T@lemed

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INFRA-STRUCTURE PERSPECTIVES FOR THE DEVELOPMENT
OF TELEHEALTH IN BRAZIL AND LATIN
AMERICA Telemedicine University Network
Luiz Ary Messina Dr.Ing.Dipl.Inf. Gerente
RUTE messina_at_rute.rnp.br
www.rute.rnp.br
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Ministry of Science Technology Ministry of
Education

• National Education and Research Network RNP

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Education and Research Community Network
www.redecomep.rnp.br info_at_redecomep.rnp.br

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

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

• 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

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Federal Medical Council
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.

• Support to Telemedicine and Telehealth Workshops
• Manaus, Amazonas, March 2007
• Recife, Pernambuco, May 2007
• Brasília, Federal District, September 2007

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Telemedicine practice

• Ethics
• Riscs
• Responsibilities
• Payment
• Licensing
• Qualification
• Standards
• Legislation

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• 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.

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• 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 2006
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Experiences
Distant Education Continuous Education

• Medical
• Videoconferences
• Collaborative Work
• Case Study

• Teleconsulting and Image Telediagnostic

ISCMPA
FM-USP
Unifesp
Ufes
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Health Family Program Video on demand VC
Sessions Distant Courses
University HospitalFederal University of
Pernambuco - UFPE
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Telehealth - Federal University of Minas Gerais
- UFMG
? Health Family Program
BH Telehealth Belo Horizonte Municipal
Secretary of Health Minas Telecardio Minas
Gerais State Secretary of Health Rural
Internship
? National and international VC-Sessions
Supported Specialties Angiology, Ocupational,
Cardiology, Surgery, Infectious diseases,
Dermathology, Endocrinology, Gastrology,
Ginecology, Hemathology, Nefrology, Neurology,
Oncology, Orthopedics, Ophtalmology, Pediatrics,
Pneumology, Reumathologia, Urology, Nursing and
Dentistry.
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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

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Pediatrics Radiology
VC-Sessions monthly
Oncology Geriatrics Teenagers
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Image acquisition Prepare to send Connect to the
specialist Accept connection Send and receive
images Send diagnosis Receive diagnosis Follow-up
TELEDIAGNOSIS On and Off-line
Ultrasound, X-Ray, Tomo
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Mexican Telemedicine Program
http//www.centec.gob.mx
Ing. Nancy Gertrudiz Salvador Dirección
e-saludnancy.gertrudiz_at_salud.gob.mx
Telecardiology Tele-education Telesurgery
Parallel Session e-health , Lisbon, April 28th
-29th 2006
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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)

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National Telehealth Program and Institutional
activities in Brazil

• 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

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Telehealth applied to Primary Care and the Family
Health Program
9 Reference Centers
Regions of implementation
9 x 100 remote sites
25.000 teams ? 100.000.000 people
Ministry of Health
www.saude.gov.br/sgtes
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List of University Hospitals Telemedicine
University Network RUTE 01/2007
HU da Universidade Federal do Maranhão da UFMA
Faculdade de Enfermagem da UNIFAP
Maternidade Escola Assis Chateaubriand da
UFC Hospital Universitário Walter Cantídio da UFC
HU João de Barros Barreto da UFPAHU Betina Ferro
de Souza da UFPA
Hospital Universitário da UFPI
HU Ana Bezerra da UFRNHospital de Pediatria da
UFRN Maternidade Escola Januário Cicco da
UFRNHU Onofre Lopes da UFRN
Faculdade de Medicina da UFRR
HU Alcides Carneiro da UFCG HU Lauro Wanderley da
UFPB
Hospital Getúlio Vargas da UFAM
Hospital das Clínicas da UFPE
Faculdade de Medicina da UFAC
HU Profº Alberto Antunes da UFAL
Faculdade de Medicina Veterinária da UFT
Hospital Universitário da UFS
Centro Pediátrico Hosannah de Oliveira da
UFBAMaternidade Climério de Oliveira da UFBA HU
Prof. Edgar Santos da UFBA
Faculdade de Medicina da UNIR
HU Júlio Müller da UFMT
Hospital Universitário na UnB
Hospital das Clínicas da UFG
HU Cassiano Antônio de Moraes da UFES
HU Maria Aparecida Pedrossian da UFMS
Hospital de Clínicas da UFUHospital Escola da
UFTMHospital Universitário da UFJF Hospital das
Clínicas da UFMG
Hospital das Clínicas da Unicamp Hospital das
Clínicas da FMUSPHospital São Paulo da
UnifespHospital Unimar HU de São Paulo / LSITEC
da USP Instituto Dante Pazzanese
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
Hospital de Clínicas da UFPR
HU da UFSC
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
Phase 1 Phase 2 Faculties Telehealth Program
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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
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Faculdade de Ciências Médicas-UERJ Departamento de Tecnologias da Informação e Educação em SaúdeDTIES Disciplina de Telemediicna Av. Prof. Manoel de Abreu 444 , 2o andar Vila Isabel, Rio de Janeiro, RJ CEP- 20550-170 Tel [phone] FAX [phone] e-mail telemedicina_at_lampada.uerj.br

III CONGRESSO BRASILEIRO DE TELEMEDICINA I
WORKSHOP EM TELESSAÚDE Rio de Janeiro,
November 8th 10th, 2007 Hotel Pestana,
Copacabana
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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.

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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

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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 Childrens Hospital,
  Virginia Commonwealth University, The Population
  Council, University of Kentucky, University of
  Arizona, University of Miami Miller School of
  Medicine, University of New York

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• 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