Tarso Augusto Duenhas Accorsi, Fernanda de Paula Nunes, Bruna Dayanne Reges Amaral, Marianne Pojali de Arruda, Bruna de Melo Souza, Ana Eliza Acerbi Sarti, Caroline Mendes Alves Borges, Cláudia Cristine Curcio, Karen Köhler, Ari Stiel Radu Halpern, Flávio Tocci Moreira, Carlos Henrique Sartorato Pedrotti
Background: 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. Methods: 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, São Paulo, Brazil. We summarized program reach, site implementation, consultation volume, specialty distribution, consultation disposition, no-show rate, schedule utilization, and post-consultation experience indicators. Results: 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. Conclusion: 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.