Telemedicine is now a reality in the lives of healthcare professionals, and visible benefits can be enjoyed by both doctors and patients. However, there are legal and ethical issues involved that are subject to different views within the profession and even among the population that uses healthcare services.

The topic has been extensively debated in recent years and indeed divides opinions. According to research conducted by the São Paulo Medical Association (APM), 85% of healthcare professionals approve the use of WhatsApp and other instant messaging applications for communication with patients. However, the same research reveals that when it comes to remote consultations, the percentage of favorable doctors drops to 42%.

Legislation for Telemedicine

In the midst of this debate, in April 2017, the Federal Council of Medicine (CFM) began a journey of opinions and resolutions with the aim of regulating Telemedicine, first releasing an opinion (CFM No. 14/2017) in favor of using WhatsApp in the medical field, with some reservations as shown in the excerpt below taken from the document itself:

“The use of WhatsApp and similar platforms for communication between doctors and their patients, as well as between doctors, in a private capacity, to send data or clarify doubts, as well as in closed groups of specialists or the medical staff of an institution or chair, is permitted, with the caveat that all information passed is absolutely confidential and cannot exceed the limits of the group itself, nor can it circulate in recreational groups, even if composed only of doctors, emphasizing the explicit prohibition of replacing in-person consultations and those for diagnostic or evolutionary supplementation at the doctor's discretion with any of the existing platforms or those that may exist.”

A resolution (CFM No. 2.227/2018) was then regulated and later reformed at the end of 2018, defining and disciplining telemedicine as a way of providing medical services mediated by technologies.

Due to protests from Brazilian doctors and representative entities of the profession, the resolution was revoked in 2019.

By 2020, after the onset of the pandemic, the same Council, on March 19, through a letter sent to the Ministry of Health, exceptionally authorized the use of telemedicine until the end of the disease's spread.

Services like Zapper Duo facilitate the use of Telemedicine by healthcare professionals.

Telemedicine During the Pandemic

What was once a convenience has now become a necessity. Given the delicate moment when unnecessary trips to the emergency room can lead to greater contagion of the new coronavirus (Sars-CoV-2) and overloading the healthcare system, WhatsApp and other messaging applications appear as a great ally in the fight against the collapse of hospitals, enabling a first screening and guidance for patients to be done remotely.

In times of crisis, when solidarity becomes even more essential, actions emerge that offer online consultations to further ensure social isolation, as is the case with the Covid Mission platform, which offers free telemedicine assistance through a volunteer doctor to anyone showing symptoms of COVID-19 infection.

With the facts raised, one can imagine that the pandemic will also be a watershed moment regarding referrals related to Telemedicine and everything involving its regulation.

The urgent need for this alternative use will certainly bring about a cultural and behavioral change among healthcare professionals and their clients, potentially leading to an irreversible path.

As in any field, if used correctly and adhering to standards and guidelines, technology can only bring benefits and optimize services.

Therefore, a phrase that could best summarize this trend would be: “Technology will not replace the doctor, it will only replace the doctor who does not use technology.”

REFERENCES:

FEDERAL COUNCIL OF MEDICINE (CFM). Opinion CFM No. 14/2017

FEDERAL COUNCIL OF MEDICINE (CFM). Resolution CFM No. 2.227/2018

FEDERAL COUNCIL OF MEDICINE (CFM). Revocation of Resolution CFM No. 2.227/2018

FEDERAL COUNCIL OF MEDICINE (CFM). Letter CFM No. 1756/2020 – COJUR