Introduction How telemedicine is used in Portugal? What are the main specialties involved? Where is it mostly used? Based on the main results of a research about telemedicine capacity and use in Portugal, this paper identifies the telemedicine activities and equipments and characterizes the different modalities and specialties developed. Methods Methodologically, this research counts with four methodological approaches: documental analysis, application of a survey, interviews with experts, and deep analysis of case studies. The mixed data analysis has some limitations, such the fact that from all institutions with telemedicine activity reported, some don’t specify the equipment used to do it or even presented telemedicine production. This heterogeneity of data has some impact in project results. Results This study identified 160 telemedicine platforms geographically dispersed in Portugal. This scattered activities, due mostly to local experiences based on individual initiatives, are mostly discontinued activities. From this 160, 48% are active and mainly concentrated in Alentejo and Centro regions. From all institutions respondents (99), 42% reported telemedicine activities. They are public hospitals (55%) and Groups of Primary Care Units (29%). The institutions geographical distribution demonstrates an unequal distribution: Porto, Coimbra and Faro represent 43% of institutions with telemedicine activity. The interconnections (links between two points) exist in both vertical (hospitals –Primary Care Units, 21%) and horizontal (hospitals – hospitals, 15% and PCU – PCU, 3%). These connections are established mainly for teleconsultation (55%). Telediagnosis (71,4%) and teleconsultation (57,1%) are the most used telemedicine modality and those with higher geographical coverage. Telediagnosis is mainly done in imaging (54,5%) and neuroradiology (21,9%). Imaging is mostly represented in Faro, Setúbal, Porto, Coimbra and Évora and neuroradiolog, specially held in Porto, mainly in private institutions. The teleconsultation is maily performed in dermatology (41,9%) and cardiology (32,3%, including pediatric), and have a higher incidence in Faro and Évora. Évora have the largest teleconsultation specialties supply: dermatology, cardiology, neurology, general surgery, physical medicine and rehabilitation, orthopedics, gastroenterology and psychiatry. Regarding to the organizational structure, only ¼ of the institutions have departments, teams dedicated to telemedicine or planned telemedicine strategy development (few cases). The internal web access is mainly made by a dedicated network of health (75,7%). The main advantages attributed to telemedicine are the ability to increase the access (92%) and reduce distances among care services and citizens (91%). In contrast, the main disadvantages identified are the deterioration of the relationship between health professionals and patients (56%),and making the health care less human (54%). The major barriers pointed are technical and technological focused, mainly related with the lack of infrastructure and connectivity (61%). The low level of professionals’ compliance and financial aspects is also considered as a barrier (50%). Main conclusion Despite technological infrastructures dedicated to telemedicine, this project found that telemedicine is performed below of the production potential capacity and requires further investment in optimizing resources.

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Telemedicine, Portugal, Health Care