establishing a canada-brazil telehealth partnership establishing canadian expertise and products and...
TRANSCRIPT
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
Infotelmed and LCE
This presentation has been prepared by:
LCELCE Communications
Montreal . Canada
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
Infotelmed and LCE
Brazil: a snapshot
• 182 million inhabitants
• 50% of Latin America’s output
• 8th world economy
• US$ 15 B Foreign Direct Investment
New socialist government prioritized health and education as main goals
• 7th largest world software market, US$ 10 B• among world’s 10 largest health sectors
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Brazil’s ICT sector
US$ 35 billion revenue, growth @ 10%
annual investment expected @ US$ 12 billion
6 fixed telephony providers
40 million telephony users, growth @ < 2%
18 cellular providers
40 million cellular subscribers, growth @ > 20%
20 million Internet users, 30 million by 2005
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Brazil’s health care sector 1
Overall Statistics• US$ 50 B industry yearly turnover (public+ private)• 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 2
Three largely separate systems
free public Unified Health System
(SUS) covers 75% of population,
paid by Brasilia’s budget
private health plan system covers
23% of population (40 million souls),
includes medical insurance, medical cooperatives, self-management health plans, community health plans
private medical care, covers 2% of the population, self-paid
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Brazil’s health care sector 3
Status of Health Care System
private medicine and university-based public medicine very advanced:
AIDS/HIV & infectious diseases, cardiology & cardiac surgery,
oncology, plastic surgery, reconstructive surgery, immunology
public health mostly in sorry state, low level of wages and per capita investment
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: 1
Demographics, Brazil 2002
vast territory, 8 M sq.km (Canada at 9 M) 182 million inhabitants, median age 27 yrs 17 births/1,000 pop., annual growth 1.15% 86% literacy, 30% < 8 years of studies
Population Distribution north / west vast expanses (like Canada), densities < 1 per sq.km
high concentration coastline capitals (Rio at 291/sq.km) average 17 inhabitants per sq.km 76% urban, 24% rural, 89% < 50,000 inhabitants, 65% < 20,000
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But Brazil, like Canada, has health care challenges: 2
Distribution of Wealth 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 life expectancy at birth: male: 67 years, female: 75 years 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: 3
Aboriginal Health 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
Aboriginal Population large Indian reserves among poorest of poor 8 million inhabitants (1500’s) today < 600,000
Infotelmed and LCE
But Brazil, like Canada, has health care challenges: 4
Health Care Professionals, 2002
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 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
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Opportunities for Canadian telehealth (TH) expertise and products
Telehealth Status
just starting: pioneers are large and rich private hospitals, excellence centres in public universities
telehealth yet to be adopted by public health sector
few succesful experiments underway, growing fast potential is enormous:
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
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Infotelmed: who we are
Federally incorporated research and consulting company established since 1998, www.infotelmed.ca
Focus: telehealth, health care telematics, telemedicine, e-health Under contract, federal & provincial governments, diverse organizations:
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 international group of consultants & researchers medical imaging, medical physics and telehealth
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Who is involved at Infotelmed
Jocelyne Picot, BA, MA, PhD, President of Infotelmed
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: developed and implemented unique tools and mixed qualitative-
quantitative 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)
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LCE Communications: who we are
LCE carries mandates with Brazilian institutions technical & scientific partnerships, technology transfer & distribution
Edumed Institute mandate: to mediate and negotiate projects with governmental entities &
private institutions - aim: financing, grants, donations to establish technical and scientific partnerships:
health care, telemedicine, telehealth, computer-mediated education
LCELCE Communications
Montreal . Canada
Consulting & engineering office, since 1990 services in telecom and telehealth systems worldwide contracts, Brazil as niche market mandates cover:
telemedicine applications, telehealth programs, telecom technologies
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Who is involved at LCE
Luiz C. Esteves, P.Eng., M.Sc.
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
Author, McGraw-Hill book company, 1981
in the works - telehealth
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The Edumed Institute – the Brazilian partner
not-for-profit NGO organization (2000) 21 staff members and associates
develops and partner with telehealth and educational projects
headquartered in Campinas, Brazil’s foremost technological
area with representations countrywide coordinates consortium of 25 public/private institutions
work relies on partnerships with: universities, hospitals, government, private sectors
R&D in IT and digital communications applications development of distance health education and training
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Who is involved at Edumed
Dr. Renato E.M. Sabbatini, Ph.D.
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
Amazon Telehealth Project telemedicine services, indigenous people
Pediatric Oncology Network Project videoconferencing and Internet network
of specialized hospitals for cancer treatment
Brazilian Telecardiology Network videoconference and telemedicine initiative via hi-speed network,
protocols and clinical directives for cardiovascular health services
Telemedicine for Family Health wireless IP distance education network for municipal health secretariats
UNIMED health cooperative telemedicine / distance education project, neuroradiology subproject
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Project One – first steps which
have already been taken
Initial efforts have been: Health Canada - Amazon Telehealth Project highlights CIDA - submission of Amazon Telehealth Project highlights Industry Canada –preliminary discussions and meetings
Already happening with Edumed: case conferences set up with CHUM in Montreal 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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Next steps: bilateral visits and feasibility study
Feasibility study aimed at information and intelligence gathering visits to Edumed Institute by the Canadian consultants
interviews and information gathering in the region served by Edumed in-depth study of relevant documentation from:
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 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
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Involvement of other partners
AudiSoft portable wireless narrowband videoconference & telemedicine unit
Colabnet user-controlled satellite bandwidth allocation software & home
care wireless support solutions (Smart Labrador partner)
March Networks home care wideband support solutions
Smart Labrador, MUN Faculty of Medicine telemedicine and CME/CHE content support (IC ’s Smart Communities)
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Thank you!
We appreciate you giving us your time
to participate in this presentation And now we need to know:
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