Telemedicine is gaining increased attention worldwide as a solution for improving access to care, improving quality of care, and lowering costs.
Much of Latin America faces a major challenge that could in part be addressed with telemedicine: a shortage of providers, and large populations living in rural areas where access to physicians—particularly specialists—is lacking.
In my multiple visits to Latin America over the past two years, it is clear that while most countries in the region have used telemedicine to varying extents for many years, scalability remains a major goal.
Governments across Latin America are generally strong advocates of telemedicine, and are investing in the networks and infrastructure that will support this technology.
Below I highlight ways in which countries throughout the region are using or intend to use telemedicine, and what trends we might observe in the years ahead.
In Brazil, telemedicine today is used strictly for provider-to-provider consultation, as physicians are not legally allowed to consult with patients over videoconference.
Telemedicine has been largely driven by the need to provide care virtually between specialists in urban centers to patients in remote areas, due to a lack of specialists in the rural areas.
The Brazilian government has long supported the use of telemedicine to provide better access and treatment to remote areas. Since 2006, it has facilitated two public initiatives--the Brazilian National Telehealth Network Program (launched by the MOH) and the RUTE-Telemedicine University Network (launched by the Ministry of Science, Technology, and Innovation) both of which serve to deploy telemedicine across Brazil.
One of the first major initiatives started in 2006 in Parintins, a city of 100,000 located in the middle of the Amazon. With no roads to or from the city, the goal was to use telemedicine to enable communication between physicians in Parintins and specialists in Sao Paulo. Parintins partnered with private technology companies, including Intel, to build the necessary infrastructure (e.g., WiMAX network). This telemedicine program continues to operate today, and has informed other telemedicine efforts including Brazil’s national telehealth program, Telessaude (http://www.telessaudebrasil.org.br/).
Another major initiative in Brazil is to bring intensive care unit (ICU) care to rural areas. The Brazilian MOH initiated tele-ICU programs so that now many hospitals in different regions are connected to rural parts of the country. These tele-ICUs reduce the need to transport patients into a city for health conditions such as heart attacks, strokes, and sepsis. Physicians in urban areas are able to use PTZ cameras to visually inspect the patient, and collect and interpret vital signs in real-time. Cerner, in partnership with Brazilian companies Intensicare and IMFtec, has provided the technology and software for most of these virtual ICUs.
Mexico, Chile, Peru, and Argentina
In Mexico, the social security network provides healthcare to formal sector workers. The network is currently working with companies such as Lumed Health http://www.lumedhealth.com/ to expand telemedicine capabilities. In addition, telemedicine is being used between the U.S. and Mexico with health systems such as the Mayo Clinic and Massachusetts General conducting consultations with physicians in Mexico.
In Chile, the Ministry of Health has implemented a “Digital Health Strategy.” Its primary goal is also to address provider shortages and to improve access to care in rural areas. There are currently several telemedicine projects and POCs underway in Chile. AccuHealth (https://www.accuhealth.cl/), for example, is a Chilean company that provides tele-monitoring services specifically to bring home care to patients who suffer from chronic conditions. The company plans to expand to Mexico and Colombia in the near term.
In Peru, the government is spearheading efforts to build a fiber optics network across the entire country (www.proinversion.gob.pe/RedDorsal/). This infrastructure will be used to better support telemedicine services.
In Argentina, the government has worked with the MOH and the Ministry of Federal Planning, Public Investment and Services to promote telemedicine. This collaboration has culminated in the CyberHealth Project, which is focusing on the installation of fiber optics and upgrading hospitals to allow for videoconferencing. It aims to connect 325 healthcare institutions across the nation to enable remote consultations and sharing of expertise.
The Future of Telemedicine in Latin America
Telemedicine is being increasingly recognized as a solution to achieve more with less. In Latin America, it has great potential to address the fact that providers and health care resources are not distributed equally among the urban and rural populations.
The future of telemedicine in the region is promising. Governments are investing in and taking active roles in digitizing their health systems (e.g., implementation of electronic medical records, improving interoperability) along with building the infrastructure required to support telemedicine. The Pan American Health Organization (PAHO) has convened a meeting of the MOH leaders from several Latin American countries to discuss strategic plans for e-Health across the region. This collaboration, where protocols, guidelines, and best practices can be shared, will be increasingly important.
Intel Health & Life Sciences looks forward to continuing its partnerships with public and private entities across Latin America to continue these important efforts.