INFRA-STRUCTURE PERSPECTIVES FOR THE DEVELOPMENT OF TELEHEALTH IN BRAZIL AND LATIN AMERICA

Telemedicine University Network

www.rute.rnp.brLuiz Ary MessinaDr.Ing.Dipl.Inf.Gerente RUTEmessina@rute.rnp.br

National Education and Research Network – RNP

Ministry of Science & TechnologyMinistry of Education

Education and Research Community Network

National Education and Research Network – RNP promoting the use of advanced networks in Brazil www.rnp.br A 1Gbps R&E-Ring in each of the 27 state capitals!

www.redecomep.rnp.brinfo@redecomep.rnp.br

Enable the communication infra-structure Guarantee the service quality and integration Stimulate collaborative research, medical

assistance and interinstitutional courses Involve the main actors: government, academy

and enterprise Provide indicators and evaluate tele-services Enable demonstration projects Organize specialties groups

Which infra-estructure services are essential for a Telemedicine University Network?

Resolução CFM nº 1.643/2002 Art. 1º - Defines Telemedicine as the Medicine practice through the use of interactive audio-visual communication methodologies, with the aim to assist, educate and research in Health.

Federal Medical Council

Support to Telemedicine and Telehealth Workshops:

• Manaus, Amazonas, March 2007

• Recife, Pernambuco, May 2007

• Brasília, Federal District, September 2007

Telemedicine practice Ethics Riscs Responsibilities Payment Licensing Qualification Standards Legislation

Applications in: dermathology, oncology radiology, surgery, cardiology, psychiatry, home care, rehabilitation, pediatry, obstetrics, ginecology and neurology.

Health professionals are becoming more creative in telehealth applications.

Most health professionals will be affected by telehealth applications.

Introducing Telehealth disciplines in the Health Faculties.

• Hospital São Paulo e Escola Paulista de Medicina - Unifesp, (São Paulo) • Hospital das Clínicas - FM USP, (São Paulo) • Hospital Universitário de São Paulo/LSITEC - USP (São Paulo)• Hospital das Clínicas da Unicamp (Campinas/SP)• Instituto Dante Pazzanese de Cardiologia (São Paulo) • Hospital Universitário Pedro Ernesto - UERJ (Rio de Janeiro) • Fundação Oswaldo Cruz, (Rio de Janeiro)• Hospital Universitário Prof. P. E. de São Thiago - UFSC (Florianópolis) • Hospital das Clínicas Prof. Arnóbio Marques - UFPE (Recife)• Hospital Universitário Walter Cantídio - UFC (Fortaleza)• Hospital da Irmandade da Santa Casa de Misericórdia, (P. Alegre)• Hospital Universitário Getúlio Vargas - UFAM (Manaus)• Hospital das Clínicas – UFMG, (Belo Horizonte) • Hospital Universitário - UFES (Vitória)• Hospital Universitário Prof. Alberto Antunes - UFAL (Maceió)• Hospital Universitário Prof. Edgar Santos - UFBA (Salvador)• Hospital das Clínicas - UFMA (São Luís)• Hospital Universitário Lauro Wanderley -UFPB (João Pessoa)• Hospital Universitário - UFPR (Curitiba)

Institutions participating – January 2006Institutions participating – January 2006

MedicalVideoconferencesCollaborative WorkCase Study

Teleconsulting and Image Telediagnostic

Distant EducationContinuous Education

Experiences

Unifesp Ufes

FM-USP

ISCMPA

University HospitalFederal University of Pernambuco - UFPE

Health Family ProgramVideo on demandVC SessionsDistant Courses

RECIFE

CABO DE SANTO AGOSTINHO

IGARASSU

CAMARAGIBE

Telehealth - Federal University of Minas Gerais - UFMG

Health Family Program

BH Telehealth – Belo Horizonte Municipal Secretary of HealthMinas Telecardio – Minas Gerais State Secretary of Health Rural Internship

National and international VC-SessionsSupported Specialties : Angiology, Ocupational, Cardiology, Surgery, Infectious diseases, Dermathology,

Endocrinology, Gastrology, Ginecology, Hemathology, Nefrology, Neurology, Oncology, Orthopedics,

Ophtalmology, Pediatrics, Pneumology, Reumathologia, Urology, Nursing and Dentistry.

Health Channel

2006• 38 hours/week

transmission,11 channels

• 4 ½ hours/week production

1995• 6 hours/week

transmission, 2 channels

• 1 hour/week production

“Pediatrics Radiology”VC-Sessions monthly

OncologyGeriatricsTeenagers

Image acquisitionPrepare to sendConnect to the specialistAccept connectionSend and receive imagesSend diagnosisReceive diagnosisFollow-up

TELEDIAGNOSIS On and Off-line

T@lemed

Ultrasound, X-Ray, Tomo

Mexican Telemedicine ProgramMexican Telemedicine Program

TELEMEDICINA

UNIVERSIDADES ONG’S

AUTORIDADES MUNICIPALES

AUTORIDADES ESTATALES

AUTORIDADES FEDERALES

http://www.centec.gob.mxIng. Nancy Gertrudiz Salvador Dirección e-saludnancy.gertrudiz@salud.gob.mx

Parallel Session e-health , Lisbon, April 28th -29th 2006

TelecardiologyTele-educationTelesurgery

CEDIA (Consorcio Ecuatoriano para el Desarrollo de Internet Avanzado) , Launch event of the Ecuatorian Advanced Academic Networks – September 2006

Image Telediagnosis On-Line Demonstration, between Quito (EC) and Vitória (BR)

Integration of Federal Ministries iniciatives : Health, Science & Technology, Education, Communication and Defense

Portaria n° 561, March 16th 2006, Ministry of Health constitutes the Permanent Commission of Telehealth

Portaria n° 35, January 1st 2007, Ministry of Health constitutes the National Telehealth Program in the Primary Attendance, 9 States and 900 remote municipalities

RUTE – Telemedicine University Network, Ministry of Science and Technology, started January 2006

National Telehealth Program and Institutional activities in Brazil

Telehealth applied to Primary Care and the Family Health Program

25.000 teams 100.000.000 people

Regions of implementation

9 Reference Centers

9 x 100 remote sites

www.saude.gov.br/sgtes

Ministry of Health

Instituto de Psiquiatria da UFRJInstituto de Puer. e Ped. Martagão Gesteira da UFRJInstituto de Neurologia Deolindo Couto da UFRJInstituto de Doenças do Tórax da UFRJInstituto de Ginecologia da UFRJHospital Escola São Francisco de Assis da UFRJMaternidade Escola da UFRJClementino Fraga Filho da UFRJHU Antônio Pedro da UFF Gaffrée e Guinle da UNIRIOCanal Saúde (Fiocruz)HU Pedro Ernesto da UERJ

Centro Pediátrico Hosannah de Oliveira da UFBAMaternidade Climério de Oliveira da UFBAHU Prof. Edgar Santos da UFBA

Maternidade Escola Assis Chateaubriand da UFCHospital Universitário Walter Cantídio da UFC

Hospital de Clínicas da UFUHospital Escola da UFTMHospital Universitário da UFJFHospital das Clínicas da UFMG

Hospital Universitário da UFSMHU Dr. Muguel Riet Correa Júnior da FURGHospital Escola da UFPELIrmandade da Santa Casa de Misericórdia (ISCMPA)Hospital das Clínicas da URGS

Hospital Universitário na UnB

HU Maria Aparecida Pedrossian da UFMS

HU João de Barros Barreto da UFPAHU Betina Ferro de Souza da UFPA

Hospital Universitário da UFS

Hospital Universitário da UFPIHU Ana Bezerra da UFRNHospital de Pediatria da UFRN Maternidade Escola Januário Cicco da UFRNHU Onofre Lopes da UFRN

HU Alcides Carneiro da UFCGHU Lauro Wanderley da UFPB

HU Júlio Müller da UFMT

Hospital Getúlio Vargas da UFAM

Hospital das Clínicas da UFPE

HU Profº Alberto Antunes da UFAL

HU Cassiano Antônio de Moraes da UFES

Hospital das Clínicas da UnicampHospital das Clínicas da FMUSPHospital São Paulo da UnifespHospital Unimar HU de São Paulo / LSITEC da USPInstituto Dante Pazzanese

Hospital de Clínicas da UFPR

HU da UFSC

Faculdade de Medicina da UFAC

Faculdade de Medicina da UNIR

Faculdade de Medicina Veterinária da UFT

Faculdade de Medicina da UFRR

Hospital das Clínicas da UFG

Phase 1Phase 2FacultiesTelehealth Program

HU da Universidade Federal do Maranhão da UFMAFaculdade de Enfermagem da UNIFAP

List of University Hospitals – Telemedicine University Network RUTE – 01/2007

University Hospital Infra-structure

Connection to a 1Gbps Ring Telemedicine Unit Videoconference Room Telehealth Laboratory Teleconsult, Telediagnosis Health informatics and Telemedicine courses Participate on SIGs

12 University Hospitals on-line

Faculdade de Ciências Médicas-UERJDepartamento de Tecnologias da Informação e Educação em Saúde[DTIES]Disciplina de TelemediicnaAv. Prof. Manoel de Abreu 444 , 2o andarVila Isabel, Rio de Janeiro, RJ CEP- 20550-170Tel: (5521) 2587-6149 FAX: (5521) 2587-8744e-mail: telemedicina@lampada.uerj.br

III CONGRESSO BRASILEIRO DE TELEMEDICINA

I WORKSHOP EM TELESSAÚDE

Rio de Janeiro, November 8th – 10th, 2007Hotel Pestana, Copacabana

Health Sciences Partnerships so far identified between Universities and Health Institutions in Brazil and USA

Special Interest Groups - SIGs: Oncology,  Orthopaedic Surgery, Pathology, Pediatrics,

Autopsy,  Virtual Man, Rural Internship, Sportmedicine, Radiology, Orthopedia and Trauma, Cardiology, Gastroenterolgy, Hepatology, Liver transplantation, Immunology, Infectious Diseases,  Tropical Diseases, Adolescent Medicine & Health, Contraception/Human Reproduction, Telepsychiatry, Dermatology, Bio-Informatics, Nursing, Otorrinolaringology, Anesthesiology, Pediatric Surgery, Endocrinology, Pneumology, Rheumatology, Alzheimer, Mastology, Nefrology, Urology, Violence Prevention, Health Rights, Ethical and Legal Issues.

Health Sciences Partnerships so far identified between Universities and Health Institutions in Brazil and USA

Brazilian Universities and Health Institutions:Universidade Federal Paulista UNIFESP, Universidade Estadual de São Paulo USP, Universidade Federal de Minas Gerais UFMG, Universidade Estadual do Rio de Janeiro UERJ, Universidade Federal do Rio de Janeiro UFRJ, Universidade Federal do Espírito Santo UFES, Universidade Federal de Santa Catarina UFSC, Universidade Federal do Ceará UFC, Universidade Federal da Bahia UFBA, Universidade Federal de Brasília UnB

Health Sciences Partnerships so far identified between Universities and Health Institutions in Brazil and USA

American Universities and Health Institutions:University of Florida , St. Jude Children's Research Hospital , Colorado University, University of Pittsburgh, University Medical School Chicago, Medical Missions for Children, Georgetown University, University of California , Stanford University, Cornell University Medical College, University of Iowa, University of Pennsylvania, University of Cincinnati, University of Maryland, Children Hospital in Pittsburgh, Cleveland Clinic Children’s Hospital, Virginia Commonwealth University, The Population Council, University of Kentucky, University of Arizona, University of Miami Miller School of Medicine, University of New York

Internet2 and RNP sign on October 11th an MoU in Telemedicine and Telehealth, RUTE and US Health Sciences, to jointly collaborate on the development of next-generation telemedicine and telehealth technologies and applications