The Ministry of Health of Brazil, through the Secretariat of Information and Digital Health (SEIDIGI/MS), is leading the digital transformation of the Unified Health System (SUS). This initiative aims to integrate Health Care Networks (RAS) and expand healthcare access across the country. The Department of Digital Health and Innovation (DESD/MS), a division of SEIDIGI/MS, is responsible for implementing the National Policy on Digital Health, Innovation, and Telehealth. The department plays a key role in driving the digital transformation of public health, particularly in ensuring equitable healthcare access for underserved, vulnerable, and geographically isolated populations.
Strengthen Digital Health solutions within SUS, ensuring accessibility to specialized care for remote and vulnerable populations. Implement telehealth strategies to improve healthcare management, diagnosis, and treatment while reducing unnecessary patient travel. Expand telehealth services, including Teleconsultations, Teleinterconsultations, and Tele-education, to optimize healthcare delivery. Integrate information and communication technologies (ICTs) to enhance Indigenous and Quilombola healthcare services. Improve early diagnosis of preventable diseases such as diabetic retinopathy and skin conditions through tele-diagnostics.
National Telehealth Offering: Deployment of tele-diagnostics, including Retinography, Electrocardiogram (ECG), and Teledermatology, to facilitate remote diagnosis. Teleconsultations and Teleinterconsultations: A network of 42 medical specialties providing remote consultations to reduce unnecessary in-person visits. Tele-education: Digital training programs to upskill healthcare professionals in underserved regions. Community Outreach: Expansion of telehealth services to Indigenous and Quilombola communities, including Quilombo Boa Vista (Oriximiná/PA) and Santa Tereza do Matupiri (AM). Teleophthalmology for Diabetic Retinopathy Screening: Systematic screening of major blindness-causing conditions, including diabetic retinopathy, cataracts, glaucoma, and age-related macular degeneration.
Products Digital platforms for tele-diagnostics in dermatology, cardiology, and ophthalmology. A structured Telehealth network, connecting specialists with primary healthcare providers. Risk classification tools for dermatological and ophthalmological conditions, improving healthcare prioritization. Impact Increased Healthcare Access: Patients in remote communities can now receive specialist care without long travel times. Reduced Waiting Times: Dermatologists and ophthalmologists provide specialist reports within 72 hours, accelerating diagnosis and treatment. Cost Reduction for SUS: Optimization of healthcare resources by ensuring that only necessary cases are referred for in-person specialist care. Environmental Benefits: By reducing patient travel, the initiative contributes to lower greenhouse gas emissions, generating carbon credits. Indigenous and Quilombola Health Equity: Improved healthcare services for historically underserved populations, ensuring their right to quality healthcare while allowing them to remain in their communities. Innovation Telehealth Risk Classification: Enables healthcare professionals to assess the severity of cases remotely, ensuring better prioritization. Permanent Blindness Prevention Campaign: Uses teleophthalmology to detect and prevent vision impairment regardless of age, significantly improving early diagnosis and intervention. Participatory Approach and Cross-Cutting Themes Equity: The program prioritizes Indigenous and Quilombola populations, who historically face barriers to healthcare access. Gender and Ethnicity: The initiative ensures equal access to healthcare for diverse populations, addressing disparities in rural and remote areas. Human Rights: By expanding access to quality healthcare, the initiative promotes the fundamental right to health and well-being.
Connectivity Challenges: Many remote areas lack stable internet access, impacting telehealth service delivery. Healthcare Professional Training: There is a need for continuous training to ensure optimal use of telehealth technologies. Patient Digital Literacy: Some populations require additional support in accessing and using digital health services. Scalability: Expanding the initiative to more regions requires additional investment in infrastructure and resources.
Telesalud, Transformación Digital
Effectiveness, Cost-Effectiveness, and Efficiency The resources allocated to the implementation of this Good Practice—financial, technological, and human resources—were utilized efficiently, with significant impact on healthcare access, cost savings, and service optimization within the Brazilian Unified Health System (SUS). Effectiveness The initiative successfully improved access to specialized healthcare services, particularly for remote and vulnerable populations, demonstrating its effectiveness in addressing healthcare disparities. The introduction of Teleconsultations and Teleinterconsultations enabled primary healthcare providers to manage cases more effectively, reducing unnecessary referrals and ensuring that only critical cases were escalated to specialized care. The tele-diagnostics services, including dermatology, cardiology, and ophthalmology, provided timely and accurate diagnostic support, leading to earlier treatment initiation and better clinical outcomes. Cost-Effectiveness By reducing unnecessary in-person consultations and travel costs for patients, the program optimized healthcare expenditure while maintaining high-quality care. The reduction in patient travel not only decreased healthcare costs but also minimized environmental impact, generating carbon credits that could be leveraged for further investments in sustainable healthcare initiatives. The integration of digital solutions streamlined workflows for healthcare professionals, reducing administrative burdens and enhancing productivity without the need for excessive staffing increases. Efficiency Financial Resources: The project utilized existing digital infrastructure and leveraged technology to expand access to care at a fraction of the cost of traditional healthcare expansion methods (e.g., building new facilities or hiring large numbers of specialists). Technological Resources: The deployment of telehealth solutions maximized the reach of specialized healthcare professionals, allowing for more efficient resource allocation and better case prioritization through risk classification. Manpower: The initiative optimized the use of specialist expertise by ensuring that professionals only attended to cases that truly required their intervention, reducing workload inefficiencies and improving service delivery. Conclusion Overall, the Good Practice demonstrated a high level of efficiency by ensuring that limited financial and human resources were maximized through digital solutions. The cost-effectiveness of telehealth was evident in reduced travel costs, optimized specialist utilization, and improved patient outcomes. However, challenges such as connectivity limitations and digital literacy gaps remain barriers to further scalability. Addressing these challenges through targeted investments in infrastructure and digital education could further enhance the efficiency and impact of the initiative.
Technology Transfer and Knowledge Dissemination Yes, the Good Practice (GP) successfully transferred technology and disseminated valuable knowledge that can be adapted to other contexts. The initiative leveraged telehealth solutions, risk classification algorithms, and digital diagnostic tools, which are highly transferable to different healthcare systems, including those in low-resource settings. Additionally, capacity-building efforts, such as tele-education and training programs for healthcare professionals, ensured that the knowledge and skills required for digital health implementation were widely disseminated. Adaptability and Replicability Potential Adaptability: The initiative is adaptable to various healthcare environments, particularly in countries or regions facing similar challenges, such as limited access to specialized healthcare, geographic barriers, and high costs associated with patient travel. Replicability: The digital health strategies implemented (e.g., teleconsultations, telediagnosis, and teleophthalmology) can be replicated in other public health systems, humanitarian settings, and rural healthcare programs worldwide. Scalability: The modular nature of the initiative allows it to be expanded to additional medical specialties or integrated with existing digital health infrastructures, making it a scalable solution for broader adoption. Demonstration in Other Contexts Yes, this successful GP could be demonstrated in other contexts, particularly in: Low- and middle-income countries (LMICs) with underdeveloped healthcare infrastructure. The use of telehealth minimizes the need for physical healthcare expansion, making it an efficient and cost-effective alternative. Remote and rural areas worldwide, where geographic and socioeconomic barriers limit access to healthcare professionals. Humanitarian and emergency health response settings, where telehealth can provide rapid triage, diagnosis, and consultation services in crises or post-disaster scenarios. Urban areas with overburdened healthcare systems, where risk classification algorithms and digital consultations can help manage patient flow and optimize resource allocation. Conclusion This initiative presents a high potential for adaptability, replicability, and scalability due to its flexibility, cost-effectiveness, and reliance on digital tools rather than large-scale physical infrastructure investments. While connectivity challenges and digital literacy gaps may pose obstacles in some settings, these can be mitigated through investment in telecommunication infrastructure and targeted training programs. Given its positive impact on equity, efficiency, and healthcare accessibility, this GP could serve as a model for other countries aiming to implement sustainable and innovative digital health solutions.
Sustainability The sustainability of this Good Practice (GP) is supported by a combination of financial, technological, environmental, and social factors, ensuring its long-term viability within the Unified Health System (SUS) and its potential expansion to other contexts. 1. Financial Sustainability The initiative reduces healthcare costs by optimizing the use of specialized medical services, ensuring that only necessary cases are referred for in-person care. Cost savings from reduced patient travel, fewer unnecessary consultations, and better triage efficiency contribute to long-term financial sustainability. The potential for public-private partnerships and international funding (e.g., for expanding digital health infrastructure in underserved regions) enhances financial sustainability. 2. Technological Sustainability The GP relies on scalable and adaptable digital health solutions, such as teleconsultations, tele-diagnosis, and AI-driven risk classification, which can be continuously improved and expanded. Cloud-based and interoperable digital platforms ensure data security, scalability, and integration with other healthcare initiatives. The initiative fosters continuous digital literacy training for healthcare professionals, ensuring long-term adoption and system integration. 3. Environmental Sustainability By reducing the need for patient travel to healthcare facilities, the initiative lowers greenhouse gas emissions, contributing to environmental sustainability. The reduction in hospital overcrowding and unnecessary procedures leads to lower consumption of medical supplies and energy resources. The project supports climate-friendly healthcare policies through telehealth-driven carbon footprint reduction, potentially generating carbon credits for reinvestment in further digital health initiatives. 4. Social Sustainability The initiative promotes equity by providing Indigenous, Quilombola, and rural populations with access to high-quality specialized healthcare, ensuring their right to health. By minimizing patient displacement, the project preserves cultural and social structures within vulnerable communities. Capacity-building programs for healthcare professionals ensure that local expertise is strengthened, reducing reliance on external specialists and fostering healthcare workforce sustainability. Conclusion This Good Practice is designed for long-term sustainability, supported by cost-effective implementation, scalable digital solutions, environmental benefits, and social impact. While connectivity challenges and digital literacy gaps may require additional investments, the overall low-cost, high-impact model makes it a viable and enduring solution for healthcare systems worldwide.
The biggest challenge is connectivity. To reduce this asymmetry, in 2023, the President of the Republic, Luiz Inácio Lula da Silva, inaugurated Infovia 1 – the Norte Conectado Program. This segment benefits more than 3 million people and provides high-quality broadband internet to 11 municipalities, from Santarém (PA) to Manaus (AM). These locations are traditionally accessed by boats, with an average travel time of up to 15 days, or by aircraft, at a high cost. The Ministry of Health, through SEIDIGI, ensured the availability of telehealth services in these regions alongside the arrival of high-speed internet connectivity.
Lessons Learned and Recommendations for Institutions and PAHO’s Technical Cooperation The implementation of this Good Practice provided several key lessons that can be valuable for institutions and PAHO’s Technical Cooperation in scaling and adapting similar initiatives in other contexts. These insights highlight the importance of infrastructure development, workforce capacity building, regulatory frameworks, and patient engagement in ensuring the success of digital health solutions. 1. Digital Infrastructure is a Prerequisite for Telehealth Success One of the main challenges faced was connectivity limitations, especially in remote and underserved areas. The deployment of Infovia 1 – Norte Conectado Program in Brazil demonstrated the critical role of broadband internet expansion in enabling telehealth solutions. Lesson for PAHO and Institutions: Investing in broadband expansion and satellite internet solutions is essential for ensuring equitable access to digital health services. Public-private partnerships can facilitate infrastructure development, reducing costs and ensuring sustainability. 2. Capacity Building for Healthcare Professionals Ensures Adoption Initial resistance and a lack of familiarity with telemedicine tools were observed among some healthcare professionals. However, continuous training and tele-education programs helped overcome these barriers and increased adoption. Lesson for PAHO and Institutions: Digital health training should be integrated into medical and nursing curricula to build a workforce prepared for telehealth practices. Continuous education programs should be provided to upskill healthcare workers and increase digital literacy. Institutions should develop user-friendly telemedicine platforms to ensure seamless adoption. 3. Regulatory Harmonization Facilitates Scalability A well-defined regulatory framework was necessary to ensure compliance with data protection laws, telemedicine protocols, and national healthcare guidelines. Inconsistent policies at different government levels posed challenges in standardizing telehealth services. Lesson for PAHO and Institutions: Regional and national telehealth policies should be harmonized to ensure smooth implementation. Clear data protection regulations must be in place to ensure patient confidentiality and trust in digital health services. International collaboration on best practices in telemedicine regulation can help develop standardized frameworks across countries. 4. Community Engagement is Key to Digital Health Success In some communities, low patient trust in remote healthcare and limited digital literacy were barriers to adoption. However, targeted community engagement strategies improved acceptance and participation. Lesson for PAHO and Institutions: Awareness campaigns should be implemented to educate communities about the benefits of telehealth. Culturally sensitive communication strategies must be used, especially in Indigenous and Quilombola communities, to build trust in digital healthcare solutions. Training programs for community health workers can enhance patient education and increase engagement with telemedicine services. 5. Equity Must Be a Central Component of Digital Health Strategies Telehealth services proved to be a powerful tool for reducing health disparities by expanding access to specialized care for Indigenous, Quilombola, and rural populations. However, ensuring equity requires targeted policies that address cultural, social, and economic barriers. Lesson for PAHO and Institutions: Digital health initiatives should be designed with inclusivity in mind, ensuring that vulnerable populations are prioritized. Offline solutions (e.g., mobile health units and community-based telehealth centers) should complement digital interventions in areas with low connectivity. Gender, ethnicity, and human rights perspectives must be integrated into program design to ensure equal access to services. Final Takeaway for PAHO and Other Institutions This Good Practice has demonstrated that digital health can be a transformative tool for healthcare equity, efficiency, and quality improvement. However, success depends on strong infrastructure, workforce training, clear regulatory frameworks, community engagement, and sustainability planning. By adapting these lessons, PAHO and other institutions can effectively support regional governments in expanding telehealth initiatives across Latin America and the Caribbean, ensuring that digital health solutions reach the most vulnerable populations while maintaining high-quality, cost-effective healthcare delivery. It is of utmost importance for digital health, as it emphasizes that other countries in the Americas benefit from the potential of digital technology in healthcare. PAHO's principle is to promote equitable access to digital health.
Health Policy
| América del Sur |
| Brasil |
| Centro Colaborador de la OPS/OMS |
| Población indígena |
| Población afrodescendiente |
| Innovación, Nuevas Oportunidades |
| Objetivo 3 - Meta 3.4 |
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