Impact and future of telemedicine amidst the COVID-19 pandemic: a systematic review of the state-of-the-art in Latin America

[Scope and limitations of teleconsultation during the covid-19 pandemic: accounts from primary healthcare professionals in the Autonomous City of Buenos Aires]

The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.

Inequalities in health system coverage and quality: a cross-sectional survey of four Latin American countries

The premise of health as a human right in Latin America has been challenged by health system fragmentation, quality gaps, a growing burden of chronic disease, sociopolitical upheaval, and the COVID-19 pandemic. We characterised inequities in health system quality in Colombia, Mexico, Peru, and Uruguay. We did a cross-sectional telephone survey with up to 1250 adults in each country. We created binary outcomes in coverage, user experience, system competence, and confidence in the system and calculated the slope index of inequality by income and education. Although access to care was high, only a third of respondents reported having a high-quality source of care and 25% of those with mental health needs had those needs met. Two-thirds of adults were able to access relevant preventive care and 42% of older adults were screened for cardiovascular disease. Telehealth access, communication and autonomy in most recent visit, reasonable waiting times, and receiving preventive health checks showed inequalities favouring people with a high income. In Uruguay, inequality between government and social security services explained a substantial proportion of disparities in preventive health access. In other study countries, inequalities were also substantial within government and social security subsectors. Essential health system functions are unequal in these four Latin American countries.

Telemedicine Management: Approaches and Perspectives—A Review of the Scientific Literature of the Last 10 Years

This research paper describes the approaches and perspectives of telemedicine worldwide. The objective of this literature review was to analyze the theoretical and empirical studies that address telemedicine management in the last 10 years based on the scientific literature obtained from the Scopus, Scielo, Ebsco, ProQuest, Dialnet, and Redalyc databases, from which 50 articles were selected. The inclusion criteria were the last 10 years, scientific articles, language, variables, and open access. The non-inclusion criteria were repeated articles, not addressing the variable, and not open access. The results show a tendency to manage telemedicine through various approaches and scenarios. These can be grouped into humanistic, socioeconomic, ethical, contingency in the Armed Forces—NASA, and application in the field of medicine with teaching to the entire chain of users, as well as controls and monitoring of patients. In this sense, it is concluded that telemedicine management worldwide faces challenges that must be overcome to reduce still-existing barriers and achieve better access to health systems worldwide.