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South America ... New regulations for the ethical use of Telemedicine

Like other continents, with the advent of the COVID-19 crisis, the countries from South America were forced to review their models of patient care. In this moment of change, the pressure to save more lives and make health with quality more accessible, telemedicine has taken the position as a fundamental instrument.

With political and social situations different from those in Northern nations, most countries in South America offer universal access to healthcare systems, often completely free of charge for the majority of the population. The entire process is managed by the state. The cultural and social heterogeneity, the wide disparities in territorial occupation, and the limited budget for those giant health systems contribute to an unequal access to the best health model. In order for telemedicine to achieve its goals quickly, important changes were made to laws and regulations.

Brazil, the largest nation in Latin America, with more than 200 million inhabitants, already has a history of at least 30 years of telemedicine, but with a range of use of telemedicine of only 5% in its territory, according to the Ministry of Health of Brazil (2020). Even with limited scope, there is already maturity in its legislation. The last change was at the beginning of this year when the Federal Council of Medicine - Brazil, for the first time, allowed teleconsultation for all physicians, and all specialties. But even after that there were some restrictions:

  • Teleconsultation implies, as a mandatory premise, the previous establishment of a face-to-face relationship between doctor and patient.

  • In long-term care or chronic illnesses, face-to-face consultation at intervals not exceeding 120 days is recommended.

  • The establishment of a doctor-patient relationship only on a virtual basis is permitted for health care coverage in geographically remote areas, as long as the recommended physical and technical conditions and health professionals exist.

  • Safety conditions of medical records must be guaranteed, and a copy of the report must be sent to the patient, signed by the physician responsible for the call center, with a guarantee of digital authorship.

  • If the teleconsultation results in a medical prescription, it must contain the physician's identification (including name, and address), patient identification, time stamp, and a digital signature of the physician.  

Other countries in South America like Argentina, Chile, and Colombia follow a similar model, with clear signs of improvement of telemedicine use beyond the COVID-19 crisis. Regulations are also changing fast in these countries. The hope of South American physicians is that, after the expansion of the telemedicine services, more patients can benefit, with safety and quality of care maintained.


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