Portugal introduces national telehealth plan, the first of its kind in the world

Portugal is leading telehealth developments across the world with the newly introduced National Strategic Telehealth Plan (PENTS)

PENTS was launched by the Portuguese Ministry of Health in late 2019, with the aim of advancing their telehealth approach to healthcare. Portugal has been involved in telehealth since 1990, and their current aim is elaborate on their current vision of the country’s e-health field. The new scheme is expected to harmonise telehealth across the country by scaling up good examples and maximising their impact.

Micaela Seeman Monteiro, director of the National Telehealth Center, said: “Many of our telehealth services are local. Sometimes they do not reflect real organisational change and therefore may lack sustainability when champions leave. Only through a national strategy, with a clear overview of the goals to be achieved and supported by policy-makers, managers, professionals, patients and caregivers will it be possible to turn initiatives into an articulated and synergistic system, which is more than the sum of its parts.”

The strategy will also allow for improvements to be made to infrastructure, interoperability and serviceability and also support legislation.

Monteiro continued: “The regulatory framework has to become more robust in order to increase trust. The education of healthcare professionals must include digital health. Citizens’ digital health literacy must also increase.”

Giving patients power through telemonitoring

The plan includes input from 50 institutional stakeholders and experts across the health spectrum. This includes information and advice from Saúde em Diálogo, a platform that combines 52 patient associates. This allows for patient contribution to help shape the future of telehealth across Portugal.

“The strategy emphasises patient centrality as it focuses on telehealth as an important means for care integration. Patients and informal caregivers play here an important role in co-managing health – particularly in the setting of chronic disease multi-morbidity,” Monteiro explained.

Telemonitoring has become an insightful path for patient empowerment across Portugal. The Portuguese government has launched a special program for chronic diseases such as chronic obstructive pulmonary disease and chronic heart failure. This has meant that emergency episodes have reduced by 50% and unplanned hospital admissions by 70% among the patients who have taken part in the telemonitoring service so far.

Various digital tools are available

For Portuguese people managing their health, a whole range of digital tools are available with high usage rates. The online Citizen Area (RSE Área do Cidadão) allows people to access their electronic health records, book an appointment with a GP and check their vaccination card. There are now over 2,250,000 users, a number which on average increases by 300 users a day.

E-prescriptions

E-prescriptions have become a particularly popular service and is compulsory within the Portuguese national health service. Instead of patients receiving a paper prescription, they get it over text or email. Additionally, over 80% of healthcare patients use this service to get their medication highlighting its popularity.

However, Portugal is also taking this popular service one step further by becoming the first in the EU to provide the full cross-border services of patient summary and e-prescriptions by the end of November.

The Portuguese NHS has a Contact Centre which provides an array of clinical and administrative services to the population. This includes teletriage, telecare for the elderly, health care information, referrals, point of care tests for HCV and HBV in pharmacies or at home.

A lot of these services have also been made available online with over 1.87 million users have already used the website. Additionally, there is also an app, MySNS Carteira, offered where users can gather important personal information about their healthcare such as vaccine cards, access data to the NHS service, allergy registration and e-prescriptions. The app can also create reminders on smartphone calendars reminding people when to take medication. Since the app launched in 2016, it has already been downloaded 460,000 times and proving useful to many citizens.

Future plans

The Carteira app is hoping to add new features in the future, including teleconsultations. This update will enable video calls within the app for healthcare professionals to contact and engage other healthcare professionals in other departments or practices. Beta-tests are already being run and the service is hoping to begin next year.

These teleconsultations have already been shown to work well between healthcare providers and streamlines information between services. Some uses include support video calls, sharing of clinical images and lab tests results. The app has already connected over 200 healthcare facilities and over 21,000 teleconsultations have been held since January and August 2019.