Abstract

Abstract: Introduction: The World Health Organization defined the compulsory need to redirect all educational, research and public health service activities of medical schools to meet all priority health needs, attributing to them this social responsibility role. Due to the emergency situation in the public health system caused by the COVID-19 pandemic, as a measure of social accountability, remote medical care services and online education were adopted in order to continue following the curricular program and to provide assistance to local city governments. Experience report: Two months before graduation, medical students followed-up on the monitoring of residents and COVID-19 healthcare professionals of forty-three ILPIs (Long-Term Elderly Care Facilities) in the city of Sao Jose do Rio Preto, state of Sao Paulo, Brazil. The medical students made daily telephone calls to all these ILPI units, requesting information, generally from the head nurses and owners, about the main COVID-19 symptoms that were detected in the residents and employees of these facilities. All the collected information was discussed daily with the teacher in charge of mentoring the program, fed into an online database and into a work schedule chart, then relayed to the local Municipal Health Secretariat. A COVID-19 contingency plan was devised by the team, authorized by the Local Health Secretariat and then presented to the ILPIs, aiming to offer them the best guidance throughout the pandemic. Discussion: the COVID-19 pandemic revealed the Health Education System’s fragilities, limitations and capacity to adapt to this crisis, thus largely contributing to improving the training of new medical doctors. During the program, medical students faced many challenges, especially regarding the difficulty to contact some ILPIs by telephone, omitted or erroneous information provided by employees in these facilities and delays in reporting suspected cases. In spite of this scenario, daily contact with these facilities allowed the team to identify the ILPIs that were more adequately prepared and the ones that needed auditing and further supervision. Also, this daily contact established a bond between the team and the ILPIs. Conclusion: During the pandemic, it was possible to perform actions according to the logic of social accountability, demonstrating that remote online medical practice is a tool capable of both maintaining interns in contact with the practical aspects of medical care and providing medical assistance to the community and to the local government.

Highlights

  • The World Health Organization defined the compulsory need to redirect all educational, research and public health service activities of medical schools to meet all priority health needs, attributing to them this social responsibility role

  • During the pandemic, it was possible to perform actions according to the logic of social accountability, demonstrating that remote online medical practice is a tool capable of both maintaining interns in contact with the practical aspects of medical care and providing medical assistance to the community and to the local government

  • Ficou nítido que a forma mais eficaz de diminuir a disseminação da doença era implementar medidas de prevenção pautadas em isolamento social, higiene rigorosa e monitoramento diário

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Summary

RELATO DE EXPERIÊNCIA

Telemedicine in long-term elderly care facilities as “social accountability” in the context of Covid-19. Relato de experiência: A dois meses do fim da graduação, discentes de Medicina acompanharam as 43 instituições de longa permanência para idosos (Ilpis) – públicas e privadas – do município de São José do Rio Preto com o intuito de monitorar residentes e funcionários em relação à Covid-19. Cotidianamente, essas informações eram registradas numa plataforma on-line, na planilha de organização do trabalho, e depois relatadas para a Secretaria Municipal de Saúde (SMS) e discutidas com o professor responsável pela mentoria. Os discentes encontraram diversos desafios: dificuldade no contato telefônico com algumas Ilpis, informações omitidas ou fornecidas de forma equivocada pelos funcionários e atrasos na comunicação de casos suspeitos. Palavras-chave: Telemedicina; Instituição de Longa Permanência para Idosos; Responsabilidade Social; Infecção por Coronavírus; Educação Médica

Conclusion
CONTRIBUIÇÃO DOS AUTORES
CONFLITO DE INTERESSES
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