Brazil has the most advanced health care facilities and services in South America, and is an early adopter of several technologies in the region. In this article we will discuss the development of the e-health market in Brazil and the areas with the largest potential of growth.
As Brazil’s population becomes older, with life expectancy taking large leaps every year, and an announced freeze on rises of federal budgets, it is now urgent for Brazil to look into smarter investments to provide health services to the population. The Brazilian constitution assures that everyone must have access to healthcare, and digital and e-health systems seem to be the most straightforward way to achieve it.
There is clear evidence that massive investments in technology will be coming both from the private and public sectors over the next few years. The Brazilian Health Ministry announced in December 2016 an investment of BRL 67 million in 3 supercomputers, that will be able to integrate all the current computer systems used by the government, sharing resources and unifying electronic medical records into a single system. The public healthcare system, known as SUS, is being migrated from paper to electronic medical records, but even though the deadline for the migration to the new system was due early December 2016, only about 35% of the SUS units adhered to the electronic system by that time.
Adoption of Telemedicine and Tele-education
Since its very first projects in Brazil, dating back to the mid 90’s, telemedicine is considered one of the e-health systems with the broadest adoption both in private and public sectors. The great majority of private hospitals have telemedicine facilities and they are also commonly found in university hospitals and also in the some of SUS network of hospitals.
SUS has been rolling out across several municipalities a programme called Programa Telessaúde Brasil Redes, which is intended to bring healthcare using telemedicine to areas with no access to a minimum level of healthcare service. Since launch in 2007, the programme was further expanded to other areas, and proven that it was an important tool not only to provide education to the professionals, but also to reduce the number of patient transfers to other hospitals or facilities with 70%, avoiding long and unnecessary trips for patients.
However, one of the greatest challenges not only for this programme but for telemedicine in general, may not be in the technology or its acceptance, but the current legislation. Consultations are not allowed to happen exclusively online or via telephone, and personal contact between a professional and the individual is always necessary, limiting the full capability of this type of technology.
Telemedicine has also been tested with success outside traditional hospital environments, in a partnership between the highway administrator CCR Group and the hospital Israelita Albert Einstein, which are using telemedicine to transmit vital signs data about patients directly from the accident location from the moment the victim receives first aid until arrival at the hospital. This allows doctors to monitor and intervene in the care of the patient before they arrive at the hospital. This pilot project started at the end of 2016, and is expected to be rolled out to public hospitals that receive patients involved in these types of accidents.
Another area which has been widely explored with expansion of internet usage in Brazil is tele-education services in relation to health, or telehealth. Generally speaking, Brazilians are extremely concerned about health issues and services related to information and education are often well sought after. Mobile operators consider health related educational services as one of their most promoted value added services. Google also realised the potential of the market as the engine began to display knowledge graphs with detailed information about the most common diseases in March 2016. The knowledge graph service for diseases was developed in Google’s Brazilian offices, which was the second country to have this service rolled out.
Knowledge Management and Research
All IT systems related to SUS are managed by DATASUS, a department within SUS responsible for managing health, financial and administration information for the entire organisation. DATASUS has systems to collect and process information related to the registration of new cases of diseases, immunisation, outbreaks, among other things. Unfortunately the systems available through DATASUS are not fully integrated with one another.
In addition to these, there are sporadic projects such as the “Risco Dengue”, announced in 2010 by the Brazilian Health Ministry. Launched as a pilot project in 2010, the tool uses criteria and historical data to determine the risk for new outbreaks of dengue fever in different areas of Brazil. The results generate heat maps that allows the municipalities to take preventive measures in the areas where there are high risks for epidemy.
Use of Healthcare Information Systems
Tools such as scheduling of consultations and examinations online have been available and actively used by Brazilians for several years. Services for online scheduling of consultations are popular particularly among health insurance companies like Amil, Bradesco Saúde and Unimed. Through these services you can login, and based on the profile of your health insurance plan you can browse through a list of specialists available and book an appointment online.
Automated services via SMS that send reminders about appointments are very commonly used as well, even in small private clinics. One of the companies that provides this type of service in Brazil is iClinic, which claims that this system reduces missed appointments by up to 30%.
Laboratories and hospitals also push e-mail reminders to patients prior to examinations or tests, especially in cases where there are preparation or recommendations that must be taken prior to the appointment or procedure. Some laboratories also provide test results to platforms which can be accessed and retrieved online by patients.
Markets yet to be explored
If there are markets such as telemedicine that are already fully exploited, there are a few other ones that are still inexistent such as ePrescribing. Most prescriptions issued by clinics or even at smaller health centers are handwritten, and the options for medicine prescriptions are looked up in thick books. There is no centralised systems to handle prescriptions electronically, so the only form of control that exists is the retention of the prescription at the drugstore.
Other areas that are not totally untouched but still have lot of potential in the Brazilian market are within m-Health and IoT. Following the quick rise of the number of diseases related to sedentarism like diabetes, a disease with extremely high mortality rates in Brazil, combined with the fact that Brazilians are extremely concerned about their health, creates a great market for real time monitoring solutions via the internet.