Developments in the regulation of Brazilian digital medical education and its implications for health

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Marcos Vinicius Tatageba and Leonardo Jorge Cordero de Paula. Photos: reveal

Technology is rapidly evolving and changing our daily lives and everything around us. In the field of health is no different. Every year new devices facilitate diagnosis and technologies that offer more aggressive treatments, and in doing so we discover a new way to practice medicine in a more decentralized and democratic way. The impacts are enormous when it comes to expanding care and access to the entire health system.

According to the latest PNAD – National Sample Household Survey, conducted by the IBGE, it appears that 84.72% of the population lives in urban areas. Although the SUS is very effective, this orientation imposes a significant burden on the public health system in large cities. Not to mention that in the country there are 115 isolated people who do not have direct access to health care.

Brazil is a silo for the training of senior health executives. There are more than 500,000 trained physicians, of whom approximately 64% hold specialist titles. For 2030, expectations are even greater: this figure should exceed 800,000. This is what the study carried out by the CFM – Federal Council of Medicine, in partnership with the University of São Paulo, indicates. In 2021 alone, at the height of COVID-19, more than 24,000 new doctors graduated.

Specifically in the medical field, there are more career opportunities than doctors available. Brazil currently has 2.4 professionals per thousand inhabitants, which is higher than the population of Japan, for example, and close to countries such as the United States (2.6), Canada (2.7) and the Kingdom United (2.8). In many countries considered developed, this figure is less than 4 per thousand inhabitants.

The big challenge is to lighten the burden on the system and ensure that more people are served. How to democratize health services and ensure access to them for the entire population?

Telemedicine is a starting point and has also proven effective in this regard.

Now the decision regulating the use of telemedicine, has clear rules and has been included in the Official Gazette of the Federation, and is already in force in the country.

This method was urgently approved during the pandemic and its regulation will mark a milestone in the country’s medical field.

As we have already said, it is an excellent tool to reach people who do not have access to health care. Today, for example, it is possible to perform and report an image examination by teleradiology. Only skilled technicians and good software allow radiologists elsewhere to analyze reports and improve diagnoses.

We have also made major advances in telemedicine where it is possible to perform ECGs, stress tests, Holter and ABPM in remote locations which must be referred by trained professionals. Not to mention other devices that perform physical otoscopy examinations (tool for visualizing the internal structures of the auditory meatus and eardrum), which analyze a throat infection. In addition, it allows and implements listening to the heart and lungs, and can identify many diseases, such as a possible acute heart attack. These technologies are also important for the follow-up of patients with chronic diseases, not to mention that they provide comfort to those who can benefit from a consultation by video call.

A recent survey conducted by the telemedicine platform showed that Brazilians approve of the method. Of the 5,961 respondents, 81% consider remote service a good option. From the healthcare professional’s perspective, in addition to the savings, in terms of resources and time, there is the potential to serve more people. When it comes to digital medical training, we follow the same logic. Thanks to the Internet, professionals far from reference centers can access quality education. Improve knowledge and train new professionals across the country, thus democratizing medical care and reaching more patients.

Evolution of science and breaking taboos

Going back specifically to developments in the cardiology specialty, the first telemedicine trials began in Brazil in the mid-1990s. And in 1995, InCor – Instituto do Coração de SP, ECG-FAX, which provided the analyzes carried out by the entity doctors and tests were, in turn, faxed to other cities. In 1996, the foundation made it possible to monitor patients at home, thanks to a system called ECG-Home.

Digital education is a one-way street. It is true that this type of learning is still partially resisted, but it must be emphasized that distance learning is regulated by the MEC, in order to increase the educational offer in the country specifically.

Institutions recognized by the Ministry of Education follow a series of requirements to ensure the training of qualified professionals and are constantly monitored to maintain quality.

We need to let technology break down barriers. Health and knowledge are essential to the formation of an equal and balanced nation. We still have a long way to go, but good solutions are emerging to make virtual care as effective and assertive as face-to-face care, with a direct impact on the health care of the population.

straight!

* Marcos Vinicius Tatageba is CEO and Founder of Educar Mais, the educational group that manages the Brazilian School of Medicine (EBRAMED)

* Leonardo Jorge Cordero de Paula is a cardiologist and Academic Director of the Brazilian School of Medicine (EBRAMED). He specializes in health administration and education, and is currently a clinical physician at Incor – Instituto do Coração


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