Avaliação da assertividade diagnóstica por Telemedicina em área offshore

Abstract

Telemedicine, defined as the use of information technology and communication services for the benefit of health care and distance support, is a solution to several issues, including the lack of specialists, such as an estimated 40 specialists for each 10,000 Americans living in rural areas, compared with 134 per 10,000 urban residents. In addition, it may also assist in the issue that 71% of hospital emergency care of patients with health insurance was due to non-emergency conditions or conditions that could be treated on an outpatient basis; In the United States alone, this represented over 92 million emergency room visits. It is also noteworthy that for US elderly adults, 38% of medical care (including 27% in medical emergencies) could have been replaced by telemedicine. Telemedicine is also an essential cost-cutting resource as medical care is estimated to increase by 5.8% between 2018 and 2025, representing about 19.9% of US GDP in 2025. Specifically in remote areas, such as offshore platforms, the on-board health-care Telemedicine system is a key factor in reducing healthcare coverage costs and expenses.The overall objective of this study is to evaluate the diagnostic assertiveness in remote areas where there is Telemedicine and health professional, in relation to cases where there is no support from Telemedicine and / or health professional. Among the specific objectives, we can mention the application of a support system in the management of chest pain cases in remote areas; show a profile of the medical cases of employees in remote areas and, finally, the cost-effectiveness of Telemedicine implementation and applicability with health professionals in remote areas. This is a cross-sectional study, which evaluated 22,000 medical appointments from January 2015 to January 2019, with a population of employees from various oil and gas companies, attended by a multinational center in a capital of the Brazil. We collected data from the company (International Health Care) in Brazil, regarding care through Telemedicine. From January 2015 to January 2019, 22,643 offshore consultations were performed, of which 907 generated a non-urgent landing or referral to the hospital due to medical recommendation and 97 air evacuations (MEDEVAC – urgent medical evacuation performed by air ambulance). Of these 97 MEDEVACs, 26 were due to cardiologic complaints. Through the results obtained, we evidenced positive consequences of the applicability of Telemedicine and the presence of health professionals in remote areas. There is a higher resolution in the localities with health professionals, and this is even greater when we have Telemedicine with videoconference. Disembarking less, there is a higher resolution with the maintenance of patients on board, a number significantly higher when there is no such support. It is also verified that with the cardiologic diagnostic kit and health professional, the indication of the performed disembarks were all correct and necessary, confirmed in the in-hospital care.