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Abstract(s)
As limitações de orçamento impostas ao setor da saúde em Portugal têm tornado a tele-saúde numa necessidade nas diferentes especialidades médicas no âmbito da teleconsulta, auxílio de diagnósticos diferenciais, auxílio na interpretação, partilha de exames complementares de diagnóstico e até na área da educação médica. Com a tecnologia ao dispor da ciência, impera rentabilizar e potenciar os recursos físicos e materiais já existentes em hospitais nacionais, que por falta de equipa qualificada se tornam devolutos com consequências importantes na resposta às necessidades dos utentes associados aos serviços hospitalares. É neste contexto nacional e com os olhos postos nos benefícios globalmente aceites, que em 2015 foi criada a Norma de Orientação Clínica para Telepatologia/Patologia Digital tendo por base a experiência do serviço de Telepatologia implementado em Janeiro de 2013 no serviço de Anatomia Patológica do Centro Hospitalar Universitário da Cova da Beira. O projeto contou com uma alteração no desenho do processo das análises de amostras de material biológico o que justificou a pertinência do estudo que teve a finalidade de quantificar os ganhos no tempo de diagnóstico e os resultados económicos decorrentes da implementação de um serviço que prescindiu da dependência do processo associado ao envio das amostras para análise externa ao Centro Hospitalar Universitário da Cova da Beira, EPE. Através do estudo foi possível concluir que houve um ganho médio de cerca de 8 dias após a implementação do projeto de Patologia Digital aparentemente não relacionado com o facto do número de exames anuais realizados pelo laboratório ter diminuído nem com a diferença entre o número de exames por mês, por técnico. Foi ainda possível a comparação entre o processo de análise de uma amostra pelo serviço de Anatomia Patológica anterior à criação deste modelo de telepatologia, e o processo de análise das mesmas após a sua implementação, que inclui macroscopia realizada pelo Técnico de Anatomia Patológica sob supervisão do Anatomopatologista, digitalização da totalidade da lâmina e o envio para análise remota por parte do médico patologista. Por fim, a avaliação deste processo revelou não haver perda de qualidade na avaliação da amostra suportando que a existência de um banco de imagens e o processo de dupla verificação está associado a melhorias do diagnóstico.
The Portuguese health system’s budget constraints have made telemedicine a necessity in different medical specialties for consultation, differential diagnosis assistance, helping with interpretation, sharing complementary exams and even for medical education purposes. With technology within science’s reach, it’s logical and of key importance to maximize the existing resources which by lack of qualified personnel fall victim to abandonment or underutilization, greatly impacting the ability to fulfil the community’s healthcare expectations and needs. Within this context, and by taking into account the globally accepted telehealth benefits, 2015 saw the creation of “Norma de Orientação Clínica para Telepatologia/Patologia Digital” which built on the experimental Telepathology service implemented in January 2013 at Centro Hospitalar da Cova da Beira’s Anatomical Pathology service. The experiment redesigned the process of analyzing biological material samples which highlights the relevance of this research as a way to quantify the improvements regarding the necessary amount of time for a diagnosis as well as the economical advantages of no longer depending on external laboratories to provide such service to Centro Hospitalar Universitário da Cova da Beira, EPE. By the end of this research it was possible to establish that on average, there was an 8-day gain after the Patologia Digital project took off with results apparently neither related with a decrease in the number of exams per year nor the difference in number of exams per month per technical professional. It was also possible to compare the analysis process of the same sample through the previous process and through the new process including macroscopy done by the Anatomical Pathology technician under the Anatomopathologist’s supervision, full digitization of the slide and sending it to a remote location to be analyzed by a Medical Pathologist. In addition, the evaluation of this process revealed no reduced quality concerning the accuracy on evaluating a sample, further supporting the idea that an image pool and double-checking are associated with improvements in diagnosis.
The Portuguese health system’s budget constraints have made telemedicine a necessity in different medical specialties for consultation, differential diagnosis assistance, helping with interpretation, sharing complementary exams and even for medical education purposes. With technology within science’s reach, it’s logical and of key importance to maximize the existing resources which by lack of qualified personnel fall victim to abandonment or underutilization, greatly impacting the ability to fulfil the community’s healthcare expectations and needs. Within this context, and by taking into account the globally accepted telehealth benefits, 2015 saw the creation of “Norma de Orientação Clínica para Telepatologia/Patologia Digital” which built on the experimental Telepathology service implemented in January 2013 at Centro Hospitalar da Cova da Beira’s Anatomical Pathology service. The experiment redesigned the process of analyzing biological material samples which highlights the relevance of this research as a way to quantify the improvements regarding the necessary amount of time for a diagnosis as well as the economical advantages of no longer depending on external laboratories to provide such service to Centro Hospitalar Universitário da Cova da Beira, EPE. By the end of this research it was possible to establish that on average, there was an 8-day gain after the Patologia Digital project took off with results apparently neither related with a decrease in the number of exams per year nor the difference in number of exams per month per technical professional. It was also possible to compare the analysis process of the same sample through the previous process and through the new process including macroscopy done by the Anatomical Pathology technician under the Anatomopathologist’s supervision, full digitization of the slide and sending it to a remote location to be analyzed by a Medical Pathologist. In addition, the evaluation of this process revealed no reduced quality concerning the accuracy on evaluating a sample, further supporting the idea that an image pool and double-checking are associated with improvements in diagnosis.
Description
Keywords
Análise Custo-Benefício Gestão de Recursos Tele-Saúde Telemedicina Telepatologia