Synchronous Teleconsultation and Monitoring Service Targeting COVID-19: Leveraging Insights for Postpandemic Health Care

• Published in: JMIR medical informatics Vol. 10; no. 12; p. e37591
• Main Authors: Marcolino, Milena Soriano, Diniz, Clara Sousa, Chagas, Bruno Azevedo, Mendes, Mayara Santos, Prates, Raquel, Pagano, Adriana, Ferreira, Thiago Castro, Alkmim, Maria Beatriz Moreira, Oliveira, Clara Rodrigues Alves, Borges, Isabela Nascimento, Raposo, Magda César, Reis, Zilma Silveira Nogueira, Paixão, Maria Cristina, Ribeiro, Leonardo Bonisson, Rocha, Gustavo Machado, Cardoso, Clareci Silva, Ribeiro, Antonio Luiz Pinho
• Format: Journal Article
• Language: English
• Published: Canada JMIR Publications 22-12-2022
• Subjects: Coronaviruses; COVID-19; Original Paper; Software; Telemedicine; Brazil; telemedicine; remote consultation; primary health care; text message; COVID-19; digital health; telemonitoring; usability; mobile health; telehealth; delivery of health care; public health; remote care
• DOI: 10.2196/37591
• EISSN: 2291-9694

Although a great number of teleconsultation services have been developed during the COVID-19 pandemic, studies assessing usability and health care provider satisfaction are still incipient.
This study aimed to describe the development, implementation, and expansion of a synchronous teleconsultation service targeting patients with symptoms of COVID-19 in Brazil, as well as to assess its usability and health care professionals' satisfaction.
This mixed methods study was developed in 5 phases: (1) the identification of components, technical and functional requirements, and system architecture; (2) system and user interface development and validation; (3) pilot-testing in the city of Divinópolis; (4) expansion in the cities of Divinópolis, Teófilo Otoni, and Belo Horizonte for Universidade Federal de Minas Gerais faculty and students; and (5) usability and satisfaction assessment, using Likert-scale and open-ended questions.
During pilot development, problems contacting users were solved by introducing standardized SMS text messages, which were sent to users to obtain their feedback and keep track of them. Until April 2022, the expanded system served 31,966 patients in 146,158 teleconsultations. Teleconsultations were initiated through chatbot in 27.7% (40,486/146,158) of cases. Teleconsultation efficiency per city was 93.7% (13,317/14,212) in Teófilo Otoni, 92.4% (11,747/12,713) in Divinópolis, and 98.8% (4981/5041) in Belo Horizonte (university campus), thus avoiding in-person assistance for a great majority of patients. In total, 50 (83%) out of 60 health care professionals assessed the system's usability as satisfactory, despite a few system instability problems.
The system provided updated information about COVID-19 and enabled remote care for thousands of patients, which evidenced the critical role of telemedicine in expanding emergency services capacity during the pandemic. The dynamic nature of the current pandemic required fast planning, implementation, development, and updates in the system. Usability and satisfaction assessment was key to identifying areas for improvement. The experience reported here is expected to inform telemedicine strategies to be implemented in a postpandemic scenario.