Saúde Pública atrelada à tecnologia: Os obstáculos na adoção do sistema de teleconsulta pela perspectiva das Lógicas Institucionais

Resumo (EN)

The adoption of teleconsultation in Brazil faces significant obstacles stemming from regional, cultural, and technological differences. This study analyzes how these obstacles are connected to the different institutional logics that shape medical practice in the face of technological innovations. The research seeks to confirm and understand the reasons for the persistence of such obstacles. The theoretical framework is grounded in institutional logics, examining how teleconsultation introduces changes in medical routines which, in some contexts, may generate tensions with traditional practices. The literature review indicates that institutional logics may complement one another, compete, or in some cases, generate tensions that hinder the implementation of new practices. The methodology combines documentary research and interviews with relevant stakeholders in the healthcare field, enabling a comparison between obstacles identified in the literature and empirical data. The analysis revealed that, beyond technical limitations, symbolic disputes emerge, understood as conflicts of values, interests, and perspectives on medical practice among different institutional logics. The findings show that obstacles identified in the literature—such as the lack of medical training, resistance from specific groups (such as the elderly and individuals with low digital literacy)—are directly related to the logics of the Profession and the Family, which tend to prioritize traditional practices and face-to-face contact. Meanwhile, issues of data security and privacy, along with regulatory challenges, reflect the logic of the State, which seeks to balance innovation with proper regulation. The absence of technological investments and unequal access are associated with the logics of the Market and the Corporation, where the pursuit of profit and economic efficiency often contrasts with the needs of the public healthcare system. Furthermore, some issues—such as professional remuneration and interruptions caused by government transitions that affect the continuity of teleconsultation policies—align with the logics of the Corporation and Democracy, generating uncertainties regarding the consolidation of practices. Overall, these findings demonstrate that the obstacles to teleconsultation persist not only due to technical limitations but also because they reflect tensions between different institutional logics, whose values and interests explain their endurance in Brazil.