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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. LCE LCE Communications Montreal . Canada. This presentation has been prepared by:.

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Establishing a Canada-Brazil Telehealth Partnership

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  1. 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

  2. LCE LCE Communications Montreal . Canada This presentation has been prepared by: • 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

  3. 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 Infotelmed and LCE

  4. 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 Infotelmed and LCE

  5. 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 Brazil’s health care sector 1 Infotelmed and LCE

  6. 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 Brazil’s health care sector 2 Infotelmed and LCE

  7. 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 Brazil’s health care sector 3 Infotelmed and LCE

  8. 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 Infotelmed and LCE

  9. 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 Infotelmed and LCE

  10. 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

  11. 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 Infotelmed and LCE

  12. 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 Infotelmed and LCE

  13. 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 Infotelmed and LCE

  14. 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) Infotelmed and LCE

  15. LCE LCE Communications Montreal . Canada 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 • 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 Infotelmed and LCE

  16. 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 Infotelmed and LCE

  17. 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 Infotelmed and LCE

  18. 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 Infotelmed and LCE

  19. 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 Infotelmed and LCE

  20. 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 conferencesset up with CHUM in Montreal • supply, satellite-based, home care, portable wireless VC products • translation & certificationproposal, cardiac triage software • participationof Dr. Picot, International Telehealth Seminar, May, Brazil • participation of Dr. Sabbatini, CST Quebec conference, October Infotelmed and LCE

  21. 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 Infotelmed and LCE

  22. 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) Infotelmed and LCE

  23. 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: esteves@lce.cajpicot@infotelmed.ca company information:www.LCE.cawww.infotelmed.ca Infotelmed and LCE

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