The Ontology for the Telehealth Domain – TEON

Information about telehealth is distributed over many systems, generating content overlap and heterogeneity. As a way to standardize nomenclatures and organize content in telehealth systems and applications, the use of standardized vocabularies is recommended. However, most of them rely on informal text-free definitions that bring confusion. Together with this limitation, and due to recent Brazilian regulations concerning the delivery of telehealth services, a Telehealth Ontology (TEON) was developed. This study describes and presents TEON, elucidating its main use-case, its applicability and potential to improve information exchange, interoperability and decision support. TEON was developed based on the upper-domain ontology BioTopLite2 (BTL2) and Ontology for Biomedical Investigations (OBI). The scope of the work includes a set of competency questions to guide the domain modelling. TEON was formalized with Description Logics (DL) and the Web Ontology Language v.2 (OWL2). The telehealth services are composed of three main components: actors, the service itself and temporal-location barriers. The main roles are identified as the requestor, the teleconsultant and the manager. With TEON, we are able to specify if services are synchronous or not. Services are described by means of participants in the process, i.e. by specifying the agents and patients according to their roles. The envisioned use of TEON is to enable the integration of heterogeneous databases from different telehealth systems, considering the formal perspective embedded in ontologies. Currently, TEON is being included in HealthNet (teleconsultation), INDU (tele-education), dataNUTES (management), and SMART (monitoring) through as an integration interface, in order to generate indicators and reports to support telehealth manager’s decision-making and to facilitate providing indicators to the system for monitoring and results evaluation of the National Brazilian Telehealth Program of the Ministry of Health

Implementing an Electrocardiography Telediagnostic Service in Pernambuco, Brazil

In Brazil, cardiovascular diseases account for more than 10% of hospital admissions, and are considered a significant contributor to healthcare costs. One of the most frequently ordered diagnostic tests in the investigation of cardiovascular diseases is the 12-lead electrocardiogram (ECG). Cardiologists are not widely available to provide reports in small municipalities in Brazil, and eHealth services can be a feasible alternative to low resource environments. The use of tele-electrocardiography (Tele-ECG) can improve the management of patients and support decision making regarding referral to advanced medical centres. This study describes the implementation of a telediagnostic service for Tele-ECG in the state of Pernambuco, Brazil. The service was provided as a campaign in each community and was conducted by a team composed of a nurse and a technician from the university telehealth unit using a telehealth platform HealthNet, a laptop and a mobile digital electrocardiograph. In 2016, 34 visits were held to municipalities in Pernambuco, with 6,138 ECGs performed on patients from waiting lists, 63.5% of whom had never had an ECG, with 39.6%of the tests showing evidences of abnormal clinical situations and 0.1%) showing artefacts. The field interventions highlighted the contribution of telehealth as a feasible strategy to enhance access to care and reducing time to ECG reports, the need for patient transportation and costs for the Brazilian healthcare system, the Unified Health System. Considering the restricted budgets of the municipalities to acquire digital devices to perform ECGs and the shortage of specialised medical staff, the success of this field intervention increased the interest of public managers for telediagnostic services

Telemental health in Brazil: past, present and integration into primary care

Background Telemental Health Care has reported very good results and is included within mental health priorities by the World Health Organization. Objective To provide an overview of the current situation of the integration of Brazilian telemedicine activities into primary health care. Methods Critical review based on MEDLINE database, using the keywords “telemedicine”, “primary health care” “mental health” and “telemental health”, on websites of the Brazilian Ministry of Health and Brazilian Telehealth Network Program, and on personal communication. Results The Brazilian Telehealth Network Program is well positioned and connects primary health care with academic centers. Regulations standards allow a broader scope of activities for psychologists, however, are more restrictive for physicians. In Brazil most of telemental health activities are focused on education and second opinion consulting. A huge challenge must be overcome considering the regional differences and the telehealth implementation experience. Research initiatives have been initiated both in the implementation and evaluation of the mental health assistance into primary health care. Discussion Brazilian Telemental Health initiatives into Primary Care are aligned with other examples around the world, have a great potential for improving mental health care service delivery, and access to proper mental health care, especially if articulated in a national program and coordinated research

Análisis del proceso de implementación del Programa Telessaúde Brasil Redes en estado de Pernambuco

Made available in DSpace on 2017-01-27T16:28:44Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 9.pdf: 336412 bytes, checksum: e52443032129b7b2f5357758b97fe905 (MD5) Previous issue date: 2015Universidade Federal de Pernambuco. Hospital das Clínicas. Núcleo de Telessaúde. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil.Universidade Federal de Pernambuco. Hospital das Clínicas. Núcleo de Telessaúde. Recife, PE, Brasil.A telessaúde vem ampliando seu campo de ação no Sistema Único de Saúde (SUS), com foco na Atenção Primária à Saúde (APS). Pernambuco desenvolve a telessaúde com financiamento do Ministério da Saúde e incentivos obtidos junto a agências de fomento à pesquisa, e tem ampliado suas ações através do Programa Telessaúde Brasil Redes (PTBR-Redes). Objetivou-se analisar a implementação deste programa em Pernambuco entre 2007 e 2011. O estudo foi qualitativo, e foi utilizado o método de triangulação de fonte de dados para validação da pesquisa. A institucionalização e o desenvolvimento do PTBR-Redes em Pernambuco ressalta a experiência pregressa da Universidade Federal de Pernambuco em telessaúde e a proposta para sua formulação junto a outras universidades brasileiras. A falta de articulação política no estado, a alta rotatividade de profissionais de saúde, e a dificuldade de conexão à internet são problemas que dificultam o funcionamento do PTBR-Redes. Recomenda-se que sejam realizadas avaliações aprofundadas desse programa, pois são imprescindíveis para a sua sustentabilidade.Telehealth has been widening its scope of action in Sistema Único de Saúde - SUS (the brazilian public health system, literally Unified Health System) focusing in Primary Health Care. Pernambuco develops telehealth financed by Department of Health and subsidies paid by research funded-institutions, and has expanded its actions with the Programa Telessaúde Brasil Redes (PTBR-Redes). The implementation of this program in Pernambuco from 2007 till 2011 is the objective of this essay. The study was qualitative using data triangulation to establish its validity. The PTBR-Redes institutionalization and development in Pernambuco emphasize the former telehealth experience of Universidade Federal de Pernambuco and the motion for its formulation in other brazilian universities. The lack of political articulation in this state, the high turnover of health professional and the difficulty of connection to the internet are problems that slow down the PTBR-Redes working. We recommend that deep evaluation of this program should be done, insofar as it is essential for its sustainability.La telesalud ha ampliado su campo de acción en el Sistema Único de Saúde (SUS) de Brasil, con el enfoque en la Atención Primaria de Salud (APS). Pernambuco desarrolla la telesalud través de proyectos financiados por agencias del fomento de la investigación y por el Ministerio de Salud y viene ampliando sus acciones través del Programa de Telessaúde Brasil Redes (PTBR-Redes). El objetivo de este trabajo es analizar el proceso de implementación de este programa en Pernambuco entre 2007 y 2011. El estudio fue de tipo cualitativo, utilizando triangulación de datos para atestar la fiabilidad de la investigación. El proceso de institucionalización y desarrollo de PTBR-Redes pone de relieve la experiencia pasada de la Universidade Federal de Pernambuco em telesalud y la propuesta para su formulación en otras universidades brasileñas. La falta de articulación política en el estado, la alta rotación de los profesionales de salud, las dificultades de conexión a internet son algunos de los problemas que dificultan el funcionamiento de PTBR-Redes. Se recomienda que se lleve a cabo la evaluaciones en profundidad del programa, ya que son esenciales para su sostenibilidad

Análise do processo de implementação do Programa Telessaúde Brasil Redes em Pernambuco

Telehealth has been widening its scope of action in Sistema Único de Saúde - SUS (the brazilian public health system, literally Unified Health System) focusing in Primary Health Care. Pernambuco develops telehealth financed by Department of Health and subsidies paid by research funded-institutions, and has expanded its actions with the Programa Telessaúde Brasil Redes (PTBR-Redes). The implementation of this program in Pernambuco from 2007 till 2011 is the objective of this essay. The study was qualitative using data triangulation to establish its validity. The PTBR-Redes institutionalization and development inPernambuco emphasize the former telehealth experience of Universidade Federal de Pernambuco and the motion for its formulation in other brazilian universities. The lack of political articulation in this state, the high turnover of health professional and the difficulty of connection to the internet are problems that slow down the PTBR-Redes working. We recommend that deep evaluation of this program should be done, insofar as it is essential for its sustainability.La telesalud ha ampliado su campo de acción en el Sistema Único de Saúde (SUS) de Brasil, con el enfoque en la Atención Primaria de Salud (APS). Pernambuco desarrolla la telesalud través de proyectos financiados por agencias del fomento de la investigación y por el Ministerio de Salud y viene ampliando sus acciones través del Programa de Telessaúde Brasil Redes (PTBR-Redes). El objetivo de este trabajo es analizar el proceso de implementación de este programa en Pernambuco entre 2007 y 2011. El estudio fue de tipo cualitativo, utilizando triangulación de datos para atestar la fiabilidad de la investigación. El proceso de institucionalización y desarrollo de PTBR-Redes pone de relieve la experiencia pasada de la Universidade Federal de Pernambuco em telesalud y la propuesta para su formulación en otras universidades brasileñas. La falta de articulación política en el estado, la alta rotación de los profesionales de salud, las dificultades de conexión a internet son algunos de los problemas que dificultan el funcionamiento de PTBR-Redes. Se recomienda que se lleve a cabo la evaluaciones en profundidad del programa, ya que son esenciales para su sostenibilidad.A telessaúde vem ampliando seu campo de ação no Sistema Único de Saúde (SUS), com foco na Atenção Primária à Saúde (APS). Pernambuco desenvolve a telessaúde com financiamento do Ministério da Saúdee incentivos obtidos junto a agências de fomento à pesquisa, e tem ampliado suas ações através do Programa Telessaúde Brasil Redes (PTBR-Redes). Objetivou-se analisar a implementação deste programa em Pernambuco entre 2007 e 2011. O estudo foi qualitativo, e foi utilizado o método de triangulação de fonte de dados para validação da pesquisa. A institucionalização e o desenvolvimento do PTBR-Redes emPernambuco ressalta a experiência pregressa da Universidade Federal de Pernambuco em telessaúde e a proposta para sua formulação junto a outras universidades brasileiras. A falta de articulação política noestado, a alta rotatividade de profissionais de saúde, e a dificuldade de conexão à internet são problemas que dificultam o funcionamento do PTBR-Redes. Recomenda-se que sejam realizadas avaliações aprofundadas desse programa, pois são imprescindíveis para a sua sustentabilidade.

Tecnologia da informação em nefrologia

Este artigo apresenta uma revisão da literatura sobre as aplicações da tecnologia da informação em Nefrologia. Caracterizamos as aplicações em bancos de dados, as iniciativas mais voltadas ao ensino e alguns exemplos de sistemas de apoio à decisão. Por fim, apresentamos as experiências de Telemedicina em Nefrologia nitidamente voltadas ao suporte prestado à assistência dialítica a distância. Enfatizamos que a telessaúde pode ajudar na criação de um modelo assistencial descentralizado, voltado à prevenção, centrado na atenção básica como forma de combater a epidemia mundial de Doença Renal Crônica (DRC)