Telemedicine saves lives through ICT

It solves the problems of coverage of the Public Health Network, which mainly depend on the long distances that the inhabitants of the rural areas of the Department must travel.

Through the expansion of the coverage of this initiative, 97% of the total population of Cundinamarca will be able to receive medical attention remotely.

Beneffits: i) decrease in costs ii) avoid long trips for attent medical appointments iii ) reduces the consumption of fossil fuels.

At present, the total coverage of the initiative is 76%, due to lack of resources, It has not been possible to connect the 116 municipalities of the Department, If we obtained the infrastructure and human capital to increase the appropriation of the practice, we would save many more lives of Cundinamarca farmer.

 The rapidity of the diagnoses and the opportune attention allow to treat the pathologies in time and avoid their complications.

The population of Cundinamarca is 3 million inhabitants, of which 70% live in the rural sector and They can benefit from this practice. According to the measurements during 2019, in telecosulta were made 627 attentions, in telediagnostic 1316 and in teleradiology 13413. This represents a number of annual consultations of 15,356 in the 53 Hospital Networks linked to Telemedicine. In Teleradiology, which is defined as the ability to send radiographic images (x-rays) from one remote location to another, since the implementation of this initiative began, a total of 398,854 events were successfully attended.

Among the specialties with the highest number of services, pediatrics, internal medicine, radiology and cardiology stand out.

These figures reflect the impact of the practice, due to connectivity issues, only reaches 76% of the rural population of Cundinamarca.

This initiative is already being implemented by the Health Dependence of the Cundinamarca Government and in it's first phase (76% coverage) it has been a success, since it includes specialties in its consultations, which have allowed the rapid diagnosis.

The objective of this application is to reach a coverage of 97%. It's proposed to strengthen the physical connectivity network to reach more people, especially  those who are infected with COVID-19 and are in the rural area of the Department.

 Sustainability:

-Social appropriation of this practice by the community.

-The doctors have been trained for remote patient care.

-It has a strong environmental component for saving paper and fossil fuel.

Benefits:

-Telemedicine is a comprehensive distance health care system, made possible through the Internet, which expands the health coverage of the Public Health Department Network.

- It's an alternative solution to the barriers to accessing specialized health services (promotion, prevention, diagnosis, treatment or rehabilitation by health professionals) for communities distant from the Department.

- It facilitates the access of the rural population to services that due to their geographical location and / or the capacity of the hospital network in the area are very expensive and difficult to access.

Telemedicine allows the expansion of health care coverage to 3 millions of cundinamarqueses that live at the 116 municipalities of the Department and emphasizes the well-being of located communities in the rural sector. In this sense, it improves the quality of life of rural families that previously had to cross long distances to access a medical appointment and are now just a click away from medical and specialists services.

At date, has been beneficent 505.652 cundinamarqueses with the services of Telemedicine. These are especially farm workers and people who live in the most remote township of the Department.

Telemedicine is a highly effective solution for future viruses similar to Covid-19, It prevents the movement of infected people and allows remote consultations, especially in places with difficult access. 

This solution is closely linked to the community, the people must appropriate the practice and give it the correct use, this is only achieved through community leaders who become multipliers.

This solution is easily replicable worldwide, especially in rural populations and in places where health services don't have good coverage due to the topography of the territory.

Telemedicine eliminates access barriers to specialized medical services and shortens consultation and diagnosis times, thus preventing and treating pathologies more effectively, especially in the rural population of the department. Remote diagnostics save resources, both human and technological. As an example, a digital Electrocardiogram within the Telemedicine solve is a support for specialist diagnoses. With this system, the patient is given a diagnosis in real time; for example: if the general medical knows that the patient needs an evaluation by cardiology, the patient avoid the travel for face-to-face consult and the process that would take almost 15 days while the examination is carried out and another 15 days for the cardiologist to interpret the results of the same. With this system the patient's time is optimized and it's possible to deliver the assessment and the reading the exam in 15 minutes in the emergency room or in 24 hours through outpatient consultation, that's why it's an innovative and revolutionary project that improves the quality of life of the cundinamarqueses.

The UN recognized the Cundinamarca Government for this initiative, highlighting it's important contribution to expand health coverage in the Department. 

Represents a technological advance for Cundinamarca in health coverage, his people which is characterized by the agricultural and rural vocation of the territory. 

This initiative not only aims at connectivity but at the social appropriation of ICTs in the farmers so that they make use of this system, for this reason, it's necessary bring the project closer to the most vulnerable communities.

Telemedicine is a comprehensive system of remote health care, made possible through the Internet. His implementation represents: i) the reduction of economic costs and social costs,  ii) lower the geographic gaps  in the provision of services, iii)online access to patients medical records from any of the 53 Department Hospitals  that are part of the Health Network. 

This initiative makes possible the real and effective inclusion of health services for the rural population; technological leveling of the providing entities and standardization of processes related to information systems in the health public instiitutes.

It's time has come for Latin America to export telemedicine: BID

https://blogs.iadb.org/integracion-comercio/es/pandemias-america-latina-telemedicina/

The existing social gap between the countryside and the cities in Colombia is a reality. The Department of Cundinamarca, despite being close to the capital, faces this challenge mainly
due to the limitations that the inhabitants of rural sectors encounter in accessing their fundamental rights: health, education, food, and others that guarantee their vital minimum.
This problem has been constant throughout the history of Cundinamarca, that is why when the World Health Organization (OMS) identified the advantages of Telemedicine, the Department understood that this was a way to improve the health of the population and basic services through digital technologies (in mobile phones, tablets and computers). Telemedicine represents a technological revolution in the world and for Cundinamarca it is undoubtedly a great opportunity to improve service delivery in rural communities.

People we’re serving until now: 505,652 persons

People we served in 2019:  109,235 persons

People we served in 2018: 70,471 persons

People we served in 2017: 140,323 persons

People we’ll be serving in one year:   Approximately 110,000 persons 

People we’ll be serving in five years:   Approximately 550.000 persons 

Specific Objectives (planned to be achieved in the next 4 years):

- Improve the provision of the Department's health services through the use of specialized equipment and technological tools for information and communication.
This objective will be achieved with the training and permanent tutoring of the officials of the 53 Health Providers Entities linked to the Departmental Network that are part of the project.

- Create care protocols that allow optimizing patient care.
This objective will be reached when the Department's Telemedicine advisers build the document with the protocols in force for the efficient use of the system.

- Increase the number of procedures and remote consultations between the patient and the treating doctor through technological platforms during the next 4 years.
This objective marks the scope of the project and its projection in the next 4 years.

- Generate a process of social appropriation of Telemedicine in the most remote communities of the Department.
This objective will be achieved through health promoters who will socialize the advantages of Telemedicine to the inhabitants of the most remote rural sectors of the Department.

- Manage resources to expand the coverage of the Departmental Health Network.
This objective will be achieved by applying to grants, prizes and challengesto obtain resourses  that allow us to strengthen the Departmental Network in the short term.

Financial: the resources available for the practice do not allow increasing connectivity of Network in the desired way. Therefore, the lack of budgetary resources slows down the progress and scope of practice on connectivity and promotion.

We have the purpose of applying to grants, prizes and challenges to obtain resources that allow us to strengthen the Departmental Network in the short term.

The Government of Cundinamarca - Colombia is the legal figure, one of his dependencies called the Secretary of Health is the entity that implements the initiative through the Department's Public Health Network in which 53 entities the all territory are currently linked.

Approximately 102 persons:

- Doctors

- Health promoters.

- Systems and telecommunications engineers

The Cundinamarca Government, complying with Law 1419 of 2010, which establishes the guidelines for the development of Telehealth in Colombia. In this sense, the Development Plan "Unidos Podemos más" 2016-2020, have a goal 621 for seeks to increase by 50% the Public Policy action plan for information management in the health sector of Cundinamarca, as a support tool in making intelligent and informed decisions. In this sense, through the Secretary of
Health we are the ideal institution to continue implementing Telemedicine in the Department, likewise, we have the human and technical capacity to strengthen the network and hard work for have greater coverage.

We don't have any support to help us implement the initiative.
In addition to the Departmental Health Network, a key role would be played by health promoters, she must approach the community so that they know the advantages of Telemedicine and they learn to used correctly .

Telemedicine isn't intended as a business nor is it for profit for the Department of Cundinamarca.

It focuses on reducing the expenses of the cundinamarqueses to access health services (saving fuel and money invested in trips to attend medical appointments in the municipal capitals and decrease in waiting times for appointments with specialists) .
It's an initiative that mainly benefits the community.

Products or services do you provide them? 

 Among the results of the first phase of implementation of this initiative, it has been possible for patients to have access to the 21 medical specialties to remote form like: Cardiology, Pediatric Cardiology, Cardiovascular Diagnosis, Electro-Diagnosis, Obstetrics and Gynecology, General medicine , Pneumology, Pneumology Lab - Lung Function, Pediatrics, Radiology & Diagnostic imaging, Rheumatology and Respiratory Therap.

How do you provide these products or services? 

Remotely through the 53 healthcare service institutions linked to the Departmental Public Network.

Why do they want or need them?

Through these services, communities exercise their right to timely, acceptable and affordable access to quality health care services. It's worth mentioning that this is one of the most violated human rights for rural communities in the world.

Own Resources: Taxes and operating expenses of the Department.
First investment US $250.000
Investment for Teleconsultation US $83,400
Investment for Remote Diagnosis US $125.100

We have the purpose of applying to grants, prizes and challenges to obtain resources that allow us to strengthen the Departmental Network in the short term.

Monitoring and evaluation:
Know the correct way to carry out the Monitoring and evaluation of the practice so that users can indicate traits to improve and the specialties that we must include soon.

Marketing, media, and exposure:
create the strategy of socialization and social appropriation of Telemedicine in the most remote rural sectors of the Department so that they make use of the initiative.

I don't know the experts in the areas of monitoring and evaluation and marketing that Solve has, so I don't specify their names in this box.

The UN recognized the Cundinamarca Government for this initiative, highlighting it's important contribution to expand health coverage in the department. Telemedicine represents a technological advance for Cundinamarca, and an advance in health coverage, his people
which is characterized by the agricultural and rural vocation of the territory. This initiative not only aims at connectivity but at the social appropriation of ICTs in the farmers so that they make use of this system, for this reason, it's necessary bring the project closer to the most vulnerable communities so that they can get to know it and take advantage of it.