Optimizing Brazil Health Care with telemedicine (BRAHIT)

project summary

In BRAHIT we test in a pragmatic clinical trial, the hypothesis that a novel collaboration model across health sectors in Brazil can improve the quality of the management of patients with heart failure. Health resources are scarce in Brazil, posing a constant pressure on specialists, such as cardiologists. Stable patients who have undergone highly complex procedures in a tertiary hospital are discharged to outpatient treatment at primary care. Both the population and cardiologists are reluctant to accept transfer to sometimes less skilled primary care. We propose in BRAHIT an enhanced collaboration that is also tangible for the patients, which can ease transfer of patients from cardiologists to primary care. Despite a more homogenous primary care, Denmark also faces a collaboration gap across sectors, and social inequality. Hence, Denmark can profit from adopting positive research results in BRAHIT. BRAHIT involves the Brazilian Ministry of Health with participants from the National Institute of Cardiology hospital (INC), primary care and homecare in Rio de Janeiro. Thus, BRAHIT supports the ongoing Strategic Sector Cooperation (SSC) between Denmark and Brazil. BRAHIT is relevant for SDG targets 3.8.1, 9.5 and 10.2, addressing social inequality, quality of healthcare and improvement of the use of Health data. BRAHIT uses telemedicine and will outline a platform for data exchange, supported by the Danish company Trifork ApS. Furthermore, BRAHIT will run in parallel with an ongoing Danish project (REAFEL) supported by the Ministry of Higher Education and Science (Innovationsfonden), that targets population at risk for atrial fibrillation, which can provoke strokes. BRAHIT and REAFEL target thus different populations, in different countries, yet addressing comparable problems of social inequality and cross-sectorial gaps. Therefore, we can learn from the BRAHIT and REAFEL trials, while establishing evidence-based strategies that can persist beyond the project and be globalized to other clinical conditions.