- Poster presentation
- Open Access
Impact of knowledge transfer through the implementation of a telemedicine program in a community hospital in Brazil
Critical Care volume 17, Article number: P525 (2013)
Emergency survival rates vary significantly according to the quality of care, which depends on human and technological resources. Emergency and critical care medicine physicians must make fast decisions; the presence of experienced consultants improves survival. In developing countries, there is a shortage of skilled doctors. The aim is to describe the first Brazilian initiative of real-time teleconferencing telemedicine (TM) providing 24/7 emergency department (ED) and ICU coverage.
Since May 2012 a TM program has been implemented at two hospitals in São Paulo, Brazil - Hospital Municipal Dr. Moysés Deutsch (HMMD), a public, secondary hospital, and Hospital Israelita Albert Einstein (HIAE), a tertiary private philanthropic entity - due to a partnership with the Brazilian Health Ministry. TM Central Command was located at HIAE with Endpoint 97 MXP Cisco® Solution and a mobile Intern MXP ISDN/IP Cisco® for the remote hospital (HMMD) via dedicated GB/sec connection. Imaging examinations were evaluated using PACS technology. Every recruited patient was assessed by the Central Command through TM with an experienced consultant.
Over a 6-month period, 131 teleconsultations (114 patients) were done. Mean age was 50.1 years, 57.1% was male and mean APACHE II score was 24.3. A total of 64.8% originated from the ICU and 35.2% from the ED. Main consultation diagnoses were sepsis (31.3%); stroke (29.8%); survival from cardiac arrest (6.1%); trauma (6.1%); and acute myocardial infarction (5.3%). TM improved diagnosis in 14.5% and influenced the clinical management in 85.5% of the consultations. Invasive procedures were indicated in 61.1%. Life-saving procedures were TM related in seven patients (6.1%): stroke thrombolysis (n = 6) and limb amputation (n = 1). Seven patients (6.1%) were transferred and submitted to surgical procedures (heart surgery (n = 2), neurosurgery (n = 4) and liver transplantation (n = 1)). The majority of the patients remained at HMMD and were discharged.
A TM program is feasible to be implemented in a community hospital. The major benefit is expertise medical transfer from the tertiary hospital to the community setting, improving diagnosis and management of critical care patients, and avoiding routine transfer to a major urban center.
About this article
Cite this article
Filho, C.A., Steinman, M., Andrade, A. et al. Impact of knowledge transfer through the implementation of a telemedicine program in a community hospital in Brazil. Crit Care 17, P525 (2013). https://doi.org/10.1186/cc12463
- Central Command
- Experienced Consultant
- Major Urban Center
- Remote Hospital
- Stroke Thrombolysis