Teleconsultoria como estratégia de apoio aos profissionais da atenção primária à saúde: uma scoping review

Abstract

Introduction: Access to specialized care remains a problem for public health systems. Teleconsultation, the use of technologies to provide specialized guidance to primary health care (PHC) professionals, has emerged as an innovative strategy that can overcome this challenge. Objectives: To map the available evidence in the literature on teleconsultation as a strategy to support clinical decisions in primary health care in public systems, with the purpose of identifying the best experiences, results and practices adopted in Brazil and in the world. Method: The databases MEDLINE via PUBMED, EMBASE, Cochrane Library and LILACS via BVSalud were consulted. There was no restriction by language or date of publication. Duplicates were removed and the titles and abstracts of the articles were read and analyzed by two reviewers independently, conflicts resolved by a third evaluator. The included studies were read in full and the data extracted, according to the acronym PCC. The Population are primary health care professionals; the Key Concept is teleconsultation as a strategy to support clinical decisions of primary health care professionals and the Context are public health systems in any region or country. Results: The searches resulted in 3,932 papers. 184 duplicates were excluded and, after reading the titles and abstracts, 271 studies were selected for full text reading, of these, 72 were excluded for not meeting the research objectives and 17 due to non-recovery of the full text. Finally, 182 of these studies were included in the review. The tools used to perform teleconsultation range from simple instruments such as phone calls, smartphones and video conferencing, to electronic platform systems. Publications were found in 19 countries for 27 specialties and the two countries with the highest number of publications were Brazil and Canada. Developed products: a clinical protocol proposal for the use of Teleconsultation in the scope of SES-DF was elaborated. Conclusions: Teleconsultation improves access to specialized care for patients treated in PHC. Even with barriers such as inadequate responses to teleconsultation requests and difficulty incorporating the strategy into organizational culture, experiences have shown benefits for health systems.