O SUS que chega: perspectivas sobre a utilização da telemedicina na atenção primária à saúde em regiões rurais e remotas

Abstract

Introduction: studies demonstrate that the use of telemedicine in Primary Health Care (PHC) has the potential to improve the health status of people living in rural and remote regions. Despite the expansion of telemedicine use following the COVID-19 pandemic, initiatives to implement this tool in these regions still face difficulties, such as a scarcity of scientific studies in the Global South, structural barriers, low digital literacy, and regulatory shortcomings. Objective: To analyze the perspectives of patients, health professionals, and managers regarding telemedicine as a means of expanding access to Primary Health Care in rural communities. Methodology: the study employed three approaches: an integrative literature review on the current state of knowledge regarding the perspectives of users, health professionals, and PHC managers on telemedicine use in rural and remote regions; an exploratory qualitative study involving three focus groups with patients and professionals from a rural Family Health Strategy unit and with municipal PHC managers; and the development of a manual for telemedicine use in PHC in rural and remote regions. The literature review was conducted using indexed databases, and the results were analyzed using content analysis techniques, strictly following the steps proposed by that approach. Data from the focus groups were analyzed using thematic content analysis. The manual was developed based on knowledge gained during the previous stages, adopting a participatory perspective. Results: the literature review highlighted the global importance of telemedicine in rural and remote regions, its impact on access to primary health care in these locations, and the challenges regarding implementation and sustainability. Focus groups identified telemedicine as a tool capable of reducing geographical barriers, optimizing costs, and enhancing the monitoring of chronic conditions. However, challenges such as inadequate technological infrastructure, professional workload, limited digital literacy among some users, and the need to preserve in-person relationships were highlighted as critical issues in rural regions. Conclusion: telemedicine has established itself as a valuable resource; however, its implementation in rural areas must be carried out in a participatory and culturally sensitive manner, prioritizing a place-based approach and the strengthening of Primary Health Care (PHC) attributes. Technology should be viewed not as a substitute for human care, but as an effective mediator between healthcare services and the people receiving care.