DOCHansen

Institute launches groundbreaking platform that connects general practitioners with Hansen’s Disease specialists in Mato Grosso and Paraná

DOCHansen will facilitate patient care and service

Image: Freepik

The Alliance Against Leprosy (AAL) is launching a groundbreaking virtual platform that will assist doctors in managing complex Hansen’s Disease cases. Named DOCHansen and financed by the International Order of Malta against Leprosy (CIOMAL), the tool is the fruit of the AAL’s Technical Cooperation with the Mato Grosso (MT) State Health Secretariat and will operate on a pilot basis for the next six months, bridging the gap between doctors who have questions about the disease and experienced Brazilian Hansen’s Disease specialists.

“The project was conceived as a consequence of our work in Mato Grosso since 2019, where we trained more than 800 health professionals. We observed the ephemeral nature of the impact of the trainings. The doctors are isolated and have many doubts. Without mentoring, knowledge is lost. Combined with the high turnover of doctors in health care units, we believe that remote consulting will have a great impact on the quality of patient care,” comments Dr.  Laila de Laguiche, MD, Hansen’s Disease specialist and president of the Alliance Against Leprosy.

According to data from the latest 2021 survey which was conducted by the World Health Organization (WHO), Brazil has the second highest number of new cases of Hansen’s Disease in the world (28,660), second only to India (114,400). Although the incidence of cases is high in Brazil, there is a lack of specialists in the area. According DOCHansen’s ambassador, Dr. Francisco Almeida, “the participants in the training sessions have many doubts about the disease, its diagnosis, and its evolution. There is an increasing number of exchanges of sensitive information, including patient images, in WhatsApp groups, which violates the code of medical ethics.

DOCHansen will operate, during this pilot phase, in nine cities in Mato Grosso and in one city in Paraná, all of which were previously chosen by the State Health Secretariat in Mato Grosso, and in Paraná, by the 22nd Ivaiporã Health Regional Office, based on the number of Hansen’s Disease cases. In Mato Grosso, they are: Barra do Garças, Guarantã do Norte, Lucas do Rio Verde, Juara, São José do Rio Claro, Pontal do Araguaia, Alta Floresta, Tangará da Serra and Cuiabá. In the Paraná regional office, it will work in Ivaiporã, which meets the medical care needs of the surrounding cities. These two points of DOCHansen’s activities in Brazil may work as a measure of comparison between the needs of hyperendemic localities (Mato Grosso) and those of low endemicity (Paraná), facilitating the management of future program actions. The Institute’s intention is to roll out across the whole of Brazil after the trial phase.

How will it work?

The doctor who is invited to participate in DOCHansen and who is registered in the Medicina Direta platform, when seeing a patient with suspected Hansen’s Disease or who is under treatment, or who has already recovered from Hansen’s Disease, but who remains under follow-up, can access the DOCHansen platform, insert their doubts by filling out the forms, and, within 72 hours, receive an answer from a consulting doctor. All contact will be carried out via the platform, avoiding any leak of information in social media groups without the protection of sensitive data, which is a requirement of the Federal Council of Medicine (CFM).

The professionals who will use the platform will be located mainly in the Basic Health Units (BHU). The activities on the Platform will be in line with the CFM Resolutions. The technological tool is approved by the Brazilian Society of Health Informatics (SBIS) and by the Class Council itself. DOCHansen’s management team believes that, according to demand, more consultants will be able to collaborate with the initiative. The requirement will be proof of having worked in the specialty for at least six years or holding the title of specialist in Hansen’s Disease for at least three years. The desire of the president of the Alliance Against Leprosy, Dr Laila de Laguiche, is that the consultant doctors, who are specialists in Hansen’s Disease, will be more valued in the job market and be paid for their work on DOCHansen.

Medical experts in Hansen’s Disease are essential in diagnosis

According to Dr. Francisco Almeida, consultant and ambassador of DOCHansen, and active medical degree professor, the “teaching about Hansen’s Disease is disappearing from the curricula, which means that the new professionals lack knowledge about the disease. That is why the DOCHansen initiative is so important.

“The gateway to the job market for most newly graduated doctors remains Primary Health Care and/or the emergency room. Therefore, it is essential that they know the disease in order for the patients to be well managed. The gap in knowledge of the complexity of the disease is mainly responsible for the drop in the detection rate observed over the years,” says the DOCHansen ambassador.

Still thinking about the shortage of medical specialists, the initiative is a telemedicine tool and has some limitations. “Clinical experience is still the gold standard tool that offers the greatest certainty for diagnosing and following up cases. No laboratory test is yet available to replace an accurate physical examination in all clinical forms of Hansen’s Disease. In addition, advanced cases of the disease are sometimes highly complex, making the specialist’s eye necessary for a better outcome, minimizing the occurrence of irreversible disabilities that can result from Hansen’s Disease”, explains Dr. Francisco.

Technical Capacity

The Alliance Against Leprosy Institute has an outstanding performance in social impact projects. Since 2021 it has maintained the award-winning TECHansen action, which aims to donate materials, equipment, and assistive technology to patients who have physical disabilities or changes caused by the disease in the eyes, nose, hands, and feet. Learn more about the action TECHansen.

About the Alliance Against Leprosy Institute

Headquartered in Curitiba (PR) and with an international outlook, the Alliance Against Leprosy Institute is a non-profit association that unites science, education, and philanthropy in the fight against Hansen’s Disease. The AAL Institute was founded by dermatologist and Hansen’s Disease specialist Dr. Laila de Laguiche, a professional with 20 years of experience in the area and a post-graduate degree in International Health and Tropical Diseases from the Institute of Tropical Medicine in Antwerp (Belgium). She has already acted as representative of the South region and International Relations of the Brazilian Hansen’s Disease Society (SBH). The entity also has a team of advisors made up of important names in Hansen’s Disease in Brazil and Latin America.

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