Alignment and specificities of Brazilian health agencies with international premises for the implementation of digital health in Primary Health Care: a rhetorical analysis

Abstract Objective To analyze the alignment of the arguments of Brazilian and international organizations for the adoption of digital health in Primary Health Care (PHC), from COVID-19. Methods This qualitative document analysis used a rhetorical analysis according to Perelman and Obrecht’s-Tyteca. Two independent researchers searched documents on the websites of the World Health Organization (WHO), the Pan-American Health Organization (PAHO), and the Brazilian Ministry of Health, Federal Council of Medicine, and Federal Council of Nursing between December 2021 and June 2022. The search terms were “digital health”, “telehealth”, “telemedicine”, “e-health”, “ telessaúde ”, “ teleenfermagem ”, “ telemedicina ", and “ saúde digital ”. Twenty official documents (recommendations, informative pages, guidelines, resolutions, laws, and ordinances) were identified, considering context, authorship, authenticity, reliability, nature, and key concepts. Results The international and Brazilian arguments emphasize the applicability of Information and Communication Technologies (ICTs) in health. In logical arguments based on the structure of reality, international bodies emphasize the overlap between health needs and the conditions for the applicability of ICTs, but in Brazil, there was a need to regulate the digital practices of these health professionals. In the structuring of the real, the international discourse contains illustrations of the relationship between the context of the health crisis caused by the COVID-19 pandemic and the concrete conditions for the applicability of digital health, while in Brazil the need to strengthen an environment conducive to the digital health policy. Conclusions The Brazilian alignment with international premises is evident, however, there is a need to strengthen the inclusion of digital health in the PHC policy in a socially and economically sustainable way.