheiro Moraes Fantini 
2   Academia Brasileira de Neurologia, Comissão de Exercício Profissional, São Paulo SP, Brazil.
,
Ricardo Nitrini 
3   Academia Brasileira de Neurologia, Diretoria Científica, São Paulo SP, Brazil.
5   Universidade de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil.
,
Gilmar Fernandes do Prado 
4   Academia Brasileira de Neurologia, Diretoria Executiva, São Paulo SP, Brazil.
9   Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil.
› Institutsangaben
› Weitere Informationen
   Lizenzen und Reprints

ABSTRACT

Background: After the public health emergency due to COVID-19 was declared in Brazil, the federal government temporarily regulated and authorized the use of telemedicine services for patient consultation, monitoring, and diagnosis. For more than a decade, neurologists have recognized the benefits of telemedicine in the acute management of stroke patients. However, as the use of telemedicine was restricted until the COVID-19 pandemic, the view of Brazilian neurologists about telemedicine is unknown. Methods: All neurologists registered at the Brazilian Academy of Neurology were invited by e-mail to participate in a survey about personal perceptions on telemedicine use. Results: One hundred sixty-two neurologists from all regions of Brazil answered the online questionnaire. The survey showed that 18.5% of participants worked with telemedicine before the pandemic, while 63.6% reported working with telemedicine during the pandemic. The main telemedicine modalities used during the pandemic were teleorientation and teleconsultation. Discussion: According to our data, the COVID-19 pandemic deeply influenced the behavior of Brazilian neurologists, who developed a more favorable view about telemedicine and actively searched for information about telemedicine. As there is a need for more training in this area in Brazil, universities and medical societies must strive to improve telemedicine education. Expanding the use of high-quality teleneurology can contribute to a better care for patients with neurological diseases in Brazil.

RESUMO

Antecedentes: Considerando a Emergência em Saúde Pública de Importância Nacional em decorrência da infecção pelo coronavírus, o governo federal brasileiro temporariamente regulamentou o uso da telemedicina diretamente entre médico e paciente, para consulta, monitorização e diagnóstico. Há mais de uma década os neurologistas reconhecem os benefícios da telemedicina no tratamento do AVC agudo. Entretanto, como o uso da telemedicina no país era restrito até a pandemia da COVID-19, a magnitude do envolvimento dos neurologistas brasileiros com a telemedicina não é conhecida. Métodos: Todos os membros da Academia Brasileira de Neurologia foram convidados por e-mail a responder voluntariamente um questionário sobre seu envolvimento pessoal com telemedicina antes e durante a pandemia. Resultados: 162 neurologistas, representando todas as regiões do Brasil, responderam o questionário. A pesquisa mostrou que 18,5% dos respondedores trabalhavam com telemedicina antes da pandemia da COVID-19, enquanto 63,6% afirmaram trabalhar com telemedicina durante a pandemia. As principais modalidades de telemedicina utilizadas durante a pandemia são a teleorientação e a teleconsulta. Discussão: De acordo com esses resultados, a pandemia da COVID-19 influenciou profundamente o comportamento dos neurologistas brasileiros, que passaram a demonstrar uma ideia mais favorável sobre telemedicina, e determinou uma busca ativa de informações sobre teleneurologia. Há necessidade de maior capacitação nesta área em nosso país. Universidades e sociedades médicas devem se esforçar para melhorar a educação em telemedicina. A expansão do uso da teleneurologia com alta qualidade contribuirá para um melhor cuidado dos pacientes com doenças neurológicas no Brasil.

Keywords:

Telemedicine - Neurology - COVID-19 - Teleneurology - Remote consultation

Palavras-chave:

Telemedicina - Neurologia - COVID-19 - Teleneurologia - Teleconsulta

Authors’ contribution:

ERSA, RBD, CEM: conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, validation, writing of original draft, draft review and editing; FGMMF, RN, GFP: conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, draft review and editing.




Publikationsverlauf

Eingereicht: 15. Oktober 2020

Angenommen: 01. April 2021

Artikel online veröffentlicht:
01. Juni 2023

© 2021. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 WHO. A health telematics policy in support of WHO’s Health-For-All strategy for global health development: report of the WHO group consultation on health telematics, 11-16 December, Geneva, 1997 [Internet]. Geneva, Switzerland: World Health Organization; 1998 [cited 2020 Aug 26]. 39p. Available from: https://apps.who.int/iris/handle/10665/63857
  • 2 Bashshur RL, Howell JD, Krupinski EA, et al. The Empirical Foundations of Telemedicine Interventions in Primary Care. Telemed J E Health. 2016 May;22(5):342-75. https://doi.org/10.1089/tmj.2016.0045
  • 3 Craig J, Patterson V. Introduction to the practice of telemedicine. J Telemed Telecare 2005;11(1):3-9.
  • 4 Federal Council of Medicine. Resolution No. 1,643/2002, of August 7, 2002. [Internet]. Brasília; 2002 [cited 2020 Aug 26]. Available from: https://sistemas.cfm.org.br/normas/visualizar/resolucoes/BR/2002/1643
  • 5 Ministry of Health. Ordinance No. 467, of March 20, 2020. [Internet]. Brasília: Diário Oficial da União; 2020 [cited 2020 Aug 26]. Available from: https://www.in.gov.br/en/web/dou/-/portaria-n-467-de-20-de-marco-de-2020-249312996
  • 6 Brazil. Law No. 13,989, of April 15, 2020. [Internet]. Brasília: Diário Oficial da União; 2020 [cited 2020 Aug 26]. Available from: https://www.in.gov.br/en/web/dou/-/lei-n-13.989-de-15-de-abril-de-2020-252726328
  • 7 Mazighi M, Meseguer E, Labreuche J, et al. TRUST-tPA trial: Telemedicine for remote collaboration with urgentists for stroke-tPA treatment. J Telemed Telecare. 2017 Jan;23(1):174-80. https://doi.org/10.1177/1357633X15615762
  • 8 Hatcher-Martin JM, Adams JL, Anderson ER, et al. Telemedicine in neurology: Telemedicine Work Group of the American Academy of Neurology update. Neurology. 2020 Jan 7;94(1):30-8. https://doi.org/10.1212/WNL.20200488202004888708
  • 9 Carvalho CRR, Scudeller PG, Rabello G, et al. Use of telemedicine to combat the COVID-19 pandemic in Brazil. Clinics (São Paulo). 2020;75:e2217. https://doi.org/10.6061/clinics/2020/e2217
  • 10 Caetano R, Silva AB, Guedes ACCM, et al. Challenges and opportunities for telehealth during the COVID-19 pandemic: ideas on spaces and initiatives in the Brazilian context. Cad Saude Publica. 2020;36(5):e00088920. https://doi.org/10.1590/0102-311X00088920
  • 11 Tatum WO, Hirsch LJ, Gelfand MA, et al. Assessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures. JAMA Neurol. 2020 May 1;77(5):593-600. https://doi.org/10.1001/jamaneurol.2019.4785
  • 12 Giordano V, Koch H, Godoy-Santos A, et al. WhatsApp Messenger as an Adjunctive Tool for Telemedicine: An Overview. Interact J Med Res. 2017 Jul 21;6(2):e11. https://doi.org/10.2196/ijmr.6214
  • 13 Rezende EJC, Tavares EC, Alves HJ, et al. Teleconsultations in public primary care units of the city of Belo Horizonte, Brazil: profile of patients and physicians. Telemed J E Health. 2013 Aug;19(8):613-8. https://doi.org/10.1089/tmj.2012.0179
  • 14 Giavina Bianchi M, Santos AP, Cordioli E. The majority of skin lesions in pediatric primary care attention could be managed by Teledermatology. PLoS One. 2019 Dec 2;14(12):e0225479. https://doi.org/10.1371/journal.pone.0225479
  • 15 Mantese CE, Aquino ERS, Figueira MD, et al. Telemedicine support for primary care referrals to neurologist consult: decision making between different specialists when guiding the case over the phone. Arq Neuropsiquiatr. 2021 Apr;79(4):299-304. https://doi.org/10.1590/0004-282X-ANP-2020-0137
  • 16 Harzheim E, Gonçalves MR, Umpierre RN, et al. Telehealth in Rio Grande do Sul, Brazil: Bridging the Gaps. Telemed J E Health. 2016 Nov;22(11):938-44. https://doi.org/10.1089/tmj.2015.0210
  • 17 Katz N, Roman R, Rados DV, et al. Access and regulation of specialized care in Rio Grande do Sul: the RegulaSUS strategy of TelessaúdeRS-UFRGS. Cien Saude Colet. 2020 Mar;25(4):1389-400. https://doi.org/10.1590/1413-81232020254.28942019
  • 18 Esteves LA, Ribeiro AT, Silva EGD, et al. Evaluation of safety, effectiveness and reproducibility of telemedicine for neurosurgical screening. Einstein (São Paulo). 2019 Aug 22;17(4):eAO4609. https://doi.org/10.31744/einstein_journal/2019AO4609
  • 19 Lutz de Araujo A, Moreira TC, Rados DRV, et al. The use of telemedicine to support Brazilian primary care physicians in managing eye conditions: The TeleOftalmo Project. PLoS One. 2020 Apr 2;15(4):e0231034. https://doi.org/10.1371/journal.pone.0231034
  • 20 de Souza CHA, Morbeck RA, Steinman M, et al. Barriers and Benefits in Telemedicine Arising Between a High-Technology Hospital Service Provider and Remote Public Healthcare Units: A Qualitative Study in Brazil. Telemed J E Health. 2017 Jun;23(6):527-32. https://doi.org/10.1089/tmj.2016.0158
  • 21 Dorsey ER, Topol EJ. State of Telehealth. N Engl J Med. 2016 Jul 14;375(2):154-61. https://doi.org/10.1056/NEJMra1601705
  • 22 Sharma A, Maxwell CR, Farmer J, et al. Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey. Neurology. 2020 Aug 4;95(5):215-20. https://doi.org/10.1212/WNL.20200488202004889844