Implementation of a telecardiology system in the state of Minas Gerais: the Minas Telecardio Project.
BACKGROUND
Although cardiovascular diseases are the main cause of morbimortality in Brazil, the access of small-town populations to electrocardiography and cardiology assessment is limited. The use of telecardiology to assist the access of distant towns to electrocardiography and a second opinion in cardiology is promising; however, it has not been formally assessed.


OBJECTIVE
To assess the feasibility of implementing a low-cost public telecardiology system in small Brazilian towns.


METHODS
A total of 82 towns in the state of Minas Gerais, with a population < 10,500 inhabitants, presenting > 70% coverage by the Family Health Program (Programa Saude da Familia-PSF), local government compliance and internet access, were selected. Each town was supplied with digital electrocardiography (ECG) device and a team was trained. The implementation was coordinated by HC/UFMG, together with four university hospitals in the state of Minas Gerais (UFU, UFTM, UFJF and UNIMONTES). The ECG assessments were carried out in the towns and sent through the Internet for prompt analysis by an on-duty telecardiology team. Online and offline discussions on the medical cases were carried out through the Internet, as well as refreshment courses.


RESULTS
During the implementation period, a total of 253 health professionals were trained. From July 2006 to November 2008, the project assisted 42,664 patients, with a total of 62,865 ECG assessments being performed. A total of 2,148 emergency cases were treated, as well as 420 teleconsultations. The intermediate evaluation showed good acceptance of the implemented technology and a 70% decrease in patient referrals to other reference centers.


CONCLUSIONS
The use of the customary resources in informatics to assist the access of small-town populations to electrocardiography and specialized cardiology assessment is feasible.
Ribeiro
Antonio Luiz P
AL
Universidade Federal de Minas Gerais, Belo Horizonte, MG. antonior@cardiol.br
Alkmim
Maria Beatriz
MB
Cardoso
Clareci Silva
CS
Carvalho
Gláucio Galeno R
GG
Caiaffa
Waleska Teixeira
WT
Andrade
Monica Viegas
MV
Cunha
Daniel Ferreira da
DF
Antunes
Andre Pires
AP
Resende
Adélson Geraldo de A
AG
Resende
Elmiro Santos
ES
D001938:Brazil; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D004562:Electrocardiography / Q000191:economics / Q000379:methods*; D006801:Humans; D017150:Public Sector; D017216:Telemedicine / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data