Tele-health Initiatives in Latin America

Telehealth initiatives in Latin America
C@ribNET launches an integrated opportunity
How to construct a highway to
Health Knowledge ?
RNP/PAL/0200
© 2003 – RNP
Tabebuia roseoalba - por Flávio Cruvinel Brandão – www.flickr.com
The World Health Organization
has adopted the following description:
“Telemedicine is the delivery of health care services, where
distance is a critical factor, by all health care professionals
using information and communication technologies for the
exchange of valid information for diagnosis, treatment and
prevention of disease and injuries, research and evaluation,
and for the continuing education of health care providers, all
in the interests of advancing the health of individuals and
Telemedicine - opportunities and developments in Member States:
their communities”
report on the second global survey on eHealth 2009. (Global Observatory for eHealth Series, 2)
CFM: Defines Telemedicine as the Medical practice through
the use of interactive audio-visual communication
methodologies, with the aim to assist, educate and research
in Health. CFM – Medical Federal Council, Resolution nº 1.643/2002 Brazil
Uma sociedade criativa e competitiva
Novo modelo: ciência + ciberinfraestrutura
The national backbone infrastructure in the US and the Digital Agenda/Geant 2020 from the
European Union expand research and education networks to homes:
nervous system of the new science.
Experimentar redes do futuro
Network experimental services arquitectures: mobility, computation and security
New ways to run joint applications: universities and enterprises
RNP Global and Regional Integration
RedClara Ring
Members Clara
to be connected
Connection to
Geant2 a 2.5 Gbps
Connection to
Internet2
Cyberinfrastructure – RNP Today
•  280% increase in aggregate capacity
•  24 states connected up to 10Gbps
•  Amazonia included
•  320 institutions connected minimal1Gbps
•  27.500 research groups connected
•  3,5 million users
National Research and Education Network
23
´s
Research and Education
Metropolitan Comunity Network
in 22 Capitals + São Carlos +
1 Rede Petrolina, Pernambuco e Juazeiro, Bahia
1 Rede Ouro Preto e Mariana, MG
Petropolis, Niteroi, RJ
Campinas, SP
Pelotas, RS
Uberlandia, Uberaba, Itajuba, MG
João Pessoa, PB
Castanhal, Marabá, Santarém, Altamira, PA
Belém
Vitória
Manaus
Brasília
The Brazilian Telehealth initiative enables videoconferencing, diagnosis, second
opinion also formative, continuous and permanent education and web conferencing, by
linking university and teaching hospitals via RNP (Rede Nacional de Ensino e
Pesquisa), Brazil’s national research and education R&E network.
Integrating the Health Ministry to the NREN RNP
Remote
Assistance
•  Networks and Resources in Brazil
Program Telehealth Brazil Networks
Primary Care
2011:
12 states and 1200 atendance points
225.685 Telediagnosis
67.969 Teleeducated
16.100 Teleconsulting
Collaaborative
Research
Continuous
Education
www.telessaudebrasil.org.br
The Open Health University – Training on-the-job
for thousands health professionals
www.universidadeabertadosus.org.br
The Telemedicine University Network, RUTE,
connects University and Teaching Hospitals
in all states www.rute.rnp.br
Today: 55 Telehealth Centers
Articulation and Coordination Levels
Municipal
23 Redecomeps
Research and Education
Community Network
State
Sec. de Estado da Saúde
Portaria 402 – Telehealth Expansion
National
Telehealth Brasil Network
UNASUS
RUTE
RedCLARA
International
ABC
Latin America and
Caribbean
ePortuguese
IADB
WHO
PAHO
World Banl
NRENs
**Hospital Universitário da UFPI
*HU da UFMA
**Faculdade de Medicina da UFT
**Faculdade de Enfermagem da UNIFAP
**HU João de Barros Barreto da UFPA
**HU Betina Ferro de Souza da UFPA
•  Connection to 1Gbps in 27 state capital + 12 cities
•  Crieate Telehealth Centers
•  Videoconference rooms, Teleconsulting, Telediagnosis
•  VC rooms certification
•  Video- and webconference training
•  Crieation and Participation in Special Interest Groups
**Faculdade de Medicina da UFRR
*Hospital Getúlio Vargas da UFAM
**HU Júlio Müller da UFMT
**Faculdade de Medicina da UNIR
**Faculdade de Medicina da UFAC
**Hospital das Clínicas da UFG
**HU Maria Aparecida Pedrossian da UFMS
*Hospital das Clínicas da Unicamp
*Hospital das Clínicas da FMUSP
*Hospital São Paulo da Unifesp
*HU da USP
*Instituto Dante Pazzanese
***HC-FMRP/USP
*Hospital de Clínicas da UFPR
*HU Polydoro Ernani de São Thiago da UFSC
*Irmandade da Santa Casa de Misericórdia
de Porto Alegre (ISCMPA)
**Hospital de Clínicas da UFRGS
**Hospital Universitário da UFSM
**HU Dr. Miguel Riet Correa Júnior da FURG
**Hospital Escola da UFPEL
55
núcleos
operacionais
núcleos operacionais
+12 em 2012
**Maternidade Escola Assis Chateaubriand da UFC
*Hospital Universitário Walter Cantídio da UFC
*Hospital das Clínicas da UFPE
*HU Lauro Wanderley da UFPB
**HU Alcides Carneiro da UFCG
**HU Ana Bezerra da UFRN
**Hospital de Pediatria da UFRN
**Maternidade Escola Januário Cicco da UFRN
**HU Onofre Lopes da UFRN
*HU Prof. Alberto Antunes da UFAL
**Hospital Universitário da UFS
*HU Prof. Edgar Santos da UFBA
**Centro Pediátrico Hosannah de Oliveira da UFBA
**Maternidade Climério de Oliveira da UFBA
**Hospital Universitário na UnB
*Hospital das Clínicas da UFMG
**Hospital de Clínicas da UFU
**Hospital Escola da UFTM
**Hospital Universitário da UFJF
*HU Cassiano Antônio de Moraes da UFES
*Canal Saúde (Fiocruz)
*HU Pedro Ernesto e FCM da UERJ
**HU Antônio Pedro da UFF
**HU Gaffrée e Guinle da UNIRIO
**Inst. de Psiquiatria da UFRJ
**Inst. de Puer. e Ped. Martagão Gesteira da UFRJ
**Inst. de Neurologia Deolindo Couto da UFRJ
**Inst. de Doenças do Tórax da UFRJ
**Inst. de Ginecologia da UFRJ
**Hospital Escola São Francisco de Assis da UFRJ
**Maternidade Escola da UFRJ
**HU Clementino Fraga Filho da UFRJ
Timetable and Implementation costs under RUTE
2006
phase I
19 institutions
US$ 3 Mio
2008
phase II
38 institutions
US$ 4,5 Mio
2011
phase III
28 institutions
US$ 2 Mio
MCU, VC equipment, webconference SW, desktops and notebooks,
switches, projectors, cameras, scanners, monitors, printers, no-breaks,
sound equipment, others
VC room reform
Last mile and member institution network infrastructure
National coordination, administration, marketing, maintenance, trips
Workshops
Scholarhips
RUTE Operational Procedures
Aiming at: the national integration on teaching, research and the improvement of
health care service for the population
Establishment of the organizational and technological infrastructure:
national coordination,
advisory committee made up of telemedicine experts of the country’s
best teaching and research institutions,
interest groups on specific health areas,
executive, maintenance, communication and operational teams
national and local;
The Advisory Committee recommends the procedures for innovative use;
Each member institution presents a project and establishes the Telehealth Center
with a physical area and a dedicated team;
Member institutions create SIGs to promote and develop collaboration activities
on specialties and subspecialties;
Organize workshops to encourage everyone’s understanding of the collaborative work.
RUTE – Special Interest Groups
–  a community whose interest is to advance knowledge and learning in a specific area, where
members work together to produce solutions on a question or a series of questions.
–  Health professionals, researchers, managers and professors
–  Today: 40 SIGs; circa 50-60 sessions/month ; 310 participating institutions
SIGs statistics– N° of participant institutions
SIG's RUTE
Coord
Dez
2008
Dez
2009
Dez
2010
Dez
2011
UERJ
UFBA
Child and Adolescent Health
9
24
29
36
UERJ
Pediatrics Radiology
13
24
28
31
Teaching Hospitals Management
-
9
16
26
Cardiology
-
15
22
24
Human Milk Bank
-
28
33
33
Indigenous Health
-
-
3
6
SIG Technical Operations
-
7
23
26
UFSC
Standards in Telemedicine and eHealth
5
11
14
14
UERJ
TelePsiquiatry
3
9
15
19
UFRN
Collaborative Medical Education
-
6
8
13
Oftalmology
7
12
15
16
Intensive Nursing and High Complexity
3
52
80
125
6
25
26
26
Unifesp
UFU
IFF
Fiocruz
Unifesp
Unirio
RUTE
Unifesp
Unifesp
UERJ
UFMG
* Expansion to ALC and Palops
SIGs statistics– N° of participant institutions
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SIGs Record in Nov 21st 2011:
7 sessions/day
Telehealth in the State of Minas Gerais
Federal University of Minas Gerais - UFMG
Minas Gerais Health State Department
12hours/day
1200 ecg/day
1200 Teleconsult/month
(UFMG, UFU, UFTM, UFJF,
Montes Claros, UFSJ)
Ca. 70% of the telepatients need no transfer to
Reference Centers
Ca. 10% municipal health budget savings
660 Municipalities
821 Points
Computer graphics 2, 3, 4D, illustration, serious games,
simulation and training
Prof. Dr. Chao Lung Wen
[email protected]
Virtual Human Being
Dr. Hermes Prado Jr
CEAPS – HCRP – USP
[email protected]
Grade de segunda opinião formativa
Prof.Dr.Shimizu,
Japan, APAN
Health Sciences
Group
Innovation in Telehealth
Collaborative Projects Selection for ICTs and Enterprises Consortia aimed
at the developmenet of Telehealth InnovationTechnologies
Telepresence rooms in 4 University Hospitals
Rio, São Paulo, Minas Gerais, Pernambuco
March 1st 2012
Secretário Executivo do Ministério da Ciência, Tecnologia e
Inovação, Luiz Antonio Rodrigues Elias;
Secretário de Atenção à Saúde do Ministério da Saúde,
Helvécio Miranda Magalhães Júnior;
Secretário de Educação Superior do Ministério da Educação,
Amaro Henrique Pessoa Lins
In the center
RNP General Director, Nelson Simões
Ministro de Ciência, Tecnologia e Inovação,
Marco Antônio Raupp
Connecting National Research and
Education Networks in Latin America
Regional Protocols for eHealth Public Policies in LAC
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Project RG-T1509
Compromiso de Implantación de
Políticas Públicas de Telesalud
UNIVERSIDADES PÚBLICAS CON CURSOS EN EL ÁREA DE SALUD CON
INICIATIVAS EN TELESALUD en Ecuador y el PROGRAMA NACIONAL
TELEMEDICINA/TELESALUD
•  Universidad Tecnológica
Equinoccial (UTE),
•  Universidad del Azuay
•  Universidad San Francisco
De Quito
•  Universidad Técnica Particular de Loja (UTPL)
•  Escuela Politécnica del Litoral
•  Universidad Central del Ecuador
–  FACULTAD DE CIENCIAS MEDICAS
En el Ecuador existen 71 Universidades
Instituciones de salud vinculadas a RENATA
Comunidad de Salud de RENATA definió plan estratégico en Pereira , Viernes 01 de Julio de 2011 10:45
Al II Encuentro Presencial asistieron representantes de los 18 hospitales y clínicas que integran la Comunidad de Salud de l
a Red Nacional Académica de Tecnología Avanzada RENATA, quienes definieron líneas de trabajo y planes de acción
INSTITUCIONES y Núcleos de eSalud
Hospital Susana López De Valencia
Centro Médico IMBANACO de Cali S.A
Fundación Cardiovascular De Colombia Instituto Corazón De Ibagué
Fundación Cardiovascular De Colombia Instituto Corazón Manizales
Fundación Cardiovascular De Colombia Instituto Corazón Santa Marta
Fundación Valle de Lili
Hospital Departamental Santa Sofía de Caldas
Hospital Pablo Tobon Uribe
Hospital San Juan de Dios
Hospital San Vicente de Paul
Hospital Universitario San Jorge
IPS Universitaria
Hospital de Villavicencio
Fundación Santa Fé de Bogotá
Corporación Hospitalaria Juan Ciudad-Méderi
Hospital Universitario del Quindío
Centro de la Ciencia y la Investigación Farmacéutica – CECIF
Corporación para Investigaciones Biológicas
Corporación CORPOGEN
Fundación AFFIC (ciencias forences)
Telehealth Course LA – 10/04/2012
II
III
IV
V
VI
General Concepts
Design, Implementation, Evaluation
Human Resources
Scenary
National Projects
16
396
25
Federal University of Minas Gerais
Launch by the Brazilian Health Minister
Countries
Students
Tutors
What is the best Workplan to build up the C@ribNET Health Community ?
Telehealth Project Goals
1.  Structure the Project Management
2.  Designate the Executive Coordination, the Project Manager and the Health Advisory Board
3.  Diagnostic the actual situation of the health member institutions
4.  Specify the communication infra-structure plan in each institution
5.  Specify the components of the technical solutions
6.  Promote the first Workshop
7.  Call for project proposals for each institution
8.  Establish the technical terms and counterpart with each institution
9.  Acquire equipment, services and stablish connection
10.  Implant the infra-structure in each institution
11.  Test and accept equipment, services and connection
12.  Create institutionally and certify the Telehealth Centers
13.  Launch and activate the Telehealth Centers
14.  Promote the second Workshop
15.  Evaluate and publish the results
Dialogue and Collaboration
How much are we interested in collaborate ?
How far are we opened to share knowledge ?
How much time is it available for dialogue ?
What are the constraints to sustain joint development ?
Are there responsibles to plan, describe, delegate and coordinate ?
What tasks must be shared and integrated ?
Who assumes the costs private x public ?
Is there a will for academic x enterprise x government consortia ?
How should we proceed in Global Health ?
Is there really much goal difference between presential and virtual dialogue ?
When is it one and not the other necessary ?
The Telehealth market is in expansion and consolidation ?
Continuous Education x Collaborative Research x Remote Assistance ?
The time has come for ICTs in Health !
Model proposed
The use of the Caribbean Knowledge and
Learning Network for integrating, expanding,
disseminating and applying Health Knowledge !