Barriers for successful implementation of telemedicine in developing countries: the Colombian case

Implementation of telemedicine programs in Latin America has been documented in different reports, finding that Mexico, Chile and Colombia are the countries with the highest public coverage. Nevertheless, efforts made in Colombia in this regard are considered insufficient, and previously unidentified factors have delayed the full progress of this technology in the country. An integrative review was conducted in PubMed and ScienceDirect databases, and Colombian governmental repositories between 2011 and 2021. A total of 135 articles were processed in Rayyan QCRI software to characterize the telemedicine adoption process in Colombia. Published works in this area concern the economical evaluation of telemedicine services, focusing in estimating costs for its implementation, but cost-benefit, cost-effectiveness and cost-utility studies are needed for a complete policy in this regard, which should discuss important factors as infrastructure, current legislation, financing of public actors, availability of scientific evidence for decision-making, and political will. Finally, once the project is underway, monitoring, evaluation, and adaptation of the systems must be guaranteed to ensure the planned objectives and desired benefits are met, and barriers to the effective use of the project are overcome. Successful implementation of telemedicine programs in developing countries should consider several aspects. First, complexity, adaptability, compatibility with existing work practices, and cost of the project. Second, stakeholders must be included. Third, standards for interoperability, security, and privacy must be established to improve project acceptability and implementation. Fourth, sufficient financial and legislative support must be secured to support the project. Fifth, planning must be considered to ensure that the health system is ready for the project. Sixth, necessary education must be provided to all project stakeholders. KEY MESSAGES: • E-medicine barriers were identified to prompt its implementation in developing countries. • Boost healthcare access, reduce costs, and enhanced disease surveillance is possible through telemedicine.