Telediagnóstico em Cardiologia na Atenção Básica: estudo da avaliabilidade no Estado da Bahia.

Abstract

Cardiovascular diseases are the main cause of morbidity and mortality in Brazil, causing a great impact on public health indicators. Telediagnóstico in cardiology of the Telehealth Brasil Redes National Program supports the consolidation of Health Care Networks ordered by Primary Care within the Unified Health System, using Information and Communication Technologies to perform diagnostic support services across geographic distances and temporal and qualifying health professionals, strengthening Primary Care, improving the quality of care and increasing resolvability. The objective of this research was to assess the evaluability of the telediagnostic service in cardiology of the Scientific Technical Nucleus of Telehealth, in Primary Care in the state of Bahia. This was a pre-assessment or evaluability study, with a qualitative approach, of the actions of the telediagnostic service in cardiology. The study also described the implementation of the service in the state of Bahia, characterized the program in its theory and practice from the modeling of the service, analyzed the objectives, activities and results observed in the concrete practice of the service, as well as identified and analyzed focuses for its improvement. Fifteen interviews were conducted with managers responsible for implementing the service in the city, with professionals involved in supporting the diagnosis and issuing of reports, in the request and execution of the electrocardiogram exam, in addition to users who used the service. The results revealed convergences between the objectives, activities and results proposed by the program among the key informants, with a broadening of the look at the objectives and reorganization of the results. They were: timely diagnosis and early intervention, better monitoring of patients with cardiovascular diseases, qualification of the clinic of non-specialist physicians, qualification of referrals to Specialized Care, faster regulatory processes, greater resoluteness in Primary Care, improvement of the process of work, improved access to the service and to the specialist, reduced costs for patients and the municipality, improved quality of life for patients and reduced mortality. It presented as a limitation the impossibility of conducting direct observation in the field, due to the moment of pandemic and the imposed measures of social distancing, in addition to being a case study in a small population municipality and a health region in the state of Bahia, which does not constitute elements to extrapolate these results to other contextual characteristics. The study revealed that the telediagnosis service in cardiology developed by Telessaúde Bahia, in partnership with the Minas Gerais Telehealth Center, is sufficiently implemented to be the object of a systematic evaluation, focusing on future evaluations, a careful cost analysis. benefit through studies of economics, as well as effect from health indicators focused on cardiovascular diseases in the Bahia scenery.