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Mario Adriano dos Santos, M.D. Headshot

How Cisco and Universidade Federal de Sergipe Are Bringing Specialty Health Care To Brazilians

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I grew up in the state of Sergipe in Brazil. It is located in one of the poorest regions of the country, a small, almost rural state, about 1000 kilometers northeast of Rio de Janeiro. We faced many challenges in Sergipe, but one of the biggest was not being able to access good health care.

Brazil has a universal health system that provides free health care to citizens -- for 70 percent of the population, this is their only source of care. It is easy to access basic services and treatment for common conditions like injuries, high blood pressure, and diabetes through 30,000 family practice clinics and health teams that reach 100 million people in 5,260 municipalities. These clinics and teams are designed to reach the country's poor and isolated communities.

But the problem lies with specialty care. Most physician specialists practice in major urban centers like Sao Paulo, Rio de Janeiro, and, in Sergipe, the capital city of Aracaju, population 500,000.

I am an immunologist, and if you go to rural areas, you won't find an immunologist, a neurologist, or even someone who can treat asthma. When patients need care for uncommon or chronic diseases, they must travel dozens, even hundreds of kilometers, to urban hospitals.

Most poor families in Sergipe and other parts of Brazil simply cannot afford to do this. So they go without care, and their conditions worsen.

For children, the problem is even more dire. Without proper health care children can experience developmental delays, learning difficulties, physical challenges, and even premature death. Sick children can take a heavy toll on parents, who are often drawn away from jobs to care for them, extending the family's cycle of poverty.

As a child, I envisioned myself doing something to solve this problem when I grew up --something to help people suffering from disease in my own community. Today, after 15 years of attending university and medical school and doing my residency in Sao Paulo, I am realizing that vision.

My employer, the Universidade Federal de Sergipe, has partnered with Cisco to use collaboration and cloud technology to improve the way we deliver health care. A key component of this will be using video conferencing tools like Cisco WebEx and TelePresence to connect family practice clinics in remote areas to specialists in endocrinology, gastroenterology, pulmonology, and allergy/immunology at university hospitals in the cities of Aracaju and Lagarto. Instead of traveling 100 or more kilometers to see a specialist, parents and their children can go to their local family health clinic and interact with that specialist through high-definition video as if they were face-to-face.

Call it telemedicine or care-at-a-distance: The technology will enable families to see pediatric specialists in their own communities without the burden and expense of travel. It will allow the limited number of specialists in Brazil to reach more patients who need them. The potential is huge.

Improving the quality and accessibility of care for Brazil's citizens is one of the government's top priorities. If we are successful in Sergipe, the program could be replicated in other parts of the country. We know there is a lot at stake, so we are going to track our results closely so we can report on the impact we are making.

The time has never been better to adopt telemedicine for children's health care. Our society in increasingly "wired" and comfortable with technology. Brazil ranks fourth worldwide in Internet use and fifth in mobile phone use. The parents and children I've talked to are excited about using technology in their own communities -- to get "up close" with specialists they would have otherwise have traveled hundreds of kilometers to see.

Our first remote consultation took place on February 13, when a 10-year-old girl, her mother, and two doctors at the family practice clinic in Lagarto met with two specialists at the University Hospital in Aracaju -- 70 kilometers away. The patient's mother was very happy with the technology and said it saved her family money and time.

And these remote consultations are only one piece of our overall technology program, Connected Healthy Children - Brazil:

  • Video conferencing and business collaboration technologies (Cisco TelePresence, WebEx, and others) will connect rural health care providers with specialists at medical "centers of excellence" to get insights and advice on patient cases.
  • The same technologies will be used for continuing medical education, to deliver educational content about current medical treatments and practices to rural and remote clinicians. We can even see this rural-urban network helping us fight disease outbreaks and epidemics by giving us a channel to distribute on-demand information about detection, treatment and prevention.
  • As a research and teaching hospital, we will continue to think creatively about how to use technology to improve access to health care, and, we hope, increase quality of life for our patients. It's possible that the best use of the technology we've been given hasn't even been discovered yet. I look forward to making those discoveries and building a model of care that will not only help the people in the region where I grew up, but throughout Brazil.
Connected Healthy Children -- Brazil is part of Cisco's Corporate Social Responsibility initiative to make quality health care available to more children worldwide.