Bin Kaio Jia, Santana Alves Patrícia Gabriela, Costa Raquel, Eiras Paula Cruz, Nader de Araujo Luciano, Pereira Antonio José Rodrigues, Carvalho Carlos, Malik Ana Maria
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
JMIR Form Res. 2023 Jan 11;7:e39034. doi: 10.2196/39034.
With the arrival of the pandemic, telemedicine has been widely used to provide medical care and can be used to assist patients in regions far from urban centers that are difficult to access, such as riverside communities in the Brazilian Amazon region. A telemedicine project connecting São Paulo, a mega-metropolis, to Paysandú, a riverside district in the Amazon, was built to serve the local population where access to the nearest medical care is 6 hours away by speedboat.
This study aims to assess the feedback from patients and doctors regarding the use of telemedicine in outpatient care at Paysandú, a riverside district in the Amazon.
This is a single-center study following the guidelines "Evaluating digital health products" from Public Health England, with local adaptations for the project and the Brazilian reality, that was conducted between São Paulo and Santarém in Brazil. A survey was carried out with patients who were treated by a doctor in the city of São Paulo, about 2500 km from the local basic health unit, between September 27 to December 15, 2021. At the end of each teleconsultation, the attending physician answered an administrative survey form, and the patient answered a satisfaction survey.
A total of 111 patients completed the satisfaction survey from a total of 220 consultations carried out during the period (95% CI margin error 0.22%). According to the survey, more than 95% of patients were satisfied with the service, 87.4% (n=97) had previous experience with videoconferencing, and 76.6% (n=85) reported that their demand was fully solved. Additionally, according to the hired doctor's feedback, the average duration of the consultations was between 15 and 20 minutes. Of the 220 teleconsultations performed, 90.9% (n=200) of the demands were solved with support from the local health team, and 99.1% (n=218) of the appointments had a problem with audio or video.
This teleconsultation project between São Paulo and Paysandú showed that it is possible to offer medical care from more developed locations to communities far from urban centers, as is the case with Paysandú District. Beyond the feasibility of the infrastructure, acceptance and satisfaction among patients were high. This health care supply model has proven to be functional and should be expanded nationally or perhaps internationally to regions lacking medical assistance. Escalation of the project does not seem too difficult once infrastructure issues are solved.
随着疫情的到来，远程医疗已被广泛用于提供医疗服务，并可用于帮助那些地处偏远、难以到达的地区的患者，比如巴西亚马逊地区的河畔社区。一个连接大都市圣保罗和亚马逊河畔地区派桑杜的远程医疗项目建成，为当地居民提供服务，当地居民乘坐快艇前往最近的医疗机构需要6个小时。
本研究旨在评估患者和医生对在亚马逊河畔地区派桑杜的门诊护理中使用远程医疗的反馈。
这是一项单中心研究，遵循英国公共卫生署的“评估数字健康产品”指南，并根据该项目和巴西实际情况进行了本地化调整，在巴西圣保罗和圣塔伦之间开展。2021年9月27日至12月15日期间，对距离当地基层卫生单位约2500公里的圣保罗市接受医生治疗的患者进行了一项调查。每次远程会诊结束时，主治医生填写一份行政调查问卷，患者填写一份满意度调查问卷。
在此期间进行的220次会诊中，共有111名患者完成了满意度调查（95%置信区间边际误差0.22%）。根据调查，超过95%的患者对服务满意，87.4%（n = 97）的患者以前有过视频会议的经历，76.6%（n = 85）的患者表示他们的需求得到了完全解决。此外，根据受聘医生的反馈，会诊的平均时长在15到20分钟之间。在进行的220次远程会诊中，90.9%（n = 200）的需求在当地卫生团队的支持下得到了解决，99.1%（n = 218）的预约存在音频或视频问题。
圣保罗和派桑杜之间的这个远程会诊项目表明，有可能从更发达的地区为像派桑杜区这样远离城市中心的社区提供医疗服务。除了基础设施的可行性之外，患者中的接受度和满意度都很高。这种医疗供应模式已被证明是可行的，应该在全国范围内或可能在国际上扩展到缺乏医疗援助的地区。一旦基础设施问题得到解决，项目的扩大似乎并不困难。
