Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology

Bibliographic Details
Main Author: Catapan,Soraia de Camargo
Publication Date: 2020
Other Authors: Calvo,Maria Cristina Marino
Format: Article
Language: eng
Source: Revista Brasileira de Educação Médica (Online)
Download full: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022020000100304
Summary: Abstract: Medical teleconsultation can apply different technologies to mediate the communication between doctors and patients located in different geographic spaces. Its implementation has been encouraged in several countries, under the assumption of its potential to overcome distances, offering health care in a shorter time, reducing costs and workload. The scarcity of evidence about these allegations, in addition to the need of clarifying the situations in which teleconsultation can be adequate, safe and effective, have generated debates, intensified after the publication of Resolution N. 2.227/2018 by the Federal Council of Medicine, which allowed medical teleconsultation, containing principles and recommendations. This article aims to analyze the international experience of medical teleconsultation, including the media and technologies employed, their use, benefits and limitations, highlighting and associating the controversial points of the resolution recently published by the Federal Council of Medicine. An integrative review of the literature was carried out to identify these experiences from January 2013 to February 2019. Of the 1912 identified references, 42 were analyzed after applying the exclusion and inclusion criteria. Data collection and analysis indicated that telephone, e-mail, e-consulting systems, video or a combination of those have been used in several countries to mediate the doctor-patient relationship. Its use goes ranges from diagnosis to treatment, monitoring, management and prescription, both in acute and chronic conditions. The main benefits include less demand for face-to-face consultations, with the possibility of doctors’ workload management, allowing systems’ reorganization. Moreover, the teleconsultation allows overcoming distance barriers, in a flexible and convenient way for patients, possibly contributing to continuity of care, patient autonomy and resource savings, in the latter case, when it avoids work absenteeism due to face-to-face consultation. Some limitations of the teleconsultation include the inability to perform the physical examination, so it is not recommended for the first consultation. Technical and communication difficulties for each media, as well as its inadequacy for some groups of patients, are other important barriers. Data security regarding diagnosis and clinical precision, patients’ and professionals’ acceptance and the need for organizational adjustments are also considered limitations of the teleconsultation. The success of the teleconsultation depends on the integration of different organizations and professionals, aiming to maximize its potential and improve service design, encompassing clinical, technical, organizational and context issues. Therefore, it is important to investigate in which contexts, situations and conditions the teleconsultation can be beneficial, safe and effective for patient care, as well as the most appropriate means of communication.
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spelling Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by TechnologyTeleconsultationTelemedicineRemote ConsultationPatient CareAbstract: Medical teleconsultation can apply different technologies to mediate the communication between doctors and patients located in different geographic spaces. Its implementation has been encouraged in several countries, under the assumption of its potential to overcome distances, offering health care in a shorter time, reducing costs and workload. The scarcity of evidence about these allegations, in addition to the need of clarifying the situations in which teleconsultation can be adequate, safe and effective, have generated debates, intensified after the publication of Resolution N. 2.227/2018 by the Federal Council of Medicine, which allowed medical teleconsultation, containing principles and recommendations. This article aims to analyze the international experience of medical teleconsultation, including the media and technologies employed, their use, benefits and limitations, highlighting and associating the controversial points of the resolution recently published by the Federal Council of Medicine. An integrative review of the literature was carried out to identify these experiences from January 2013 to February 2019. Of the 1912 identified references, 42 were analyzed after applying the exclusion and inclusion criteria. Data collection and analysis indicated that telephone, e-mail, e-consulting systems, video or a combination of those have been used in several countries to mediate the doctor-patient relationship. Its use goes ranges from diagnosis to treatment, monitoring, management and prescription, both in acute and chronic conditions. The main benefits include less demand for face-to-face consultations, with the possibility of doctors’ workload management, allowing systems’ reorganization. Moreover, the teleconsultation allows overcoming distance barriers, in a flexible and convenient way for patients, possibly contributing to continuity of care, patient autonomy and resource savings, in the latter case, when it avoids work absenteeism due to face-to-face consultation. Some limitations of the teleconsultation include the inability to perform the physical examination, so it is not recommended for the first consultation. Technical and communication difficulties for each media, as well as its inadequacy for some groups of patients, are other important barriers. Data security regarding diagnosis and clinical precision, patients’ and professionals’ acceptance and the need for organizational adjustments are also considered limitations of the teleconsultation. The success of the teleconsultation depends on the integration of different organizations and professionals, aiming to maximize its potential and improve service design, encompassing clinical, technical, organizational and context issues. Therefore, it is important to investigate in which contexts, situations and conditions the teleconsultation can be beneficial, safe and effective for patient care, as well as the most appropriate means of communication.Associação Brasileira de Educação Médica2020-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-55022020000100304Revista Brasileira de Educação Médica v.44 n.1 2020reponame:Revista Brasileira de Educação Médica (Online)instname:Associação Brasileira de Educação Médica (ABEM)instacron:ABEM10.1590/1981-5271v44.1-20190224.inginfo:eu-repo/semantics/openAccessCatapan,Soraia de CamargoCalvo,Maria Cristina Marinoeng2020-03-25T00:00:00Zoai:scielo:S0100-55022020000100304Revistahttp://www.educacaomedica.org.br/https://old.scielo.br/oai/scielo-oai.phprevista@abem-educmed.org.br||revista@educacaomedica.org.br1981-52710100-5502opendoar:2020-03-25T00:00Revista Brasileira de Educação Médica (Online) - Associação Brasileira de Educação Médica (ABEM)false
dc.title.none.fl_str_mv Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
title Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
spellingShingle Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
Catapan,Soraia de Camargo
Teleconsultation
Telemedicine
Remote Consultation
Patient Care
title_short Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
title_full Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
title_fullStr Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
title_full_unstemmed Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
title_sort Teleconsultation: an Integrative Review of the Doctor-Patient Interaction Mediated by Technology
author Catapan,Soraia de Camargo
author_facet Catapan,Soraia de Camargo
Calvo,Maria Cristina Marino
author_role author
author2 Calvo,Maria Cristina Marino
author2_role author
dc.contributor.author.fl_str_mv Catapan,Soraia de Camargo
Calvo,Maria Cristina Marino
dc.subject.por.fl_str_mv Teleconsultation
Telemedicine
Remote Consultation
Patient Care
topic Teleconsultation
Telemedicine
Remote Consultation
Patient Care
description Abstract: Medical teleconsultation can apply different technologies to mediate the communication between doctors and patients located in different geographic spaces. Its implementation has been encouraged in several countries, under the assumption of its potential to overcome distances, offering health care in a shorter time, reducing costs and workload. The scarcity of evidence about these allegations, in addition to the need of clarifying the situations in which teleconsultation can be adequate, safe and effective, have generated debates, intensified after the publication of Resolution N. 2.227/2018 by the Federal Council of Medicine, which allowed medical teleconsultation, containing principles and recommendations. This article aims to analyze the international experience of medical teleconsultation, including the media and technologies employed, their use, benefits and limitations, highlighting and associating the controversial points of the resolution recently published by the Federal Council of Medicine. An integrative review of the literature was carried out to identify these experiences from January 2013 to February 2019. Of the 1912 identified references, 42 were analyzed after applying the exclusion and inclusion criteria. Data collection and analysis indicated that telephone, e-mail, e-consulting systems, video or a combination of those have been used in several countries to mediate the doctor-patient relationship. Its use goes ranges from diagnosis to treatment, monitoring, management and prescription, both in acute and chronic conditions. The main benefits include less demand for face-to-face consultations, with the possibility of doctors’ workload management, allowing systems’ reorganization. Moreover, the teleconsultation allows overcoming distance barriers, in a flexible and convenient way for patients, possibly contributing to continuity of care, patient autonomy and resource savings, in the latter case, when it avoids work absenteeism due to face-to-face consultation. Some limitations of the teleconsultation include the inability to perform the physical examination, so it is not recommended for the first consultation. Technical and communication difficulties for each media, as well as its inadequacy for some groups of patients, are other important barriers. Data security regarding diagnosis and clinical precision, patients’ and professionals’ acceptance and the need for organizational adjustments are also considered limitations of the teleconsultation. The success of the teleconsultation depends on the integration of different organizations and professionals, aiming to maximize its potential and improve service design, encompassing clinical, technical, organizational and context issues. Therefore, it is important to investigate in which contexts, situations and conditions the teleconsultation can be beneficial, safe and effective for patient care, as well as the most appropriate means of communication.
publishDate 2020
dc.date.none.fl_str_mv 2020-01-01
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dc.publisher.none.fl_str_mv Associação Brasileira de Educação Médica
publisher.none.fl_str_mv Associação Brasileira de Educação Médica
dc.source.none.fl_str_mv Revista Brasileira de Educação Médica v.44 n.1 2020
reponame:Revista Brasileira de Educação Médica (Online)
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reponame_str Revista Brasileira de Educação Médica (Online)
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