The Melhor em Casa program has added 57 professional teams to provide home care under the Unique Healthcare System (SUS). The improvement in home care came about as result of Decree No. 1620 which authorizes 39 new multi-professional patient home-care teams (EMAD) and 18 professional support teams (EMAP). In total this makes 57 new teams in the states of Minas Gerais, Rio de Janeiro, Goias, San Paulo and Bahia. “The program has improved home-care in some areas and expanded it into areas that were lacking home-care teams, this being one of the federal government’s priorities,” says the coordinator of the Melhor em Casa program, Aristides Oliveira. Since its launch in November 2011, the program has mobilized 343 multi-professional teams and 140 professional teams in 19 states, serving 84 municipalities. Of these, a total of 122 EMADs and 45 EMAPs are already providing care for the populations of 44 municipalities across 15 states. In 2014, the total investment will be R$1 billion for the deployment of one thousand home remote patient monitoring teams and another 400 support teams. Patients who need to rehabilitate their motor skills, elderly patients, patients with non-degenerative chronic diseases, or in post-surgical recovery who can be discharged are all examples of cases that can be cared for by the multi-professional teams throughout the week (Monday to Friday), 12 hours a day and even on weekends and holidays. The teams are generally made up of doctors, nurses, nursing technicians, physiotherapists and social workers. Other professionals such as speech therapists, nutritionists, occupational therapists, dentists, psychologists, pharmacists, physiotherapists and social workers can be selected for the support team. Each support team can on average care for 60 patients at a time. The Melhor em Casa program also helps to reduce waiting times in hospital emergency departments as, when medically appropriate, the care will be given in the patient’s home, as long as they and their family have given their consent. Teams will have been deployed in every region in the country by 2014. Recently, the Ministry of Health changed some of the rules of the program to increase the number of municipalities who have the right to receive the Melhor em Casa program. Municipalities with more than 40,000 inhabitants can receive the program as long as they have a Mobile Emergency Care Service (SAMU 192) or an emergency service belonging to their main hospital. The previous regulations limited it to municipalities of 40,000 inhabitants in metropolitan regions. Another important change refers to the flexibility of the working hours of the professionals who make up the teams. Nursing professionals or auxiliary personnel, for example, can add to their weekly load of at least 120 hours. The regulations had already provided for 160 weekly hours. The criteria for the deployment of more than one home-care team was also reduced. Municipalities with more than 150 thousand inhabitants may establish a second home-care team and so on. Before, municipalities had to have a population of 200,000 inhabitants to get a second team. This is undoubtedly important news for those developing remote home patient monitoring solutions, as telemedicine can play a big role in this model of medical care, which is increasingly being adopted by healthcare systems.
