Belo Horizonte Telehealth: Incorporation of Teleconsultations in a Health Primary Care System

Introduction: The Belo Horizonte Telehealth program, a pioneer in telemedicine within the Brazilian National Health System (Sistema Único de Sauùde in Portuguese ), was implemented by the Belo Horizonte City Health Department (SMSA-BH) in 2004. The purpose of the present study is to analyze opinions on the obstacles, difficulties, and suggestions on the use of teleconsultations. Methods: Semi-structured interviews were conducted among primary healthcare professionals and health managers. Content analysis for the latter was carried out using NVIVO ® software to categorize responses. Simple descriptive quantitative aspects were analyzed to verify the use of the system over the years by the primary care unit (PCU) professionals. Results: The difficulties encountered were related to the use of the system, inadequate response to teleconsultation requests, infrastructure problems, lack of practicality for the use of the program, difficulty in incorporating the program into the organizational culture, and lack of managerial support. Changes in management organization over the years have interfered with the use of the teleconsultation system. The most requested specialties were neurology, cardiology, endocrinology, and angiology. Discussion: The main suggestions for increasing the number of teleconsultations requests included dissemination of information and prioritization by the management; improvement of the infrastructure; organization of the time and the agenda of the PCU professional; training the professionals for its use; and preconditioning the referrals to secondary level care to a previous teleconsultation. Conclusion: Teleconsultations need to be incorporated in the daily routine of PCUs by both managers and health professionals to assure its usage and improve the quality of care.