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口腔医学中的远程医疗:巴西南部一州公共卫生保健经验报告。

Telehealth in Oral Medicine: report of an experience from public health care in a southern Brazilian state.

机构信息

Universidade Federal do Paraná - UFPR, Department of Stomatology, Curitiba, PR, Brazil.

出版信息

Braz Oral Res. 2022 Mar 14;36:e031. doi: 10.1590/1807-3107bor-2022.vol36.0031. eCollection 2022.

Abstract

This study aimed to describe the telediagnosis of oral lesions through a telehealth program offered in the State of Paraná, southern Brazil. This report included all oral medicine-related teleconsultations between January 2015 and December 2019. Primary care dentists from the public health services of the state were trained to use the Telessaúde Brasil Redes platform, a national telehealth program that provides telediagnostic support through teleconsultations with specialists. Clinical information and images of oral lesions were solicited to each teleconsultation request. An oral medicine specialist evaluated the cases and provided diagnostic hypotheses, management, and referral suggestions. Finally, dentists were invited to evaluate the services. A total of 162 cases were submitted by 44 dentists. The patient's main complaint was described in 98.8% of cases, while the duration/evolution and the type of lesions were 64.81% and 40.12%, respectively. No images were attached to 19 (11.70%) patients. The information sent was sufficient for diagnostic reasoning in 125 (77.16%) requests. The specialist considered 78 cases (48.1%) to be resolved in primary care. Among respondents (45.7%), dentists considered that the teleconsultation "totally attended" their needs in 92% of requests. The description of the telehealth platform usage in oral medicine in Paraná showed the need to improve the participation of primary care dentists and the quality of clinical information provided as barriers to be overcome, aiming for the best usage of the platform.

摘要

本研究旨在描述通过巴西南部巴拉那州提供的远程医疗计划进行口腔病变的远程诊断。该报告包括 2015 年 1 月至 2019 年 12 月期间所有与口腔医学相关的远程咨询。州公共卫生服务的初级保健牙医接受了使用 Telessaúde Brasil Redes 平台的培训,该平台是一个国家远程医疗计划,通过与专家进行远程咨询提供远程诊断支持。每个远程咨询请求都需要提供临床信息和口腔病变图像。一位口腔医学专家对病例进行评估,并提供诊断假设、管理和转诊建议。最后,牙医被邀请评估服务。共有 44 名牙医提交了 162 例病例。98.8%的病例描述了患者的主要投诉,而 64.81%的病例描述了持续时间/演变情况,40.12%的病例描述了病变类型。19 名患者(11.70%)未附上图像。发送的信息足以对 125 例(77.16%)请求进行诊断推理。专家认为 78 例(48.1%)在初级保健中可以解决。在回答者(45.7%)中,牙医认为远程咨询在 92%的请求中“完全满足”了他们的需求。在巴拉那州口腔医学中使用远程医疗平台的描述显示,需要提高初级保健牙医的参与度和提供的临床信息质量,以克服面临的障碍,从而实现平台的最佳使用。

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