Analysis of the virtual healthcare model in Latin America: a systematic review of current challenges and barriers.

IF 2.2 Q2 HEALTH CARE SCIENCES & SERVICES mHealth Pub Date : 2024-03-25 eCollection Date: 2024-01-01 DOI:10.21037/mhealth-23-47
Alejandro De La Torre, Peter Diaz, Rafael Perdomo
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Abstract

Background: The virtual care model can be used in all aspects of healthcare, such as prevention, diagnosis, treatment, and follow-up of most medical and surgical conditions. The objective of this study was to identify the current barriers to implementing and consolidating the virtual healthcare model, of "telemedicine", in Latin American countries.

Methods: A systematic review was conducted through four databases: PubMed, Scopus, Web of Science, and Virtual Health, including articles in Spanish, Portuguese, and English. A combination of Boolean operators was used with the terms "telemedicine", "telehealth", "telecare", "home care services", "remote care" and the name of each Latin American country. Articles published from January 2020 to January 2023 that reported on the barriers and challenges of using the virtual care model were included.

Results: Nineteen articles were included. Brazil (n=5) and Argentina (n=4) were the countries where there was the greatest interest to explore barriers to virtual care. The barriers identified were categorized into five main themes: (I) technological and technical issues; (II) absence of a physical examination; (III) patient's negative perceptions; (IV) negative perceptions among healthcare professionals; and (V) structural obstacles and those associated with the healthcare system. The main obstacles reported were connectivity problems, lack of a complete physical examination, issues of privacy, high risk of medical malpractice, and absence of local regulation.

Conclusions: The virtual care model is a safe and cost-effective alternative for the delivery of health services, with multiple benefits for patients and their families. The indication for the use of virtual care should be based on a risk model for patient prioritization. Likewise, the analysis of the main barriers and benefits is fundamental to consolidating this model of care and ensuring its expansion in the region.

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拉丁美洲虚拟医疗模式分析:对当前挑战和障碍的系统性审查。
背景:虚拟医疗模式可用于医疗保健的各个方面,如大多数内外科疾病的预防、诊断、治疗和随访。本研究的目的是确定目前在拉丁美洲国家实施和巩固 "远程医疗 "这一虚拟医疗模式的障碍:方法:通过四个数据库进行了系统综述:方法:通过 PubMed、Scopus、Web of Science 和 Virtual Health 四个数据库进行了系统综述,包括西班牙语、葡萄牙语和英语文章。使用布尔运算符组合 "远程医疗"、"远程保健"、"远程护理"、"家庭护理服务"、"远程护理 "和每个拉丁美洲国家的名称。结果:共收录了 19 篇文章:结果:共纳入 19 篇文章。巴西(5 篇)和阿根廷(4 篇)是最有兴趣探讨虚拟医疗障碍的国家。所发现的障碍分为五大主题:(I) 技术和工艺问题;(II) 缺乏体检;(III) 患者的负面看法;(IV) 医疗保健专业人员的负面看法;(V) 结构性障碍和与医疗保健系统相关的障碍。所报告的主要障碍包括连接问题、缺乏完整的身体检查、隐私问题、医疗事故的高风险以及缺乏地方监管:虚拟医疗模式是提供医疗服务的一种安全且具有成本效益的替代方式,可为患者及其家人带来多重益处。使用虚拟医疗的指征应基于病人优先级的风险模型。同样,对主要障碍和益处的分析也是巩固这种护理模式并确保其在该地区推广的基础。
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