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INTRODUCTION BY INNOVATION CENTRE DENMARK IN SAO PAULO
A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
TELEHEALTH AND TELEMEDICINE IN BRAZIL:
OPPORTUNITIES AND CHALLENGES
DECEMBER 2015
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BRAZILIAN TELEMEDICINE SECTOR
A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
Telemedicine and home care
practices are expected to
grow due to prioritization by
the government of telecom
and health sectors.
Brazil is considered to be one of
the most advanced countries in
the field of telemedicine in Latin
America and the Caribbean.
Focus on democratization of
access, expansion of supply
and quality improvement of
healthcare services.
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BRAZILIAN TELEMEDICINE SECTOR
A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
Source: CONASS (National Council
of Health Secretariats) 2014
Plus, 40% of Brazilians suffer from
non-communicable chronic diseases,
which accounts for over 70% of
causes of death.
Demographic changes
and the epidemiological
pattern in Brazil require
Telemedicine solutions.
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TELEMEDICINE AND TELEHEALTH NETWORKS AND RESOURCES IN BRAZIL
A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
Source: RUTE (Telemedicine
University Network) 2015
Responsible for
structuring telemedicine
as a discipline, which
fostered the private
medical-hospital sector.
Aims at integrating all public,
university hospitals, formally
establishing telemedicine
centres, supporting
videoconferences, performing
diagnostics analysis, and
providing permanent education
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MODALITIES OF TELEMEDICINE IN BRAZIL
A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
Telemonitoring
Remote monitoring of the patient's vital signs, whose records are
continuously sent to the doctor for analysis, interpretation and
warning.
Tele-diagnostics Remote transmission of data such as medical imaging, laboratory data
and other information to obtain some diagnosis.
Teleradiology
Transmission of radiological images between health care
establishments (Estabelecimento Assistencial a Saúde - EAS) for
remote consultation and medical interpretation.
Tele-education Implementation of medical distance learning courses aiming to guide
doctors, students and patients in distant and remote areas.
Tele-homecare Monitoring and assessment of the health status of patients being
treated in their own homes through ICT.
Source: Silver Consulting 2015
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APPLICATION OF TELEMEDICINE IN BRAZIL
A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
Source: Silver Consulting 2015
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
Percentage of total number of establishments
that have used the Internet in 2014.
PROPORTION OF HEALTHCARE FACILITIES PER AVAILABLE TELEMEDICINE AND TELEHEALTH SERVICES
Source: CGIBR (Internet
Management Committee) 2014
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
PUBLIC AND PRIVATE SECTORS EXPENDITURE IN
COUNTRIES WITH UNIVERSAL HEALTH SYSTEM
Source: WHO, 2014 and CFM, 2014
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
MODALITIES OF HOMECARE IN BRAZIL PRIV
ATE Home Care refers to a set of outpatient actions, planned and ongoing, performed at home.
Home
Hospitalization
refers to a set of activities provided at home to people that have a more
complex clinical condition, which requires full time care by a healthcare
professional and the need for specialized technology.
PU
BLIC
Home Care
type 1 (AD1)
intended for users with controlled health problems and physical difficulty or
unable to go to a healthcare facility; these users typically need health care
less often and have less need for healthcare resources.
Home Care
type 2 (AD2)
intended for users with controlled health problems and physical difficulty or
unable to go to a healthcare facility; these users typically require more
frequent care, health resources and continuous monitoring from different
healthcare network services.
Home Care
type 3 (AD3)
intended for users with controlled health problems and physical difficulty or
unable to go to a healthcare facility; these users typically need more frequent
care, health resources, continuous monitoring and use of equipment from
different healthcare network services.
Source: Silver Consulting 2015
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
PLAYERS FROM THE HOMECARE SECTOR
Homecare in Brazil
Private institutions, who are service providers
Health insurance
companies, which
outsource the service
SUS (Universal Public
Health System) through
Programme Melhor em Casa
All players must meet the
requirements of decrees
and regulations set forth by
ANVISA (National Health
Surveillance System) and
CFM (Federal
Council of Medicine)
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
LEGISLATION AND REGULATION OF THE
TELEHEALTH AND HOMECARE MARKETS
• The National Health Surveillance
System (Anvisa), regulatory
agency linked to the Ministry of
Health, controlls the market of
healthcare products.
• No medical device (local or
imported) can be industrialized,
sold of delivered to consumers in
Brazil without the registration at
the Ministry of Health.
Anvisa
Source: Silver Consulting 2015
• The Federal Council of Medicine,
responsible for the fiscalization and
regulations of the medical practice.
• The council defends the corporate
interests of the category of doctors
and is responsible for the
professional registration and the
Code of Medical Ethics.
CFM
CRM: Regional Council of
Medicine, subordinated to
the CFM and present in
each Brazilian state.
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
LEGISLATION AND REGULATION OF THE
TELEHEALTH AND HOMECARE MARKETS
Anvisa
According to Anvisa:
health-monitoring software serve as
tools for prevention, diagnosis, treatment,
rehabilitation, or contraception.
• Software of medical devices: products that do not need
"hardware" (classified as a health product) in order to be
operated, i.e. executed in a single computer by default;
• Software (or accessory), part of a medical device;
software that requires a connected "hardware" in order to
function, i.e. patient cardiac monitor, infusion pump, blood
pressure measurement, gas monitor, etc.;
• Software that is not a medical device; does not fit into
the above definitions, i.e. software used only for training
healthcare professionals and others.
3 groups
Source: Silver Consulting 2015
Anvisa regulates medical
equipment and healthcare
software. Software and medical
equipment are also classified
according to their associated risks:
• Class I – low risk
• Class II – medium risk
• Class III – high risk
• Class IV – maximum risk
and purpose: invasive,
non-invasive, active
and special rules.
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
LEGISLATION AND REGULATION OF THE
TELEHEALTH AND HOMECARE MARKETS
Source: Silver Consulting 2015
The Federal Council of Medicine (CFM)
defines Telemedicine as the practice of
medical services at a distance through
the use of interactive methodologies,
such as data communication and
audiovisual intended for care, education
and research in the field of health.
Telemedicine The applications of technology in
healthcare are provided through
the Law of Computing (Lei da
Informática), which allowed the
use of information in digital form.
Legislation on telemedicine and information technology
in the healthcare field is regulated by CFM or CRM.
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
INDUSTRIAL POLICY AND RESEARCH,
DEVELOPMENT & INNOVATION
Telemedicine
Research
Development
Innovation
Industry
PDP (Productive Development Policy)
fosters the industry, strengthens
competitiveness, focusing on
productive systems with export
potential and able to generate chain
reaction effects in the industry.
FINEP (Funding Agency of
Studies and Projects),
BNDES (Brazilian
Development Bank) and
other funding agencies
foster research,
technological development,
and innovation, which has
contributed to the increase
in activities of P, D & I
performed by Brazilian
companies and research
institutions.
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impact
A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
THE MARKET OF ICT AND MEDICAL EQUIPMENT THE IMPACT OF ICT AND EMHO ON THE BRAZILIAN TELEMEDICINE AND HOME CARE MARKET
Source: Teleco 2015
Information and
Communication Technology
Medical, hospital, dental and
laboratory equipment
EMHO sector
Telemedicine
Telecom sector
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
FORECASTS FOR ICT IN HEALTHCARE
Source: Teleco 2015
Telecom sector
• A small proportion of hospitals will start to prepare personalized treatments plans for their patients.
• Automation of more than 50% of the operating routine, with increased innovations and management
systems to reduce maintenance problems and people’s dependency, will last until 2018.
• There will be digital strategy development due to rising healthcare costs combined with operation innefficiency.
• Companies and service providers will share the caring responsbility and financial results due to increased
external partnerships (currently na uncommon practice).
• Cloud computing will be dominant in the healthcare sector. By 2020, more than half of
healthcare sector institutions will be using this kind of technology or will have at least
started the migration of data servers for cloud computing.
• In order to improve the customer experience, more than half of the transactions made between patients
and hospitals will be done with mobile technologies by 2018. The institutions will need to prepare
themselves and adapts their services to meet their targets.
• A large part of healthcare organizations will invest the next three years in technologies, such as
wearable devices, remote monitoring of patients’ health and virtual care.
• Half of health institutions will suffer from 1 to 5 cyber attacks, which requires
investment to prevent interruptions and lealage of sensitive information.
• By 2020, most personal information is estimated to be available on the web
unprotected. As a result, healthcare organizations are likely to invest in data security.
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
TECHNOLOGICAL TRENDS OF HEALTHCARE-
RELATED ICT
Source: Teleco 2015
Telecom sector
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
INNOVATION IN MEDICAL EQUIPMENT FORECAST BY 2020
Source: Teleco 2015
Telecom sector
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
FINAL CONSIDERATIONS AND
RECOMMENDATIONS
Source: Teleco 2015
Telecom sector
The healthcare sector in Brazil is
facing a growing demand for
diagnostic and expensive
therapeutic resources. This is due
to a more aged population that
requires more medical attention
and the current healthcare
situation that leaves a large portion
of the population with inaccessible
and/or unaffordable health care.
• Introduce portable equipment associated with information
systems that monitor pregnant women, especially those
who experience a high-risk pregnancy;
• Propose the use of custom electronic medical records for
home care that integrate with electronic medical records
used in hospitals/clinics and allow the patient to keep and
access the health record at any time or place;
• Offer portable equipment or technological platforms that
promote health care to indigenous people or people who
live remotely from urban centres. Prioritize solutions that
reduce rates of neglected and non-communicable diseases;
• Introduce 3D virtual platforms as health professionals
training resources, healthcare workers (for home care),
and learning resources for preventive medicine and/or
proper use of medical devices;
• Offer portable and monitoring solutions for the clinical
status of patients on home oxygen therapy programs
and/or mechanical ventilation;
• Introduce warning systems in several home care areas,
i.e. falls, equipment stops, and ambulances;
• Introduce data security solutions for healthcare
information management systems.
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A PARTNERSHIP BETWEEN THE MINISTRY OF HIGHER EDUCATION AND SCIENCE AND THE MINISTRY OF FOREIGN AFFAIRS OF DENMARK
http://icdk.um.dk/
+55 11 21 27 07 50
+55 11 30 68 98 67
INNOVATION CENTRE DENMARK
São Paulo, Brazil
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