JMIR Publications

ABSTRACT

Background:

With the arrival of the pandemic, telemedicine has been widely used to provide medical care, which also is possible to be used to assist patients in regions far from urban centers that are difficult to access, such as riverside communities in the Brazilian Amazon region.

Objective:

To build a model of digital primary health care using technology, that allows for remote medical consultation and evaluate the patient´s experience.

Methods:

This is a single-centre prospective study, in the pre-construction phase of a digital product. This early study last twelve-week, from Sep 27 to Dec 15, 2021.The study was carried out linking a basic health unit in the city of Santarém and a university hospital in the city of Sao Paulo, distant from one another about 2,500 km in a straight line. a total of 585 appointments was planned in a total of 195 available hours for scheduling, where at the end of each consultation, the attending physician answers an administrative survey form, and the patient answers and satisfaction survey.

Results:

There were 35 hours of total internet outage between locations. 243 appointments were scheduled, with 23 missed. The average duration of consultations was between 15 and 20 minutes, 81% were first consultations, 51% had a new diagnosis of acute illness, 3% needed referral to a specialist, 91% of the demands were solved with support from the local health team, 99 % of appointments had some kind of problem with audio or video. 95% of patients were satisfied with the service, 87% had previous experience with videoconferencing, 77% reported that their demand was fully solved.

Conclusions:

This teleconsultation project between São Paulo and Santarém showed that it is possible to offer medical care from more developed locations to communities far from urban centers, as is the case of Paisandu district. Beyond the feasibility of the infrastructure acceptance and satisfaction among patients were high. This healthcare supply model proves to be functional and financially viable, can and should be expanded nationally or perhaps internationally, to regions lacking medical assistance. Escalation of the project does not seem too difficult, once infrastructure issues are solved.