A qualidade de serviços de telessaúde em países da América Latina a partir da norma ISO/TS 13131:2021

Abstract

INTRODUCTION: The use of telehealth resources has intensified globally as a strategy to expand access to services in different healthcare systems. In Latin America, there is a growing adoption of these technologies, although institutional and operational heterogeneities persist among countries. The ISO/TS 13.131:2021 standard establishes guidelines for structuring telehealth services based on high-quality parameters, although its practical application has been little explored to date. OBJECTIVE: To evaluate the quality of telehealth services in four Latin American countries, using a typology created from ISO/TS 13.131:2021. METHODOLOGY: This study was based on a previously developed instrument for evaluating the quality of telehealth services, constructed with the participation of representatives from national telehealth programs in 12 countries in the region, and based on ISO/TS 13.131:2021. The instrument covers three domains: Service Planning, Risk Management, and Technology Management. The instrument was validated through expert judge analysis, using the Content Validity Index (CVI). The instrument was then applied to 15 telehealth services located in Brazil, Mexico, Chile, and Peru. Data were analyzed based on the overall mean and indicators per domain. To verify associations between service quality and participating countries, statistical tests such as Analysis of Variance (ANOVA), Kruskal-Wallis, and Fisher's Exact Test were used. Service quality was categorized into three levels: "Low," "Medium," and "High," according to the results obtained in each managerial area and in the overall assessment. RESULTS: The instrument was considered validated by the CVI, with the following results: S-CVI Relevance = 0.96; Clarity = 0.86; and Overall = 0.91. Statistical analysis did not indicate a significant association between the quality of telehealth services and the evaluated countries. Considering the three analyzed domains, 60% of the services (n=9) were classified as low (46.67%) or medium quality (13.33%), while 40% (n=6) achieved the high-quality category. CONCLUSION: The results highlight variations in quality levels among the evaluated services, indicating significant gaps that need to be addressed. The validation of the instrument reinforces its applicability as a quality assessment tool, with the potential to support situational diagnoses, monitoring processes, and strategies for qualifying telehealth services.