As dimensões continentais de alguns países e a distribuição heterogênea da rede hospitalar dificultam o acesso ao atendimento inicial adequado ao trauma de face principalmente aos pacientes residentes em regiões mais remotas. Um modelo de atendimento por telemedicina pode ser uma opção ao atendimento especializado presencial. Os objetivos deste trabalho são apresentar um modelo de atendimento por especialistas à distância, por meio de videoconferência utilizando-se smartphone, e analisar a concordância deste atendimento por telemedicina com o atendimento presencial, considerado padrão ouro. Cinquenta pacientes com trauma de face e suspeita de fratura de face (n=50) foram atendidos, por duas equipes independentes, uma presencialmente e outra por telemedicina. A equipe presencial, que era formada pela equipe de plantão de cirurgia plástica na unidade de emergência, prestou o atendimento à beira do leito (história, exame físico e análise de imagens por tomografia computadorizada). A equipe telemedicina, composta por um médico generalista atendendo à beira do leito, prestou atendimento em conjunto com um cirurgião plástico à distância através de videoconferência com um smartphone. Após cada atendimento as duas equipes responderam a um questionário, com informações sobre dados epidemiológicos, dados do exame físico, sobre indicações de tomografia computadorizada, achados radiológicos da tomografia e conduta. Os dados foram analisados e comparados quanto à concordância das respostas através da análise estatística kappa, cálculo de acurácia, especificidade e sensibilidade. A amostra estudada foi representativa e concordante com a literatura, com predomínio de homens jovens. Acidentes de trânsito e violência interpessoal foram os principais mecanismos causadores do trauma. A concordância das respostas para os achados de exame físico foi considerada substancial (kappa=0,720), para a indicação da tomografia computadorizada foi quase perfeita (kappa=0,957), para os achados na tomografia foi quase perfeita (kappa=0,899) e para definir a conduta também foi quase perfeita (kappa=0,891). A alta concordância dos achados radiológicos nas tomografias computadorizadas de face também foi observada ao se calcular os valores preditivo positivo (VPP=89,9%), preditivo negativo (VPN=99,3%), sensibilidade (94,2%), especificidade (98,8%) e acurácia (98,3%). O estudo concluiu que o modelo de atendimento ao trauma de face à distância por videoconferência via smartphone é factível, encontrando altos índices de concordância quando comparados ao atendimento padrão ouro presencial, sendo uma opção ao atendimento para a triagem de pacientes vítimas de trauma de face em áreas remotas que não têm à disposição o atendimento especializado presencial / The continental size of some countries and heterogeneous distributed hospital network prevent many patients who live in remote areas from getting adequate initial assessment of facial trauma. The author presents a model for trauma assessment through telemedicine, which may be an alternative to face-to-face specialized attending. The goals of this study are presenting a model for non-attending specialized assessment through video conference via smartphones, and analyzing a comparison between telemedicine and face-to-face management, the latter currently being the gold standard. Fifty patients with either a confirmed or suspected diagnosis of facial trauma (n=50) were evaluated by two teams of physicians, one face-to-face and the other one telemedicine-based. The face-to-face team, which was made up by the attending plastic surgery team in the emergency unit, attended the patients at the bedside (physical examination and CT-scan analysis). The telemedicine team was made up by an in-house general practitioner working together with an on-call plastic surgeon through videoconference via smartphones. After each evaluation, both teams answered a similar questionnaire, which contained data concerning the patient\'s epidemiology, physical examination, CT-scan indications and findings, and the treatment option to be followed. The data were analyzed and compared regarding the similarity of answers, with the use of kappa statistics and analysis of data accuracy, sensitivity and specificity. The sample studied was representative and consistent with the literature, showing a predominance of young males. Traffic accidents and personal violence were the main causes of trauma. The agreement of answers for physical examination findings was considered substantial (kappa=0.720). For CT-scan indications, it was considered almost perfect (kappa=0.957); for CT-scan findings, it was almost perfect (kappa=0.899); and for defining the treatment option, it was also almost perfect (kappa=0.891). High concurrency of face CT-scan findings was also observed after we calculated the positive predictive value (PPV=89.9%), negative predictive value (NPV=99.3%), sensitivity (94.2%), specificity (98.8%) and accuracy (98.3%). The study concluded that the model for non-attending assessment of facial trauma through video conference via smartphones is feasible, showing high concurrence rates when compared to gold-standard in-house assessment, thus being an option for first assessment of facial trauma patients who live in remote areas, where specialized medical teams are not available

Made available in DSpace on 2014-12-17T14:55:52Z (GMT). No. of bitstreams: 1 RenataPB_DISSERT.pdf: 1489254 bytes, checksum: 88fdf1027875fb6b83dbe203da3c24f7 (MD5) Previous issue date: 2011-11-14 / It s notorious the advance of computer networks in recent decades, whether in relation to transmission rates, the number of interconnected devices or the existing applications. In parallel, it s also visible this progress in various sectors of the automation, such as: industrial, commercial and residential. In one of its branches, we find the hospital networks, which can make the use of a range of services, ranging from the simple registration of patients to a surgery by a robot under the supervision of a physician. In the context of both worlds, appear the applications in Telemedicine and Telehealth, which work with the transfer in real time of high resolution images, sound, video and patient data. Then comes a problem, since the computer networks, originally developed for the transfer of less complex data, is now being used by a service that involves high transfer rates and needs requirements for quality of service (QoS) offered by the network . Thus, this work aims to do the analysis and comparison of performance of a network when subjected to this type of application, for two different situations: the first without the use of QoS policies, and the second with the application of such policies, using as scenario for testing, the Metropolitan Health Network of the Federal University of Rio Grande do Norte (UFRN) / ? not?rio o avan?o das redes de computadores nas ?ltimas d?cadas, seja em rela??o ?s taxas de transmiss?o, ao n?mero de dispositivos interconectados ou mesmo ?s aplica??es existentes. Em paralelo, percebemos tamb?m este avan?o nos diversos segmentos da ?rea de automa??o, tais como: industrial, comercial e residencial. Em uma de suas ramifica??es, encontram-se as redes hospitalares, que podem fazer uso de uma gama de servi?os, que v?o desde o simples cadastro de pacientes at? uma cirurgia feita por um rob? sob a supervis?o de um m?dico especialista. No contexto dos dois universos, aparecem as aplica??es em Telemedicina e Telessa?de, que trabalham com a transfer?ncia, em tempo real, de imagens de alta resolu??o, som, v?deo e dados de pacientes. Surge ent?o um problema, visto que as redes de computadores, inicialmente criadas para a transfer?ncia de dados menos complexos, est? sendo agora usada por um servi?o que envolve altas taxas de transfer?ncia e apresenta requisitos em rela??o ? qualidade do servi?o (QoS) oferecido pela rede. Desta forma, este trabalho realiza uma an?lise e compara??o de desempenho de uma rede quando submetida a esse tipo de aplica??o, para duas situa??es distintas: a primeira sem o uso de pol?ticas de QoS, e a segunda com a aplica??o de tais pol?ticas, usando como cen?rio para os testes, a Rede Metropolitana de Sa?de da Universidade Federal do Rio Grande do Norte (UFRN)

As dimensões continentais de alguns países e a distribuição heterogênea da rede hospitalar dificultam o acesso ao atendimento inicial adequado ao trauma de face principalmente aos pacientes residentes em regiões mais remotas. Um modelo de atendimento por telemedicina pode ser uma opção ao atendimento especializado presencial. Os objetivos deste trabalho são apresentar um modelo de atendimento por especialistas à distância, por meio de videoconferência utilizando-se smartphone, e analisar a concordância deste atendimento por telemedicina com o atendimento presencial, considerado padrão ouro. Cinquenta pacientes com trauma de face e suspeita de fratura de face (n=50) foram atendidos, por duas equipes independentes, uma presencialmente e outra por telemedicina. A equipe presencial, que era formada pela equipe de plantão de cirurgia plástica na unidade de emergência, prestou o atendimento à beira do leito (história, exame físico e análise de imagens por tomografia computadorizada). A equipe telemedicina, composta por um médico generalista atendendo à beira do leito, prestou atendimento em conjunto com um cirurgião plástico à distância através de videoconferência com um smartphone. Após cada atendimento as duas equipes responderam a um questionário, com informações sobre dados epidemiológicos, dados do exame físico, sobre indicações de tomografia computadorizada, achados radiológicos da tomografia e conduta. Os dados foram analisados e comparados quanto à concordância das respostas através da análise estatística kappa, cálculo de acurácia, especificidade e sensibilidade. A amostra estudada foi representativa e concordante com a literatura, com predomínio de homens jovens. Acidentes de trânsito e violência interpessoal foram os principais mecanismos causadores do trauma. A concordância das respostas para os achados de exame físico foi considerada substancial (kappa=0,720), para a indicação da tomografia computadorizada foi quase perfeita (kappa=0,957), para os achados na tomografia foi quase perfeita (kappa=0,899) e para definir a conduta também foi quase perfeita (kappa=0,891). A alta concordância dos achados radiológicos nas tomografias computadorizadas de face também foi observada ao se calcular os valores preditivo positivo (VPP=89,9%), preditivo negativo (VPN=99,3%), sensibilidade (94,2%), especificidade (98,8%) e acurácia (98,3%). O estudo concluiu que o modelo de atendimento ao trauma de face à distância por videoconferência via smartphone é factível, encontrando altos índices de concordância quando comparados ao atendimento padrão ouro presencial, sendo uma opção ao atendimento para a triagem de pacientes vítimas de trauma de face em áreas remotas que não têm à disposição o atendimento especializado presencial / The continental size of some countries and heterogeneous distributed hospital network prevent many patients who live in remote areas from getting adequate initial assessment of facial trauma. The author presents a model for trauma assessment through telemedicine, which may be an alternative to face-to-face specialized attending. The goals of this study are presenting a model for non-attending specialized assessment through video conference via smartphones, and analyzing a comparison between telemedicine and face-to-face management, the latter currently being the gold standard. Fifty patients with either a confirmed or suspected diagnosis of facial trauma (n=50) were evaluated by two teams of physicians, one face-to-face and the other one telemedicine-based. The face-to-face team, which was made up by the attending plastic surgery team in the emergency unit, attended the patients at the bedside (physical examination and CT-scan analysis). The telemedicine team was made up by an in-house general practitioner working together with an on-call plastic surgeon through videoconference via smartphones. After each evaluation, both teams answered a similar questionnaire, which contained data concerning the patient\'s epidemiology, physical examination, CT-scan indications and findings, and the treatment option to be followed. The data were analyzed and compared regarding the similarity of answers, with the use of kappa statistics and analysis of data accuracy, sensitivity and specificity. The sample studied was representative and consistent with the literature, showing a predominance of young males. Traffic accidents and personal violence were the main causes of trauma. The agreement of answers for physical examination findings was considered substantial (kappa=0.720). For CT-scan indications, it was considered almost perfect (kappa=0.957); for CT-scan findings, it was almost perfect (kappa=0.899); and for defining the treatment option, it was also almost perfect (kappa=0.891). High concurrency of face CT-scan findings was also observed after we calculated the positive predictive value (PPV=89.9%), negative predictive value (NPV=99.3%), sensitivity (94.2%), specificity (98.8%) and accuracy (98.3%). The study concluded that the model for non-attending assessment of facial trauma through video conference via smartphones is feasible, showing high concurrence rates when compared to gold-standard in-house assessment, thus being an option for first assessment of facial trauma patients who live in remote areas, where specialized medical teams are not available

Thesis (MScEng (Mechanical and Mechatronic Engineering))--University of Stellenbosch, 2008. / A solution is sought for the measurement of human deep tendon reflexes as part of a comprehensive patient condition monitoring system for use in a telemedicine context. This study focused on the development, testing and performance evaluation of a prototype compact patellar tendon reflex measurement system that is able to provide a quantitative reflex evaluation for use by medical practitioners and in a telemedicine environment. A prototype system was developed that makes use of Xsens MTx orientation sensors, force-sensing resistors and an electromyogram (EMG) to measure the reflex response. Suitable parameters identified for analysis included the change in pitch, angular velocity and acceleration of the lower leg, the EMG response, the tendon impact, and various latencies associated with these measurements. Other information considered included the age, mass, and physical dimensions of the test subject. Clinical testing was performed to collect data to evaluate the system performance. Subjective reflex evaluations were conducted by three doctors according to a standard reflex grading scale using video recordings of the tests. Self-organizing maps and multi-layer feed-forward (MLFF) artificial neural networks (ANNs) were used to analyze the collected data with the aim of pattern identification, data classification and reflex grading prediction. It was found that the MLFF network delivered the correct reflex grading with an accuracy of 85%, which was of the same order as the rate of differences between the subjective reflex evaluations performed by the doctors (80%). Furthermore, analysis of the data suggested that certain parameters were not necessary for the autonomous evaluation, such as EMG data and the tendon impact. The use of ANNs to analyze a reflex measurement as proposed by this study offers an accurate, repeatable and concise representation of the reflex that is familiar to doctors and suitable for use in a general clinical setting or for telemedicine purposes.

During the 1990's high expectations were put on telemedicine technology in health care organizations, which can be seen as a reflexion of the society's interest in IT. The use of tele-medicine is expected to improve the quality and decrease costs of health care services. However, if these expectations are to be attained the visions have to be translated into fields of application in local settings where the technology would be used. This could be seen as an infusion process, which means that the technology would incrementally be used in a comprehensive and integrated manner. In this thesis, four Swedish telemedicine projects are analyzed. The approach used is that of Actor network theory (ANT), which has enabled the development of a theory of the infusion process, implementation of IT-projects, and parts of ANT, e.g. the model of the translation process and the notion of inscription. By using the concept of translation, it is possible to see the infusion process as a process where the generic features of the technology (transmitting sound and pictures in real time) are translated into concrete activities in local settings. These fields of application are realized by the mobilization of different task-based networks, where the roles of the actors are defined by the task to be solved. An iterated mobilization of the network implies further that the network will become stabilized, which is a central dimension in the process of infusion. Another way to understand the process of infusion is to describe it as cycles of implementation, where one cycle symbolizes the implementation of a field of application, which is a result of the translation of the generic features of the technology. The inscriptions in the studied technology allow a high degree of flexibility of use and flexibility of action. The flexibility means that fields of application ought to be developed in interaction between actors in local settings, and supporting programs of action are to be identified, or developed, in order to integrate technology use into daily routines. The considerable numbers of failed of IT-project implementations can be explained by the fact that a traditional planning perspective has been used on technologies, which allow a high degree of flexibility of use and flexibility of action. However, by categorizing inscriptions in technological artifacts, it becomes possible to predict what kinds of implementation strategies are appropriate for different kinds of technologies. By viewing the implementation of open networking technologies as a process of translation, the infusion process will be facilitated and a comprehensive and integrated use of technology will be enabled. / digitalisering@umu

The Technology Acceptance Model has been widely applied and has been quite successful at explaining the behavioral intention to use technology in many organizations. One of the most significant variables in the Technology Acceptance Model is perceived ease of use. The Technology Acceptance Model purports that perceived ease of use contributes to the behavioral intention to use technology. Additionally, the model purports that perceived ease of use is an antecedent of perceived usefulness. In the adoption and use of technology by physicians, previous studies show that the Technology Acceptance Model predictions have been incorrect. Specifically, the aforementioned perceived ease of use prediction is not repeatedly supported in health care environments. In order to further investigate and ultimately explain this abnormality in the Technology Acceptance Model's predictive ability in the health care industry, a positivist case study using various coding techniques was conducted to investigate physicians' behavioral intention to use a Personal Digital Assistant in their work environment. The Physicians' Technology Acceptance Model is a major result of this case study. The Physicians' Technology Acceptance Model, which is based on the Extended Technology Acceptance Model (Venkatesh et al. 2000), is absent of the perceived ease of use construct and includes two additional constructs: perceived substitution, which is defined as, "the degree to which an individual perceives that alternate sources are available to deliver the same information or assistance as the technology in question" and facilitating conditions (Venkatesh et al. 2003) , which is defined as, "the degree to which an individual believes that an organizational and technical infrastructure exists to support use of the system" (p. 453). This organizational case study rigorously follows a positivist approach ("natural-science model" of social-science research (Lee 1989b)).

[pt] Esta pesquisa trata da relação multidisciplinar de diferentes áreas do saber. Esclarece o enfoque do Design, sob o ponto de vista da construção de uma plataforma de aprendizagem colaborativa mobile orientada a usuários específicos, no campo da Telemedicina. Como sustentação para criação desta plataforma, foram levantados conceitos ligados aos principais temas abordados, seguidos pela escolha de ferramentas adequadas para sua implantação. A partir deste estudo inicial, foi possível aplicar uma dinâmica específica de aprendizagem colaborativa entre professor e alunos, baseada em uma plataforma disponível para uso em computadores e em dispositivos móveis. Esta experiência pôde ser registrada por meio de pesquisas exploratórias de contexto de uso e de seus usuários. De acordo com os resultados qualitativos levantados ao longo das etapas da pesquisa, baseados na relação entre a Telemedicina, a aprendizagem colaborativa e o Design, foi possível verificar benefícios sobre o processo de aprendizagem de temas ligados à Medicina. Tendo a tecnologia como elemento de sustentação desta iniciativa, os resultados apontam para o surgimento de novas possibilidades de aprendizagem colaborativa no campo da Telemedicina. / [en] This research focuses on the multidisciplinary relation between different knowledge areas. It clarifies the Design approach, during the process of implementing a mobile collaborative learning platform built for specific users, in the field of Telemedicine. The gathering of concepts, related to the main elements approached, served as the foundation for the creation of the proposed platform. Searching for adequate desktop and mobile tools followed this process and established a relation with the specific collaborative learning dynamic created for the interaction between teacher and students. This experience was captured through exploratory researches about the context of use and the context of its users. According to the qualitative results gathered along the stages of the research, based on the relation between Telemedicine, collaborative learning and Design itself, it became possible to verify benefits to the learning process, related to Health. Having technology as the foundation of this initiative, the results presented indicate new possibilities for collaborative learning in the field of Telemedicine.

[pt] O trabalho trata das possibilidades de atuação do designer no campo da telemedicina e apresenta uma proposta pedagógica para um curso de especialização em Design para Projetos de Telemedicina. O modelo de processo de aprendizagem, desenvolvido e aplicado ao curso, é baseado na interação entre ensino, pesquisa e desenvolvimento, e se propõe a promover a reflexão sobre o campo ao qual for aplicado, através da produção de experiências práticas. Uma primeira etapa do estudo consta de revisão de literatura sobre telemedicina. Conceitos, definições, formação, questões éticas, recursos tecnológicos, políticas de saúde e vantagens de sua aplicação em países periféricos. Um panorama da telemedicina no Brasil é apresentado, tomando como referência experiências desenvolvidas na Fundação Oswaldo Cruz - Fiocruz e na Faculdade de Medicina da Universidade de São Paulo - FMUSP. Em seguida, questões de interatividade são enfocadas, trazendo a discussão sobre convergência de mídias e a abordagem de Media Ecology - estudo do ambiente midiático como estrutura, conteúdo e impacto nas pessoas - , à luz do design. A proposta de um curso de especialização em Design para Projetos de Telemedicina surge como desenho de uma parceria entre o design e a telemedicina. O modelo pedagógico proposto integra os dois campos, e pretende ser responsável pelo surgimento de um espaço de destaque, constituindo-se como local de produção, construção e inovação em telemedicina. Na conclusão do estudo são feitas considerações sobre design colaborativo, design participativo, e acima de tudo, design centrado no homem. São apresentadas oportunidades para os designers no campo da telemedicina e possíveis desdobramentos para a pesquisa. / [en] The possibilities for designers` performance in the field of telemedicine are the focus of this thesis. A pedagogic proposal for a Design Specialist Program in Telemedicine Projects is presented. The academic structure suggested for the program is based on a learning process model conceived for integrating education, research and development; stimulating, through a trainee program based on practical experiences, a reflexive attitude towards the field to which the model is applied. The first part of the research contains a review of literature relating to telemedicine. Concepts, definitions, educational issues, ethic concerns, technological resources, political health strategies and the advantages of using telemedicine in peripheral countries are addressed. An overview of Brazilian telemedicine state of the art is presented, based on initiatives conducted by Fiocruz - Oswaldo Cruz Foundation and by the University of Sao Paulo Medical School - FMUSP. Interactivity issues are discussed next, from the perspective of design, covering the convergence of media and the Media Ecology approach - the study of media environments as structure, content and its impact on people. The proposal of a Design Specialist Program in Telemedicine Projects emerges from a partnership between design and telemedicine. The pedagogic model proposed integrates two fields, intending to favor the birth of a distinct space, which aims excellence in the production, as well as construction and innovation in telemedicine. To conclude the study, considerations concerning collaborative design, participatory design and human- centered design are presented. Design opportunities in the field of telemedicine are suggested and possible directions for further research are raised.

O agente comunitário de saúde (ACS) tem um papel fundamental no trabalho com a comunidade e na implementação do sistema de saúde brasileiro vigente devido seu contato direto com a população, a qual se apresenta crescente quanto ao número de pessoas idosas e às alterações inerentes ao envelhecimento. O objetivo deste trabalho foi avaliar um programa de educação continuada para os ACS do município Monte Negro, Estado de Rondônia, quanto aos conhecimentos sobre o processo de envelhecimento e suas patologias relacionadas à área da Fonoaudiologia. A amostra foi composta por 29 indivíduos, sendo estes solicitados a preencher um questionário semi-estruturado, contendo conhecimentos relacionados à Fonoaudiologia e ao processo de envelhecimento, em um momento pré e pós realização do curso de capacitação, além de preencher um questionário socioeconômico validado. Para a análise do questionário sobre conhecimentos fonoaudiológicos e processos do envelhecimento foram convidados cinco avaliadores, que atuam em diferentes áreas do conhecimento em Fonoaudiologia, para responder o questionário oferecido aos ACS, posterior pontuação e análise do mesmo. Como resultados pode-se observar que a análise socioeconômica mostrou que 89,65% da amostra encontram-se na classe baixa superior, 79,31% residem na área rural e 44,83% possuem ensino médio completo. Após o programa de capacitação, apenas uma área da Fonoaudiologia sofreu piora da pontuação (Motricidade Orofacial) sendo que as demais apresentaram melhora na pontuação, havendo diferença estatisticamente significativa em duas áreas (Audiologia; Fala e Linguagem). Já com relação ao CD-ROM, a elaboração ocorreu em duas etapas, sendo a preparação do material escrito e a elaboração junto ao designer durante os meses após a realização do curso. Desta forma, conclui-se que o curso de capacitação atingiu seus objetivos transmistindo conhecimentos aos ACS para que possam atuar junto à comunidade proporcionando melhora na qualidade de vida desta. A elaboração do CD-ROM foi importante para registrar o conteúdo oferecido bem como para uma posterior consulta. / The community health agents (CHA) has a role in the community working and in the implementation of the current Brazilian health system because they are in direct contact with the population, which presents a growing number of elderly people and changes inherent to aging. The aim of this study was to evaluate a training program for CHA from Monte Negro, State of Rondonia, about aging and its aspects related in Speech-language and Hearing Pathology knowledge. The sample was constituted by 29 individuals, who were asked to complete a semi-structured questionnaire, containing knowledge related to Speech-language and Hearing Pathology and the aging process at a time before and after completion of the training course, and then filled a validated questionnaire about their socioeconomic status. For the knowledge analysis of speech-language and hearing questionnaire regarding aging processes participated five reviewers, who work in different areas of expertise in Speech-language and Hearing Pathology, to answer the questionnaire offered to CHA for later scoring and assessment. The results showed the socioeconomic analysis showed 89.65% of the sample was in the higher lower class, 79.31% lived in the rural area and 44.83% have completed high school. After the training program that only an area presented a worsening score (Orofacial Motricity) and the others showed an improvement, while statistically significant difference occurred only in two areas (Audiology; Speech and Language). Regarding to the CD-ROM development, its elaboration occurred in two phases, the writing and its designing preparation during the months after the end of the course. Thus, its been concluded that the training program met its objectives for the CHA forwarding knowledge for who needs to work with the community by providing quality of life improvements. The preparation of the CD-ROM was important to record the content offered as well as to a subsequent query.

Uma sistemática de teleconsulta para o processo de programação, verificação e adaptação dos aparelhos de amplificação sonora individuais (AASI) foi desenvolvida e sua eficácia avaliada por meio de um estudo prospectivo, randomizado e cego. Participaram do estudo 50 deficientes auditivos (30 homens; 20 mulheres) candidatos ao uso do AASI, com idades variando entre 39 e 88 anos e média ISO dos limiares audiométricos entre 30 e 68,75dB. Os participantes foram alocados em dois grupos (randomização estratificada): controle (n=25), submetidos aos procedimentos face a face (F) e experimental (n=25) submetidos à teleconsulta (T). O procedimento F foi realizado pelo avaliador 1 em todos os participantes, incluindo: programação do AASI, medidas com microfone sonda (equipamento Unity PC Probe, estímulo speech noise, apresentado em 50, 65 e 80dBNPS) e orientação quanto ao uso e cuidados com o AASI. Para a teleconsulta o participante e um facilitador se posicionaram na sala junto aos equipamentos (ambiente de teste). O avaliador 1 posicionou-se em outra sala (ambiente remoto) com um notebook conectado à LAN USP. Webcams e headsets capturaram áudio e vídeo, transmitidos em tempo real pelo software Polycom PVX (384 kbps), também utilizado para compartilhamento de aplicativos. Por meio desse compartilhamento o avaliador 1 realizava todos os procedimentos diretamente no participante, com auxílio do facilitador. O tempo despendido para as consultas F e T foi cronometrado. Após as consultas o avaliador 2, cego quanto aos grupos, realizou a avaliação de percepção da fala (Hearing in Noise Test - HINT Brasil) para obter o limiar de reconhecimento de fala no silêncio (LRF) e a relação sinal/ruído (S/R) em que os participantes reconheciam 50% das sentenças apresentadas. Aproximadamente um mês após as consultas foi realizada (avaliador 2) a análise do tempo diário de uso do AASI (via datalogging do dispositivo) e do benefício e satisfação em vida diária (questionário International Outcome Inventory for Hearing Aids - IOI-HA). Maior tempo para a programação e verificação e menor tempo para orientação foi observado para o grupo experimental, sendo este estatisticamente significativo (teste t de Student). Não houve diferença entre grupos no tempo total do atendimento em minutos (82,2 controle e 81,3 experimental). A equiparação das medidas com microfone sonda aos respectivos targets foi similar para os dois grupos. Não houve diferença significativa (teste t) entre as médias do LRF no silêncio (56,24 controle e 51,78 experimental) e da relação S/R (4,94 controle e 4,17 experimental), o tempo médio de uso do AASI em horas (7,26 controle e 7,44 experimental) e das pontuações total e dos itens do questionário IOI-HA. Houve correlação (Spearman) positiva forte e significativa entre o tempo de uso do AASI e o tempo de uso informado pelo participante, para ambos os grupos. Para alguns participantes durante a teleconsulta houve interrupção da transmissão de áudio e vídeo que foi prontamente solucionada. Concluiu-se que a teleconsulta é um procedimento eficaz para a realização da programação, verificação do AASI e orientação de usuários quando, por algum motivo, serviços face a face não estiverem disponíveis. / A teleconsultation system for hearing aid (HA) programming, verification and fitting has been developed and its efficacy assessed through a prospective, randomized and blind study. Fifty hearing impaired individuals (30 men; 20 women), HA candidates, in the age range 39 - 88 years and ISO mean of audiometric thresholds between 30 and 68.75dBNA, participated in the study. The participants were divided into two groups (stratified randomization): control (n=25), submitted to face to face procedures (F) and experimental (n=25), submitted to teleconsultation (T). Procedure F was performed by evaluator 1 in all participants: HA programming, probe microphone measures (Unity PC Probe equipment, speech noise stimulus presented at 50, 65 and 80dBSPL) and HA use and care orientation. For the teleconsultation, the participant and a facilitator positioned themselves in the room with the equipment (test environment). Evaluator 1 stayed in another room (remote environment) with a notebook connected to the LAN USP. Webcams and headsets captured audio and video, transmitted in real time by software Polycom PVX (384 kbps), utilized as well for application sharing, through which evaluator 1 performed all the procedures directly in the patient, aided by the facilitator. The time spent for consultations F and T was recorded. Following the consultations, evaluator 2, blind to the groups, performed the speech perception assessment (Hearing in Noise Test - HINT Brazil) so as to obtain the speech reception threshold (SRT) in silence and the signal/noise ratio (S/N) in which the participants recognized 50% of the sentences presented. Nearly a month following the consultations the evaluator 2 carried out the analysis of daily time of HA use (via datalogging of the device) as well as benefit and satisfaction (questionnaire International Outcome Inventory for Hearing Aids - IOI-HA). An statistically significant (Students t test) greater time for the programming and verification and a smaller one for HA orientation were observed for the experimental group. No difference was found between the groups for the total consultation time in minutes (control: 82.2; experimental: 81.3). The real ear measures matching to targets were similar for the both groups. No significant difference was observed (Students t test) between the means of SRT in silence (56.24 control and 51.78 experimental) as well as the S/N ratio (4.94 control and 4.17 experimental), the daily amount HA use in hours (7.26 control and 7.44 experimental) and the IOI scores. For both groups there was a positive, strong and significant correlation (Spearman) between the daily amount of HA use (datalogging) and the reported HA use. For some participants, during the teleconsultation, the transmission of audio and video was interrupted, but readily restored. Conclusion: teleconsultation is an effective procedure for hearing aid programming, verification and fitting when face to face services are not available.