It’s no secret that present-day Brazil is reliant on WhatsApp and other instant messaging services. With an estimated 62 percent of the population on WhatsApp, people hold all sorts of important conversations on mobile communication apps. Journalists interview their sources, major football clubs negotiate million-dollar player transfers, and even members of the current government have reportedly sent out meeting invitations via WhatsApp. The use of instant messaging as a tool to bring companies closer to their customers is equally ubiquitous. Do you need to schedule a bath for your dog? Ping your groomer on WhatsApp. They’ll even send you a photograph of your fluffy friend when he is ready to be collected.

But what about healthcare? Would you be comfortable having a medical consultation via WhatsApp? Perhaps taking a photo of that mysterious rash on your stomach, asking “does this look infected?” followed by a screaming emoji?

</span></p> <p><span style="font-weight: 400;">This comes under the vast umbrella of what is known as &#8220;telemedicine,&#8221; which broadly involves the use of telecommunications and information technology to provide clinical healthcare at a distance. And this week, a resolution published by the Federal Council of Medicine (CFM) proposes the </span><a href="https://portal.cfm.org.br/index.php?option=com_content&amp;view=article&amp;id=1087:&amp;catid=3"><span style="font-weight: 400;">regulation</span></a><span style="font-weight: 400;"> of telemedicine in Brazil.</span></p> <p><span style="font-weight: 400;">In actual fact, informal telemedicine is already a reality in the country. As it is with dog groomers, personal trainers, and even psychologists, patients will often exchange messages with their trusted clinical specialists via <a href="https://brazilian.report/money/2018/06/27/brazil-internet-smartphones/">mobile phone</a>. A recent survey by Cello Health, a healthcare marketing group, shows that 87 percent of Brazilian doctors have already answered their patients&#8217; questions on WhatsApp — in the U.S. and the UK, the rate is 2 and 4 percent, respectively.</span></p> <p><span style="font-weight: 400;">With the population already well attached to their WhatsApp accounts, a simple exchange of mobile phone messages can serve as &#8220;pre-consultations&#8221; to those who may be reticent to seek medical advice. Furthermore, on the follow-up side of things, it can be useful for people who struggle to find the time in a busy schedule to make repeated visits to the doctor.</span></p> <p><span style="font-weight: 400;">However, this informal side of telemedicine is purely a complement to traditional face-to-face medical care. It is seen as an added convenience for a population which is increasingly on the move, and on their phones.</span></p> <h2>The future of Brazilian telemedicine</h2> <p><span style="font-weight: 400;">The CFM resolution to regulate telemedicine has far more ambitious plans, however. Beyond the possibility of consultations and monitoring at a distance, the document also opens up the potential for &#8220;telediagnosis&#8221; and even &#8220;telesurgery.&#8221;</span></p> <p><span style="font-weight: 400;">Among the current formal applications of telemedicine, the diagnostic side of things is the most used in Brazil. There are projects in place across the country wherein hospitals send images via email to be diagnosed remotely. A cancer hospital in the city of Barretos, in the state of São Paulo, is one such example. Photographs of lesions were sent to remote specialists who helped in the diagnosis of skin cancer. The program is particularly effective in locales where there is a lack of specialists on hand.</span></p> <p><span style="font-weight: 400;">The resolution regulates the possibility of online doctors appointments, those of which already occur to some informal extent. However, it does demand that treatment courses must involve at least one face-to-face element, usually in the form of a first consultation.</span></p> <p><span style="font-weight: 400;">&#8220;Telemedicine services can never substitute the constitutional commitment to provide full and universal care,&#8221; says the document. Exceptions may be made in remote areas, otherwise the CFM demands that long-distance healthcare services be preceded by a prior relationship between the patient and medical professional.</span></p> <p><span style="font-weight: 400;">There is also some controversy about this among the medical community. While on one hand remote doctors appointments may be more convenient for patients and reduce waiting times for consultations, there is also the fear that the diagnoses made via the internet themselves may be less accurate and take longer than a physical evaluation.</span></p> <p><span style="font-weight: 400;">One of the most innovative sections of the resolution concerns so-called &#8220;telesurgeries&#8221;. Also called remote surgeries, these are procedures which involve the use of robotics, controlled by surgeons from a distance. Such surgeries require necessary infrastructure, almost non-existent in Brazil, as well as other medical professionals on hand to assist.

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SocietyFeb 06, 2019

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BY Euan Marshall

Euan Marshall is a Scottish journalist living in São Paulo. He is co-author of A to Zico: An Alphabet of Brazilian Football.