The Telehealth for Indigenous Health in the Northeast is a project funded by the Ministry of Health and covers six Special Indigenous Sanitary Districts (DSEIs), with 56 implemented access points benefiting healthcare professionals who serve approximately 160,000 indigenous people. The project highlights the use of teleconsultation as an important tool for minimizing physical and geographical barriers between indigenous health centers and the specialized care network.

Teleconsultation consists of a conversation, mediated by information and communication technologies, between the primary indigenous healthcare professional and the IMIP specialist, with the aim of clarifying doubts about clinical procedures, health actions, and work process-related issues.

Of the teleconsultations carried out in 2022, 72.2% resulted in the avoidance of referrals to specialized consultations, and in 93% of cases there was an improvement in the quality of care for indigenous patients (self-reported data by physician users). In addition, ethnic contextualization was also incorporated into the tele-regulation process.

Teleconsultation is the care of patients through information and communication technologies. This new care modality was implemented at IMIP on an emergency basis at the beginning of the pandemic in 2020, with the aim of reducing patient and caregiver visits to the hospital, avoiding gatherings of vulnerable individuals, while still ensuring follow-up care for these patients.

In 2022, as in-person access restrictions became less frequent worldwide, efforts were made to understand the role of remote care within healthcare pathways for patients with mobility limitations or difficulties, or seeking to reduce travel time and environmental emissions. More than 20,000 teleconsultations were carried out, bringing the total to over 90,000 since implementation. Services were provided across 13 medical specialties, as well as nursing, speech therapy, occupational therapy, and social work.

We highlight the successful experience of the adult chemotherapy nursing team. This new care modality was implemented in 2020 and continued in 2022 as a routine practice for the nursing team. Its goals include avoiding unnecessary trips to the hospital for patients with inadequate lab results for chemotherapy, minimizing oncology patients’ exposure to COVID-19 and other hospital-acquired infections, clarifying questions about symptom control medications and adverse reactions, and guiding patients on lab result changes.

In 2023, more than 14,000 nursing tele-screenings were performed, totaling over 50,000 since implementation. In all, more than 3,000 patients were seen, 72% of whom live in the interior or metropolitan region of Recife.

A pilot project in internal medicine was launched in December 2022 with the goal of offering IMIP patients the possibility of a digital entry point that allows their clinical situation to be initially assessed by an internal medicine specialist. In addition to providing remote care, this specialist also directs the patient to the most appropriate level of care within the health network, thereby avoiding unnecessary travel to IMIP.

In early 2023, physicians at IMIP’s Adult Emergency Care Unit (SPA-Adulto) gained access to a remote support service for electrocardiogram reports. With this service, reports are issued within minutes of the exam being performed. Having this information available in a timely manner allows SPA-Adulto physicians to optimize the time to initiate appropriate treatments. Acting quickly is one of the key factors in improving survival in many situations, especially high-risk ones such as acute myocardial infarction and cardiac arrhythmias.

IMIP joined this Electrocardiographic Telediagnosis service (TeleECG) through the General Telehealth Directorate of the Pernambuco State Health Secretariat, which locally implements the National Telediagnosis Offering of the Ministry of Health, operated by the Telehealth Center of the Hospital das Clínicas of the Federal University of Minas Gerais. The service works by collecting the patient’s electrocardiographic signals at the IMIP Adult Emergency Unit using a digital ECG device.