{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:54Z","timestamp":1787027334319,"version":"build-2736575974"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Large-scale provider-to-provider teleconsultation models remain underreported in low- and middle-income countries. Optimal strategies for scaling outpatient telemedicine and evaluating its impact on quality, efficiency, and patient experience are still being investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective descriptive implementation study of synchronous, video-based, provider-to-provider teleconsultations coordinated by the Telemedicine Department of Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil. We summarized program reach, site implementation, consultation volume, specialty distribution, consultation disposition, no-show rate, schedule utilization, and post-consultation experience indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 365 service points were established, offering 12 specialties and performing 201,012 teleconsultations. Schedule occupancy remained at 99.8%. Among consultations, 79% resulted in follow-up within the same specialty, 16% were discharged from specialty care, and 5% were referred elsewhere. Common diagnoses included hypertension (3.9%), autism spectrum disorder (3.7%), joint pain (3.7%), ADHD (3.6%), and generalized anxiety disorder (3.3%). Net Promoter Scores were 91 for physicians and 85 for patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A centralized, structured, multi-specialty telehealth strategy was feasible across remote locations, sustained high appointment occupancy, and effectively resolved or redirected 95% of cases. Both clinician and patient satisfaction were notably high, supporting the scalability of this model in underserved regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1706130","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:37:07Z","timestamp":1780897027000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Strategic and clinical insights from the rapid scale-up of over 200,000 specialty teleconsultations in remote and underserved Brazilian regions"],"prefix":"10.3389","volume":"14","author":[{"given":"Tarso Augusto Duenhas","family":"Accorsi","sequence":"first","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda de Paula","family":"Nunes","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Dayanne Reges","family":"Amaral","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne Pojali","family":"de Arruda","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna de Melo","family":"Souza","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Eliza Acerbi","family":"Sarti","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Mendes Alves","family":"Borges","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia Cristine","family":"Curcio","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Francine","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"Department of Telemedicine, Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari Stiel Radu","family":"Halpern","sequence":"additional","affiliation":[{"name":"Department of 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