INFRA-STRUCTURE PERSPECTIVES FOR THE DEVELOPMENT OF TELEHEALTH IN BRAZIL AND LATIN AMERICA

1. "Strategies for Open and Permanent Access to Scientific Information in Latin America: Focus on Health and Environmental Information for Sustainable Development"

2. INFRA-STRUCTURE PERSPECTIVES FOR THE DEVELOPMENT OF TELEHEALTH IN BRAZIL AND LATIN AMERICA Luiz Ary Messina Dr.Ing.Dipl.Inf. Gerente RUTE messina@rute.rnp.br www.rute.rnp.br

3. Hospital São Paulo e Escola Paulista de Medicina - Unifesp, (São Paulo) • Hospital das Clínicas - FM USP, (São Paulo) • Hospital Universitário de São Paulo/LSITEC - USP (São Paulo) • Hospital das Clínicas da Unicamp (Campinas/SP) • Instituto Dante Pazzanese de Cardiologia (São Paulo) • Hospital Universitário Pedro Ernesto - UERJ (Rio de Janeiro) • Fundação Oswaldo Cruz, (Rio de Janeiro) • Hospital Universitário Prof. P. E. de São Thiago - UFSC (Florianópolis) • Hospital das Clínicas Prof. Arnóbio Marques - UFPE (Recife) • Hospital Universitário Walter Cantídio - UFC (Fortaleza) • Hospital da Irmandade da Santa Casa de Misericórdia, (Porto Alegre) • Hospital Universitário Getúlio Vargas - UFAM (Manaus) • Hospital das Clínicas – UFMG, (Belo Horizonte) • Hospital Universitário - UFES (Vitória) • Hospital Universitário Prof. Alberto Antunes - UFAL (Maceió) • Hospital Universitário Prof. Edgar Santos - UFBA (Salvador) • Hospital das Clínicas - UFMA (São Luís) • Hospital Universitário Lauro Wanderley -UFPB (João Pessoa) • Hospital Universitário - UFPR (Curitiba) Institutions participating – January 2006

4. Which infra-estructure services are essential for a Telemedicine University Network? • Enable the communication infra-structure • Guarantee the service quality and integration • Stimulate collaborative research, medical assistance and interinstitutional courses • Involve the main actors: government, academy and enterprise • Provide indicators and evaluate tele-services • Enable demonstration projects • Organize specialties groups

5. Redecomep www.rnp.br National Education and Research Network – RNP, Education and Research Community Network , Redecomep, MCT, FINEP

6. Vitória – ES, 1Gbps Redecomep www.rnp.br, Local Consortium Metrovix

7. Medical Videoconferences Collaborative Work Case Study Teleconsulting and Image Telediagnostic Experiences Distant Education Continuous Education ISCMPA FM-USP Unifesp Ufes

8. Federal Medical Council Resolução CFM nº 1.643/2002 Art. 1º - Defines Telemedicine as the Medicine practice through the use of interactive audio-visual communication methodologies, with the aim to assist, educate and research in Health. • Support to Workshops: • I Workshop de Telemedicina e Telesaúde dos Conselhos de Medicina da Região Norte do Brasil, Faculdade de Medicina • da Universidade do Estado do Amazonas (UEA) , March 2007, • Manaus; • I Workshop de Telemedicina e Telessaúde dos Conselhos Regionais de Medicina da Região Nordeste, Conselho Federal • de Medicina e o Conselho Regional de Medicina do Estado de • Pernambuco, May 2007, Recife

9. Telemedicine practive • Ethics • Riscs • Responsibilities • Payment • Licensing • Qualification • Standards • Legislation

10. Applications in: dermathology, oncology radiology, surgery, cardiology, psychiatry, home care, rehabilitation, pediatry, obstetrics, ginecology and neurology. • Health professionals are becoming more creative in telehealth applications. • Most health professionals will be affected by telehealth applications. • Introducing Telehealth disciplines in the Health Faculties.

11. IGARASSU RECIFE CAMARAGIBE CABO DE SANTO AGOSTINHO Health Family Program Video on demand VC Sessions Distant Courses Hospital das Clínicas da UFPE

12. Telehealth UFMG  Health Family Program Rede BH Telessaúde - Secretaria Municipal de Saúde Minas Telecardio - Secretaria de Estado da Saúde Internato Rural UFMG  National and international VC-Sessions Supported Specialties : Angiology, Ocupational, Cardiology, Surgery, Infectious diseases, Dermathology, Endocrinology, Gastrology, Ginecology, Hemathology, Nefrology, Neurology, Oncology, Orthopedics, Ophtalmology, Pediatrics, Pneumology, Reumathologia, Urology, Nursing and Dentistry.

13. O Canal Saúde (Health Channel) • 1995 • 6 hours/week transmission, 2 channels • 1 hour/week production • 2006 • 38 hours/week transmission,11 channels • 4 ½ hours/week production

14. “Pediatrics Radiology” VC-Sessions monthly Medical Missions for Children Oncology Geriatrics Teenagers

15. Hospital Universitário Prof. Polydoro Ernani de São Thiago hu 87 67 13 10 20 37 15 125 17 57 43 26 14 17 25 266 87 100 30 34 85 34 17 Health State Secretary of Santa Catarina - Magnetic Ressonance, Flow of exams and diagnosis Cyclops / LabIMed / HU-UFSC

16. Image acquisition Prepare to send Connect to the specialist Accept connection Send images Receive images Send diagnosis Receive diagnosis Follow-up TELEDIAGNOSIS On and Off-line Ultrasound, X-Ray, Tomo, MR

17. Colombia

18. Mexican Telemedicine Program http://www.centec.gob.mx • Ing. Nancy Gertrudiz Salvador • Dirección e-saludnancy.gertrudiz@salud.gob.mx Telecardiology Tele-education Telesurgery Parallel Session e-health , Lisbon, April 28th -29th 2006

19. CEDIA (Consorcio Ecuatoriano para el Desarrollo de Internet Avanzado) , Launch event of the Ecuatorian Advanced Academic Networks – September 2006 Image Telediagnosis On-Line Demonstration, between Quito (EC) and Vitória (BR)

20. National Telehealth Program and Institutional activities in Brazil • Integration of Federal Ministries iniciatives : Health, Science & Technology, Education, Communication and Defense • Portaria n° 561, March 16th 2006, Ministry of Health constitutes the Permanent Commission of Telehealth • Portaria n° 35, January 1st 2007, Ministry of Health constitutes the National Telehealth Program in the Primary Attendance, 9 States and 900 remote municipalities • RUTE – Telemedicine University Network, Ministry of Science and Technology, Janeiro 2006

21. Telehealth applied to Primary Care and the Family Health Program 9 Reference Centers Regions of implementation 9 x 100 remote sites 25.000 teams  100.000.000 people www.saude.gov.br/sgtes

22. Rute Expansion

23. List of Institutions – Telemedicine University Network RUTE – 01/2007 HU da Universidade Federal do Maranhão da UFMA Faculdade de Enfermagem da UNIFAP Maternidade Escola Assis Chateaubriand da UFC Hospital Universitário Walter Cantídio da UFC HU João de Barros Barreto da UFPAHU Betina Ferro de Souza da UFPA Hospital Universitário da UFPI HU Ana Bezerra da UFRNHospital de Pediatria da UFRN Maternidade Escola Januário Cicco da UFRNHU Onofre Lopes da UFRN Faculdade de Medicina da UFRR HU Alcides Carneiro da UFCG HU Lauro Wanderley da UFPB Hospital Getúlio Vargas da UFAM Hospital das Clínicas da UFPE Faculdade de Medicina da UFAC HU Profº Alberto Antunes da UFAL Faculdade de Medicina Veterinária da UFT Hospital Universitário da UFS Centro Pediátrico Hosannah de Oliveira da UFBAMaternidade Climério de Oliveira da UFBA HU Prof. Edgar Santos da UFBA Faculdade de Medicina da UNIR HU Júlio Müller da UFMT Hospital das Clínicas da UFG HU Cassiano Antônio de Moraes da UFES HU Maria Aparecida Pedrossian da UFMS Hospital de Clínicas da UFUHospital Escola da UFTMHospital Universitário da UFJF Hospital das Clínicas da UFMG Hospital das Clínicas da Unicamp Hospital das Clínicas da FMUSPHospital São Paulo da UnifespHospital Unimar HU de São Paulo / LSITEC da USP Instituto Dante Pazzanese Instituto de Psiquiatria da UFRJInstituto de Puer. e Ped. Martagão Gesteira da UFRJInstituto de Neurologia Deolindo Couto da UFRJInstituto de Doenças do Tórax da UFRJInstituto de Ginecologia da UFRJHospital Escola São Francisco de Assis da UFRJMaternidade Escola da UFRJClementino Fraga Filho da UFRJHU Antônio Pedro da UFF Gaffrée e Guinle da UNIRIOCanal Saúde (Fiocruz)HU Pedro Ernesto da UERJ Hospital de Clínicas da UFPR HU da UFSC Hospital Universitário da UFSMHU Dr. Muguel Riet Correa Júnior da FURGHospital Escola da UFPELIrmandade da Santa Casa de Misericórdia (ISCMPA)Hospital das Clínicas da URGS Phase 1 Phase 2 Faculties Telehealth Program

24. On going Extensions • Agreement - Health Ministry and National Education and Research Network – RNP, January 2007 • Excellence and Innovation Laboratory for e-health in Latin America, in Belo Horizonte; Proposal to the European Commission Framework Program 7 • Internet2, Health Sciences, Proposal to a Bilateral Cooperation

25. Agreement - Health Ministry and National Education and Research Network – RNP, January 2007

26. Excellence and Innovation Laboratory for e-health in Latin America, in Belo Horizonte; Proposal to the European Commission Framework Program 7, may 8th 2007 • Proposal: Health Care Observation and Alerting Network for Latin America • Based on the Brazilian National Health Program and Health Family Program • Coordination: Fraunhofer IGD, Germany • Partner countries: Germany, Belgium, Italy, Spain, Greece, Brazil, Mexico, Colombia, Ecuador, Uruguay, Nicaragua

27. Internet2, Health Sciences, Proposal to a Bilateral Cooperation • Participation at the Spring 2007 Internet2 Member Meeting – Health Sciences, April 22nd - 25th • Identifying areas of interest for collaboration between Internet 2 and RNP related to Health Sciences networking infrastructure and applications • Preparation for the Autumn 2007 Internet2 Member Meeting

28. Workshop University Hospitals and the Integration Education, Health, Science and Technology Local: Brasília Date: June 2007 Ministério da Educação - Coordenação-Geral de Acompanhamento das IFES e HUs Ministério da Saúde - Departamento de Gestão em Educação na Saúde Ministério da Ciência e Tecnologia

29. Que a saúde chegue mais depressa e mais barata a todos ! Let Health achieve quicker and cheaper everyone! José Mariano Gago Ministro da Ciência, Tecnologia e Ensino Superior de Portugal IV Forum Ministerial Europa – América Latina e Caribe, Abril 2006