Transcript Establishing a Canada-Brazil Telehealth Partnership

Establishing a Canada-Brazil
Telehealth Partnership
Establishing Canadian expertise and products
and helping Brazil
to establish, expand and manage
their own telehealth and telemedicine networks
This presentation has been
prepared by:
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Infotelmed Communications Inc www.infotelmed.ca
LCE Communications reg
www.LCE.ca
with the collaboration of the
www.edumed.net
Edumed Institute, Sao Paulo, Brazil
LCE
LCE Communications
Montreal . Canada
Infotelmed and LCE
Brazil: a snapshot
• 182 million inhabitants
• 50% of Latin America’s output
• 8th world economy
• US$ 15 B Foreign Direct Investment
• 7th largest world software market, US$ 10 B
• among world’s 10 largest health sectors
New socialist government prioritized
health and education as main goals
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Brazil’s ICT sector
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US$ 35 billion revenue, growth @ 10%
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annual investment expected @ US$ 12 billion
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6 fixed telephony providers
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40 million telephony users, growth @ < 2%
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18 cellular providers
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40 million cellular subscribers, growth @ > 20%
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20 million Internet users, 30 million by 2005
Infotelmed and LCE
Brazil’s health care sector
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Overall Statistics
• US$ 50 B industry yearly turnover (public+ private)
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every citizen entitled to Unified Health System
7 K hospitals, up to 3.33 beds/1,000 inhab.
15 K clinics & labs, 54 K pharmacies, 145 health coops
40% yearly growth (private)
Main trends for sector
• home care, telemedicine
• improved quality
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Brazil’s health care sector
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Three largely separate systems
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free public Unified Health System
(SUS) covers 75% of population,
paid by Brasilia’s budget
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private health plan system covers
23% of population (40 million souls),
includes medical insurance, medical cooperatives, selfmanagement health plans, community health plans
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private medical care, covers 2% of the population, self-paid
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Brazil’s health care sector
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Status of Health Care System
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private medicine and university-based public medicine very
advanced:
AIDS/HIV & infectious diseases, cardiology & cardiac surgery,
oncology, plastic surgery, reconstructive surgery, immunology
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public health mostly in sorry state, low level of wages and per
capita investment
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improving in efficiency and coverage due to IT investments,
education and training, managerial reform
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But Brazil, like Canada, has
health care challenges:
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Demographics, Brazil 2002
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vast territory, 8 M sq.km (Canada at 9 M)
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182 million inhabitants, median age 27 yrs
17 births/1,000 pop., annual growth 1.15%
86% literacy, 30% < 8 years of studies
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Population Distribution
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north / west vast expanses (like Canada), densities < 1 per sq.km
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high concentration coastline capitals (Rio at 291/sq.km)
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average 17 inhabitants per sq.km
76% urban, 24% rural, 89% < 50,000 inhabitants, 65% < 20,000
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Infotelmed and LCE
But Brazil, like Canada, has
health care challenges:
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Distribution of Wealth
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min. wage for 15% in richest southern states, up to 59% northeast
minimum wage at US$ 80 / month for 40% of working force
income 20% richest = 27 times 20% poorest
29% below poverty level
Health Status
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life expectancy at birth: male: 67 years, female: 75 years
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infant mortality < 1 yr old: 10/1,000 born alive, northeast 18, south 6
chronic and degenerative diseases account for 57% to 65% deaths
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But Brazil, like Canada, has
health care challenges:
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Aboriginal Population
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large Indian reserves
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among poorest of poor
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8 million inhabitants (1500’s)
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today < 600,000
Aboriginal Health
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National Indian Health Service
public health service under construction, family health concepts
barefoot community health agents (natives)
disease profile still related to poverty, low immune defenses
Infotelmed and LCE
But Brazil, like Canada, has
health care challenges:
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Health Care Professionals, 2002
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360K physicians (208/100,000), 170K dentists (96/100,000)
90K registered nurses (52/100,000), 500K nurse assistants
(289/100,000), 170K other allied health
total at about 1.3 million professionals
Large Regional Disparities
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65 to 554 physicians per 100,000;
São Paulo state alone accounts for
95,000 physicians (26,5%)
160 counties with 93% of physicians,
3,400 remaining with 7%
43% counties < 10 resident physicians, 38% have none
Infotelmed and LCE
Opportunities for Canadian telehealth
(TH) expertise and products
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Telehealth Status
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just starting: pioneers are
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large and rich private hospitals, excellence centres in public universities
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telehealth yet to be adopted by public health sector
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few succesful experiments underway, growing fast
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potential is enormous:
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size of country, very large distances
highly unequal resource distribution and service provision
absolute lack of services in so many areas
attention to Canadian leadership, achievements
Infotelmed and LCE
Infotelmed: who we are
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Federally incorporated research and consulting
company established since 1998, www.infotelmed.ca
Focus: telehealth, health care telematics, telemedicine, e-health
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Under contract, federal & provincial governments, diverse organizations:
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Evaluation of telehealth networks and projects, more than 50 urban, rural and
isolated communities for Health Canada, resulting in substantial reports
Reports: telehealth industry competitiveness, profile and capability in Canada
(Industry Canada) - final reports available online
Needs assessments and analyses
Development, Strategic & Operational plans - implementation of telehealth
Member, The Keston Group, www.keston.com
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international group of consultants & researchers
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medical imaging, medical physics and telehealth
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Who is involved at Infotelmed
Jocelyne Picot, BA, MA, PhD, President of Infotelmed
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Author of several reports and articles and frequent speaker on the
subject of telehealth
Adjunct Professor at McGill University
Experienced consultant and researcher in the field of telehealth and
telemedicine:
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developed and implemented unique tools and mixed qualitativequantitative approach to needs assessments and evaluation of telehealth
Consultant to the largest French-speaking hospital in Canada recognized as a Canadian expert in the field of telehealth
Founding member of the Canadian Society of Telehealth (CST)
Infotelmed and LCE
LCE Communications: who we are
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Consulting & engineering office, since 1990
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services in telecom and telehealth systems
worldwide contracts, Brazil as niche market
mandates cover:
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LCE Communications
Montreal . Canada
telemedicine applications, telehealth programs, telecom technologies
LCE carries mandates with Brazilian institutions
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LCE
technical & scientific partnerships, technology transfer & distribution
Edumed Institute mandate:
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to mediate and negotiate projects with governmental entities &
private institutions - aim: financing, grants, donations
to establish technical and scientific partnerships:
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health care, telemedicine, telehealth, computer-mediated education
Infotelmed and LCE
Who is involved at LCE
Luiz C. Esteves, P.Eng., M.Sc.
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principal consultant and director of LCE Communications
consultant to TIW, Telus, SRT, medium / large corporations
consultant to Brazilian companies
manager at space programs, telecom projects, R&D
assistant professor at Catholic University, Rio
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Author, McGraw-Hill book company, 1981
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in the works - telehealth
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The Edumed Institute –
the Brazilian partner
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not-for-profit NGO organization (2000)
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develops and partner with telehealth and educational projects
headquartered in Campinas, Brazil’s foremost technological
area with representations countrywide
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coordinates consortium of 25 public/private institutions
work relies on partnerships with:
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21 staff members and associates
universities, hospitals, government, private sectors
R&D in IT and digital communications applications
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development of distance health education and training
Infotelmed and LCE
Who is involved at Edumed
Dr. Renato E.M. Sabbatini, Ph.D.
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Post-doctoral fellow, Max Planck Institute, Neurobiology, Germany
Ph.D. (Physiology), School of Medicine, Sao Paulo University
Founder, director of The EduMed Institute
President, Latin American and Caribean Federation, International
Medical Informatics Association (IMIA – LAC)
Member, Internet Commission of the American Medical Informatics
Association (AMIA)
Dr. Sabbatini is a visionary and enthusiastic adopter and promoter
of telehealth and CME programs in Brazil
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Edumed: projects which need
Canadian expertise*
* products & content
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Amazon Telehealth Project
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Pediatric Oncology Network Project
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videoconference and telemedicine initiative via hi-speed network,
protocols and clinical directives for cardiovascular health services
Telemedicine for Family Health
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videoconferencing and Internet network
of specialized hospitals for cancer treatment
Brazilian Telecardiology Network
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telemedicine services, indigenous people
wireless IP distance education network for municipal health secretariats
UNIMED health cooperative
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telemedicine / distance education project, neuroradiology subproject
Infotelmed and LCE
Project One – first steps which
have already been taken
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Initial efforts have been:
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Health Canada - Amazon Telehealth Project highlights
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CIDA - submission of Amazon Telehealth Project highlights
Industry Canada –preliminary discussions and meetings
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Already happening with Edumed:
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case conferences set up with CHUM in Montreal
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supply, satellite-based, home care, portable wireless VC products
translation & certification proposal, cardiac triage software
participation of Dr. Picot, International Telehealth Seminar, May, Brazil
participation of Dr. Sabbatini, CST Quebec conference, October
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Infotelmed and LCE
Next steps: bilateral visits and
feasibility study
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Feasibility study
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aimed at information and intelligence gathering
visits to Edumed Institute by the Canadian consultants
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in-depth study of relevant documentation from:
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interviews and information gathering in the region served by Edumed
CIDA, Health Canada, WHO, the IADB and International Trade
complete needs assessment report, obstacles, recommendations
target: selection / definition of appropriate Canada-Brazil joint project
Bilateral visits
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Field visit by LCE and ICI to undertake study
Dr Sabattini’s visit to various telehealth sites in Canada, attendance
at CST conference in Quebec city, October 2004
Infotelmed and LCE
Involvement of other partners
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AudiSoft
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Colabnet
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user-controlled satellite bandwidth allocation software & home
care wireless support solutions (Smart Labrador partner)
March Networks
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portable wireless narrowband videoconference & telemedicine unit
home care wideband support solutions
Smart Labrador, MUN Faculty of Medicine
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telemedicine and CME/CHE content support (IC ’s Smart Communities)
Infotelmed and LCE
Thank you!
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We appreciate you giving us your time
to participate in this presentation
And now we need to know:
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what further steps do you propose we take?
what can Industry Canada do to help move
this joint project forward?
contact information: [email protected] [email protected]
company information: www.LCE.ca www.infotelmed.ca
Infotelmed and LCE