Impact of a Telemedicine Network on Neonatal Mortality in a State in Northeast Brazil

Mattos, Sandra da Silva; Mourato, Felipe Alves; Araújo, Juliana Sousa Soares de; Moser, Lúcia Roberta Didier Nunes; Hatem, Thamine de Paula; Albuquerque, Fernanda Cruz de Lira; Mariano, Nicoly Negreiros de Siqueira; Gomes, Renata Gonçalves

doi:10.1089/pop.2018.0087

Cited by 8 publications

(9 citation statements)

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“…15 The PC-Net has previously demonstrated a significant impact in detecting CHD and in lowering neonatal mortality in Paraíba, Brazil. 10,11 In this report, we highlight the importance of a telemedicine environment, with available online supervision, for the learning curve of the pediatricians in interpreting echocardiographic images of CHD.…”

Section: Discussionmentioning

confidence: 97%

“…The method proved efficient in increasing the levels of detection of CHD and had a positive impact in reducing the neonatal morbidity and mortality in that state. 10,11 PC-Net's methodology and results have been reported elsewhere. 10,12 Despite these positive aspects, no previous study was conducted to analyze the impact of the PC-Net in the learning curve of pediatricians interpreting echocardiographic images.…”

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confidence: 99%

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Echocardiography Learning by Pediatricians While Screening Congenital Heart Disease with the Aid of Telemedicine

Mattos¹,

Moser²,

Diógenes³

et al. 2020

Telemedicine and e-Health

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Background: Congenital heart disease (CHD) affects 1% of all newborns and is a major public health problem. Most children with CHD benefit from early diagnosis to optimize management. However, in many places there are no specialized professionals to do so. Introduction: A screening method for CHD was developed between two states in Northeast Brazil. It was based upon the performance of an echocardiogram by local pediatricians with support of pediatric cardiologists through telemedicine. Objective: To determine if the continuous performance of examinations together with online supervision increased the level of understanding of the pediatricians about the echocardiograms. Methods: Pediatricians received online support to perform echocardiograms for 7 years (2012-2018). Although the project aimed to teach them to acquire images and send to the cardiologists for analysis and interpretation, they were encouraged to describe their own diagnostic impressions. The level of agreement between pediatricians and cardiologists was calculated. Results: A large number (n = 3,951) echocardiograms was analyzed. From them, 2,818 were classified as abnormal, inconclusive, or normal by both the pediatricians and the cardiologists. The 7-year analysis demonstrated an overall agreement of 63.7%. As for the final diagnosis, it was possible to compare 1,457 echocardiograms. The combined analysis of the 7 years demonstrated agreement in 62.2%. Discussion: The screening of CHD under online support led to more in-depth learning of echocardiography by the pediatricians. This approach potentialized the accuracy of the screening through the years. Conclusion: By enrolling in a telemedicine-based screening program, the pediatricians' degree of understanding of echocardiography increased considerably.

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

Echocardiography Learning by Pediatricians While Screening Congenital Heart Disease with the Aid of Telemedicine

Mattos¹,

Moser²,

Diógenes³

et al. 2020

Telemedicine and e-Health

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“…(Machoñ et al;2019). O CirCor representou, portanto, a fonte de informações e aconselhamento sobre demandas que afetavam, diretamente, a população da Paraíba, a saber: 1) escassez e má distribuição de profissionais de saúde especializados na Paraíba; 2) quantidade e qualidade insuficientes de dados sobre crianças, tipo de severidade das cardiopatias apresentadas e acesso a cuidados médicos; e 3) ausência de infraestrutura de rede de assistência para crianças cardiopatas, levando ao que era conhecido como "fila da morte" (crianças nascidas com cardiopatias congênitas esperavam por tratamento, que não era prestado em tempo hábil, resultando em demandas judiciais e gerando custos exorbitantes para o Sistema Único de Saúde (SUS) (Mattos et al, 2018). Esta "fila da morte" levou o Ministério Público Federal a instaurar, em agosto de 2011, Inquérito Civil Público para sanar o problema, forçando o Governo da Paraíba a reavaliar escolhas e recorrer ao CirCor, estabelecendo-se, doravante, um padrão inusitado de cooperação transnacional e aprendizagem institucional do Estado, no setor saúde, com foco em três aspectos centrais: 1) qualificar recursos locais para garantir maior eficiência e resolutividade às demandas do sistema de saúde da Paraíba;…”

Section: A Paradiplomacia E a Influência De Comunidades Epistêmicas Na Cid Em Saúde Na Paraíba: A Criação Da Rcp E Das CCunclassified

“…Nesse âmbito, o convênio firmado entre o Governo do Estado da Paraíba (representando, aqui, um ente subnacional), e o CirCor (em forma de Comunidade Epistêmica), possibilitou a implementação e o desenvolvimento de um projeto de Cooperação Internacional em Saúde (em um contexto de diplomacia paralela ou "paradiplomacia"), no período de 2011 a 2018, e teve como dois principais objetivos: 1) viabilizar o tratamento de crianças carentes, portadoras de doenças cardíacas; e 2) reduzir os indicadores de morbimortalidade de crianças com cardiopatias congênitas, na Paraíba, por meio da implantação de uma Rede de Cardiologia Pediátrica (RCP) na região (Hazin et al, 2015). Esta parceria de assistência integrou 21 maternidades do Estado e o Complexo de Pediatria Arlinda Marques, abrangendo, além da capital João Pessoa, outras unidades hospitalares, no interior do Estado, descentralizando, assim, o atendimento, por meio das anuais Caravanas do Coração (CC), para as seguintes cidades: Campina Grande, Patos, Sousa, Cajazeiras, Guarabira, Monteiro, Esperança, Itaporanga, Picuí, Santa Rita, Catolé do Rocha, Princesa Isabel e Pombal (Mattos et al, 2018).…”

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Cooperação Internacional, Entes Subnacionais E Comunidades Epistémicas Na Criação E No Desenvolvimento Da Rede De Cardiologia Pediátrica Na Paraíba

Tavares

2021

REI

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Resumo: O artigo esboça uma visão de conjunto, não exaustiva, dos alicerces e da evolução histórica da Cooperação Internacional para o Desenvolvimento em Saúde, em nível internacional e no Brasil, para aferir a existência de arranjo cooperativo descentralizado, advindo de convênio firmado entre o Governo do Estado da Paraíba e a Organização Não Governamental (ONG) Círculo do Coração, de Pernambuco, no âmbito de uma cooperação transnacional e estruturante em saúde. A pesquisa investiga a criação, o desenvolvimento, os objetivos e os resultados da Rede de Cardiologia Pediátrica da Paraíba, entre 2011 e 2018, associando as principais bases teórico-conceituais, campos de atuação e interesses envolvendo a cooperação técnico-científico-transnacional, por meio de Estudo de Caso, e tendo por base a influência da Cooperação Internacional para o Desenvolvimento, da Paradiplomacia e das Comunidades Epistêmicas, no setor saúde, com as seguintes unidades de análise: a assistência sanitária a crianças e gestantes paraibanas, a troca de expertises entre atores nacionais e internacionais e a criação da Rede de Cardiologia Pediátrica e das Caravanas do Coração na Paraíba. Conclui-se que houve efetivação de assistência no setor saúde e difusão internacional dos resultados obtidos, resultantes da arquitetura do convênio em epígrafe.

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“…In a psychiatric setting, meeting spaces need to feel private and psychologically safe for patients and staff [53]. Hospital information systems can also improve collaboration in healthcare settings [54], improve communication between healthcare providers and service users [55] and improve accessibility of healthcare, leading to improved patient outcomes [56][57][58][59].…”

Section: Resourcesmentioning

confidence: 99%

Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study

Shoesmith

Chua

Giridharan

et al. 2020

Int J Ment Health Syst

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Background: There is strong evidence that collaborative practice in mental healthcare improves outcomes for patients. The concept of collaborative practice can include collaboration between healthcare workers of different professional backgrounds and collaboration with patients, families and communities. Most models of collaborative practice were developed in Western and high-income countries and are not easily translatable to settings which are culturally diverse and lower in resources. This project aimed to develop a set of recommendations to improve collaborative practice in Malaysia. Methods: In the first phase, qualitative research was conducted to better understand collaboration in a psychiatric hospital (previously published). In the second phase a local hospital level committee from the same hospital was created to act on the qualitative research and create a set of recommendations to improve collaborative practice at the hospital for the hospital. Some of these recommendations were implemented, where feasible and the outcomes discussed. These recommendations were then sent to a nationwide Delphi panel. These committees consisted of healthcare staff of various professions, patients and carers. Results: The Delphi panel reached consensus after three rounds. The recommendations include ways to improve collaborative problem solving and decision making in the hospital, ways to improve the autonomy and relatedness of patients, carers and staff and ways to improve the levels of resources (e.g. skills training in staff, allowing people with lived experience of mental disorder to contribute). Conclusions: This study showed that the Delphi method is a feasible method of developing recommendations and guidelines in Malaysia and allowed a wider range of stakeholders to contribute than traditional methods of developing guidelines and recommendations.

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Impact of a Telemedicine Network on Neonatal Mortality in a State in Northeast Brazil

Cited by 8 publications

References 2 publications

Echocardiography Learning by Pediatricians While Screening Congenital Heart Disease with the Aid of Telemedicine

Echocardiography Learning by Pediatricians While Screening Congenital Heart Disease with the Aid of Telemedicine

Cooperação Internacional, Entes Subnacionais E Comunidades Epistémicas Na Criação E No Desenvolvimento Da Rede De Cardiologia Pediátrica Na Paraíba

Creation of consensus recommendations for collaborative practice in the Malaysian psychiatric system: a modified Delphi study

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