Telessaúde: uma ferramenta de educação permanente em saúde para os profissionais da atenção básica do Estado do Maranhão

Abstract

The study aimed to evaluate Telehealth as a tool for Permanent Health Education (EPS) for Primary Care (AB) workers from the State of Maranhão. This is an evaluative research with quantitative and qualitative approach. In article 1 the indicators of utilization of the services offered by the State Program of Telehealth of HUUFMA, in its relation with EPS, were evaluated through secondary data from the Brazilian National Telehealth Platform for the years 2015 and 2016. The monthly system usage rate and the mean monthly request rate per municipality and primary health care unit were calculated. Teleconsultations were described regarding the requester’s profession, most frequent topics, satisfaction with the response provided, and resolvability of responses. During the study period, 13 976 teleconsultations from 47 municipalities were small and had low Municipal Human Development Index. The mean overall usage rate and the monthly usage rate by municipality and unit were higher than those reported in the literature. Nurses and Community Health Workers were the most active professionals and reported having their question was answered. In article 2, the analysis of the health professionals' perception of PHC in the State of Maranhão on the use of telehealth as an EPS tool was performed. The collection was held in the city of Caxias-MA, in June 2018. The sample was intentional, being composed of 21 health professionals from the AB teams. Data were collected through individual open interviews and analyzed through Content Analysis, which revealed three thematic categories: renewing knowledge responsibly, safely and based on scientific evidence; sharing knowledge and reducing professional isolation in AB and; barriers to the use of telehealth services and the implementation of EPS. The results portrayed the contribution of Telehealth in improving care, with changes in working practices, clinical case guidance working with a second opinion, and avoiding referrals to other specialists. As well as support in the teams' EPS process, however, there are barriers to its use. It was concluded with the use indicators of the HUUFMA Telehealth Program that the service is sustainable, with the potential to support AB and to be used as an EPS tool. Sensitization and training of professionals and, in particular, municipal managers is recommended, in order to make Telehealth multi-professional, daily and continuous in its entirety.