Implementation of a Telecardiology Service in a Health Unit in the City of Porto Alegre, Brazil: A Pilot Study

Abstract Background: The implementation of Telecardiology in primary care in the city of Porto Alegre, Brazil, is a viable and promising strategy. It would decrease the distance between patient and specialized professional services by reducing unnecessary referrals and improving the quality of primary care and satisfaction of patients and health professionals. Objective: To implement a Telecardiology service and assess user satisfaction using the CARDIOSATIS scale. Methods: This was a pilot study developed by a partnership between the Institute of Cardiology and the Telehealth Center of Rio Grande do Sul. The study was carried out at Eri Flores-Vila Vargas health center in the city of Porto Alegre, from May to October 2019, and included 21 patients attending the health center. The descriptive analysis of data was performed using the SPSS program (Statistical Package for the Sciences) version 23. Data normality was checked using the Kolmogorov-Smirnov test. Statistical significance was set at 10%. Results: Mean age of participants was 43.8 ± 16.1 years. The most common risk factors in the sample were physical inactivity (81%) and smoking (43%). Most patients had normal electrocardiogram (ECG) readings. The time elapsed from the performance of the ECG test, transmission of the ECG traces to Telehealth, and return of the final ECG report to the health center was 0-7 days. The CARDIOSATIS scale revealed a high prevalence of "very satisfied" users for the general satisfaction domain, and only 14.3% of patients were dissatisfied with their health. Conclusions: Telecardiology reduced the distance between patient and the specialized professional, with a high level of patient and health professional satisfaction. Our study can serve as a basis for the implementation of a telecardiology network in the city of Porto Alegre in the future.

Telessaúde: confidencialidade e consentimento informado / Telehealth: confidentiality and informed consent

A sociedade vivencia avanços na área da informática, com novos recursos que instrumentalizam a área da saúde e oferecem outras modalidades de atendimento. Apesar dos benefícios dessas inovações, os princípios éticos e legais devem ser preservados. Esta revisão da literatura pretende promover reflexão sobre a confidencialidade, privacidade, segurança e veracidade das informações nos serviços que utilizam a telessaúde. Foram pesquisadas as bases de dados Scielo e Lilacs para a busca de artigos publicados nos últimos 12 anos em português, espanhol ou inglês e que abordassem a confidencialidade e o consentimento nos atendimentos por meio da telessaúde. Para evitar a violação e garantir que o procedimento seja ético nas informações relativas à saúde, deve haver certificação eletrônica dos sistemas utilizados de acordo com padrões internacionais. Os usuários dos sistemas devem utilizar assinatura digital conferida por autoridade pública. O termo de consentimento livre e esclarecido deve ser assinado pelo paciente para a realização de teleconsultorias.

As our societies experience advances in the of information technology, new resources provide tools for the health sciences and create other forms of care. Despite the benefits of those innovations, ethical and legal principles must be observed. This literature review aims to stimulate a discussion on confidentiality, privacy, safety, and veracity of information on the services using telehealth systems. Scielo and Lilacs databases were researched for articles published in the last 12 years in Portuguese, Spanish, or English, which approached matters of confidentiality and consent in the services provided using telehealth systems. To avoid infringement and make sure procedures are ethical in their use of health related information, systems must be electronically certified according to international standards. System users must use digital signature verified by an authoritative public organ. Informed consent forms must be signed by patients before all teleconsultation.