| Popis: |
This observational study was carried out in the state of Amazonas (Brazil), a huge and remote Rainforest area with only 2.2 inhabitants per square kilometer. This isolation is due to both geographical setting and ethnic-cultural barriers, with the indigenous population representing around 4% (20% of the entire indigenous population of Brazil, 60 ethnic groups and more than 40 languages). The lack of dermatology specialists encourages the few Primary Health Care Doctors (PCD) to apply for asynchronous support on skin disease occurrences through the portal of the Manaus-based Telemedicine and Telehealth Centre (TTC). Subsequently, the TTC counsels the PCD at a distance through his dermatologist-consultants (DC). The performance of such a teleconsultation system was audited by a TTC independent board of experts. They reviewed a 24 months continuous case series by focusing on the quality of PCD applications and DC counseling. The quality of anamnesis, description of physical signs and attached clinical documentation by the PCD was satisfactory in only 56/100, 44/100 and 53/100, respectively. A significantly negative trend (p |
