Effect of a Structured Multilevel Telehealth Service on Hospital Admissions and Mortality During COVID-19 in a Resource-Limited Region in Brazil: Retrospective Cohort Study.

Background: The COVID-19 pandemic represented a great stimulus for the adoption of telehealth and many initiatives in this field have emerged worldwide. However, despite this massive growth, data addressing the effectiveness of telehealth with respect to clinical outcomes remain scarce.

Objective: The aim of this study was to evaluate the impact of the adoption of a structured multilevel telehealth service on hospital admissions during the acute illness course and the mortality of adult patients with flu syndrome in the context of the COVID-19 pandemic.

Synchronous Teleconsultation and Monitoring Service Targeting COVID-19: Leveraging Insights for Postpandemic Health Care.

Background: Although a great number of teleconsultation services have been developed during the COVID-19 pandemic, studies assessing usability and health care provider satisfaction are still incipient.

Objective: This study aimed to describe the development, implementation, and expansion of a synchronous teleconsultation service targeting patients with symptoms of COVID-19 in Brazil, as well as to assess its usability and health care professionals' satisfaction.

Methods: This mixed methods study was developed in 5 phases: (1) the identification of components, technical and functional requirements, and system architecture; (2) system and user interface development and validation; (3) pilot-testing in the city of Divinópolis; (4) expansion in the cities of Divinópolis, Teófilo Otoni, and Belo Horizonte for Universidade Federal de Minas Gerais faculty and students; and (5) usability and satisfaction assessment, using Likert-scale and open-ended questions.

Development and Evaluation of a Mobile Decision Support System for Hypertension Management in the Primary Care Setting in Brazil: Mixed-Methods Field Study on Usability, Feasibility, and Utility.

Background: Despite being an important cardiovascular risk factor, hypertension has low control levels worldwide. Computerized clinical decision support systems (CDSSs) might be effective in reducing blood pressure with a potential impact in reducing cardiovascular risk.

Objective: The goal of the research was to evaluate the feasibility, usability, and utility of a CDSS, TeleHAS (tele-hipertensão arterial sistêmica, or arterial hypertension system), in the care of patients with hypertension in the context of a primary care setting in a middle-income country.

The Impact of mHealth Interventions: Systematic Review of Systematic Reviews.

Background: Mobile phone usage has been rapidly increasing worldwide. mHealth could efficiently deliver high-quality health care, but the evidence supporting its current effectiveness is still mixed.

Objective: We performed a systematic review of systematic reviews to assess the impact or effectiveness of mobile health (mHealth) interventions in different health conditions and in the processes of health care service delivery.

The Impact of a Clinical Decision Support System in Diabetes Primary Care Patients in a Developing Country.

Background: Telehealth strategies have the potential to improve diabetes care, but there is a lack of evidence about the impact of these strategies in developing countries. Our objective was to analyze the feasibility, usability, and clinical impact of a decision support system (DSS) in Brazilian primary care diabetes patients.

Materials And Methods: This was a quasi-experimental study that included type 2 diabetes primary care patients >40 years of age.

2,000,000 Electrocardiograms by Distance: An Outstanding Achievement for Telehealth in Brazil.

Our aim is to describe the evolution of the telediagnostic service of the Telehealth Network of Minas Gerais (TNMG), a public telehealth service in Brazil. It started in 2006 with 82 cities, restricted to electrocardiography analysis. Currently it extends to 772 cities--performing also Holter, ambulatory blood pressure monitoring and retinography analysis--and 48 ambulances in the north of the state, as part of a myocardial infarction system of care.

Audit of primary care electrocardiograms sent as emergency to a telehealth service - the Telehealth Network of Minas Gerais, Brazil.

The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that has performed electrocardiogram (ECG) analysis since 2005. From February to March 2014, 28% of ECGs were classified as "emergency" by the primary care tele-health sites. This quasi-experimental study aimed to investigate the reasons behind the high number of emergency ECGs being sent in, the implementation of corrective actions, and an assessment of the impact of these actions.

Clinical Quality Control of a Large-Scale Teleconsultation Service.

The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service in Brazil that assists 722 municipalities in the state of Minas Gerais. As a large-scale teleconsultation service, it was important to implement clinical quality control to guarantee the quality of the service. Our aim is to describe the audit of the teleconsultation responses performed by TNMG.

Teleconsultations to Provide Support for Primary Care Practitioners and Improve Quality of care--the Experience of a Large Scale Telehealth Service in Brazil.

This observational restrospective study was designed to assess teleconsultations performed by a public telehealth service in Brazil. A satisfaction survey was used to assess the impact on clinical practice. A total of 63,975 teleconsultations were performed, from April 2007 to November 2014.

One Million Electrocardiograms of Primary Care Patients: A Descriptive Analysis.

In 722 cities of Minas Gerais (Brazil), primary care patients can have their ECGs remotely interpreted by cardiologists of the Telehealth Network of Minas Gerais (TNMG), a public telehealth service. As of December 2014, more than 1.9 million ECGs were interpreted.

Factors associated with the use of a teleconsultation system in Brazilian primary care.

Background: The Telehealth Network of Minas Gerais (TNMG) is a public telehealth service that provides support to primary healthcare in Minas Gerais, Brazil, performing teleconsultation and tele-electrocardiography. The aim of this study was to assess teleconsultation requests received by the TNMG and to investigate the factors associated with low teleconsultation utilization in most municipalities.

Materials And Methods: A cross-sectional study was carried out including 214 municipalities.

Prevalence of normal electrocardiograms in primary care patients.

Objective: Knowing the proportion the proportion of normal and abnormal electrocardiograms (ECGs) in primary care patients allows us to estimate the proportion of exams that can be analyzed by the general practitioner with minimal training in ECG interpretation, in addition to being epidemiologically relevant. The objective of this study is to assess the prevalence of normal ECGs in primary care patients.

Methods: All digital ECGs analyzed by the cardiologists of Telehealth Network of Minas Gerais (TNMG) in 2011 were evaluated.

Telemedicine application in the care of diabetes patients: systematic review and meta-analysis.

Background: The impact of telemedicine application on the management of diabetes patients is unclear, as the results are not consistent among different studies. The objective of this study is to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the impact of telemedicine interventions on change in hemoglobin A1c (HbA1c), blood pressure, LDL cholesterol (LDL-c) and body mass index (BMI) in diabetes patients.

Methods: Electronic databases MEDLINE, Cochrane Central Register of Controlled Trials and LILACS were searched to identify relevant studies published until April 2012, supplemented by references from the selected articles.