title: Formative second opinion: qualifying health professionals for the unified health system through the Brazilian Telehealth Program.
abstract: BACKGROUND
  The World Health Organization's World Health Assembly WHA58.28/2005 Resolution recommends the adoption of e-health by health systems of State Members. The Brazilian Telehealth Program integrates the national policy of education for health that combines many strategies with complementary foci, including technical-level workers, undergraduate students of the 14 health professions, residency, postgraduate courses, support, and continuing health education at work. The Brazilian Unified Health System has approximately 1.5 million workers. The objectives of this work areas are as follows: to define a new concept, the so-called "formative second opinion" (FSO); to describe the methodology for its construction; and to show its structure as well as the number of FSOs already available, classified according to the field of knowledge.
  
  
  METHODS
  The Brazilian Telehealth Program was created in 2007 and has already offered around 41,000 teleconsultations. Based on their relevance and pertinence, 710 questions asked through teleconsulting by health professionals were selected. The questions were handled so that each question should not contain any specific information about patients, preserving professional confidentiality. For each question, a bibliographic review was performed and used to build a structured and standardized answer, based on the best available scientific and clinical evidence.
  
  
  RESULTS
  This question-and-answer combination, originated thru teleconsulting, created by the Brazilian Telehealth Program, was termed the FSO and has been made available, with open access for all health professionals, at the Web site of the Program. Among the total number of 710 FSOs, diagnosis and treatment support corresponded to 238 questions (33.5%), followed by primary healthcare (90 questions) and then by subjects concerning oral health (68 questions) and nursery (39 questions). The structure and design of the FSO are also shown.
  
  
  CONCLUSIONS
  The FSO helps professionals and health workers to use the already produced best evidence and scientific knowledge to solve their daily practice questions, improving, qualifying, and increasing the resolution of primary healthcare by the Unified Health System in Brazil. Oral health is frequently asked about by professionals, matching the high prevalence of oral disease in primary healthcare.
authors.affiliation: 1 Department of Orthodontics and Pediatric Dentistry, Telehealth and Teledentistry Center, Faculty of Dentistry, University of São Paulo , São Paulo, Brazil .
authors.forename: Ana Estela
authors.initials: AE
authors.lastname: Haddad
authors.forename: Mary Caroline
authors.initials: MC
authors.lastname: Skelton-Macedo
authors.forename: Verônica
authors.initials: V
authors.lastname: Abdala
authors.forename: Caren
authors.initials: C
authors.lastname: Bavaresco
authors.forename: Daniele
authors.initials: D
authors.lastname: Mengehel
authors.forename: Camilla Galatti
authors.initials: CG
authors.lastname: Abdala
authors.forename: Erno
authors.initials: E
authors.lastname: Harzheim
mesh_terms: D001938:Brazil; D004496:Education, Continuing / Q000379:methods / Q000592:standards; D006282:Health Personnel / Q000193:education*; D006801:Humans; D017216:Telemedicine / Q000379:methods / Q000592:standards*
keywords: e-health; education; formative second opinion; health education; health information management; medical; telemedicine