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OtherPractice

Telemedicine in the driver’s seat: new role for primary care access in Brazil and Canada

The Besrour Papers: a series on the state of family medicine in Canada and Brazil

Payal Agarwal, Natasha Kithulegoda, Roberto Umpierre, John Pawlovich, Juliana Nunes Pfeil, Otavio Pereira D’Avila, Marcelo Goncalves, Erno Harzheim and David Ponka
Canadian Family Physician February 2020, 66 (2) 104-111;
Payal Agarwal
Innovation Fellow at Women’s College Hospital in Toronto, Ont.
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Natasha Kithulegoda
Research coordinator at Women’s College Hospital and a doctoral student in the Institute of Health Policy, Management and Evaluation at the University of Toronto.
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Roberto Umpierre
Adjunct Professor in the Department of Social Medicine and General Coordinator of TelessaúdeRS at the Universidade Federal do Rio Grande do Sul in Porto Alegre, Brazil.
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John Pawlovich
Clinical Associate Professor in the Department of Family Practice at the University of British Columbia.
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Juliana Nunes Pfeil
Teleconsultant and Regulator for TelessaúdeRS at the Universidade Federal do Rio Grande do Sul.
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Otavio Pereira D’Avila
Dentist and Adjunct Professor in the Department of Social and Preventive Dentistry at the Universidade Federal de Pelotas in Brazil, and a collaborator with TelessaúdeRS at the Universidade Federal do Rio Grande do Sul.
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Marcelo Goncalves
Adjunct Professor in the Department of Social Medicine and Vice Coordinator of TelessaúdeRS at the Universidade Federal do Rio Grande do Sul.
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Erno Harzheim
Associate Professor in the Department of Social Medicine at the Universidade Federal do Rio Grande do Sul and Secretary of Health for Porto Alegre.
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David Ponka
Associate Professor in the Department of Family Medicine at the University of Ottawa and Director of the Besrour Centre at the College of Family Physicians of Canada.
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Abstract

Objective To contrast how Brazil’s and Canada’s different jurisdictional and judicial realities have led to different types of telemedicine and how further scale and improvement can be achieved.

Composition of the committee A subgroup of the Besrour Centre of the College of Family Physicians of Canada and Canadian telemedicine experts developed connections with colleagues in Porto Alegre, Brazil, and collaborated to undertake a between-country comparison of their respective telemedicine programs.

Methods Following a literature review, the authors collectively reflected on their experiences in an attempt to explore the past and current state of telemedicine in Canada and Brazil.

Report Both Brazil and Canada share expansive geographies, creating substantial barriers to health for rural patients. Telemedicine is an important part of a universal health system. Both countries have achieved telemedicine programs that have scaled up across large regions and are showing important effects on health care costs and outcomes. However, each system is unique in design and implementation and faces unique challenges for further scale and improvement. Addressing regional differences, the normalization of telemedicine, and potential alignment of telemedicine and artificial intelligence technologies for health care are seen as promising approaches to scaling up and improving telemedicine in both countries.

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Canadian Family Physician: 66 (2)
Canadian Family Physician
Vol. 66, Issue 2
1 Feb 2020
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Telemedicine in the driver’s seat: new role for primary care access in Brazil and Canada
Payal Agarwal, Natasha Kithulegoda, Roberto Umpierre, John Pawlovich, Juliana Nunes Pfeil, Otavio Pereira D’Avila, Marcelo Goncalves, Erno Harzheim, David Ponka
Canadian Family Physician Feb 2020, 66 (2) 104-111;

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Telemedicine in the driver’s seat: new role for primary care access in Brazil and Canada
Payal Agarwal, Natasha Kithulegoda, Roberto Umpierre, John Pawlovich, Juliana Nunes Pfeil, Otavio Pereira D’Avila, Marcelo Goncalves, Erno Harzheim, David Ponka
Canadian Family Physician Feb 2020, 66 (2) 104-111;
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