title: Design and Implementation of a Telepediatric Primary-Level and Low-Cost System to Reduce Unnecessary Patient Transfers.
abstract: Most inhabitants in Latin America are concentrated in large urban foci with different access to facilities. Although the main hospitals offer specialized services, economically vulnerable populations cannot easily afford these services, the pediatric population being most affected. This article presents the design and implementation of a low cost telepediatric system, applied to primary care hospitals through a study in Bogotá, Colombia, mainly aimed to reduce the number of unnecessary transfers commonly sent to specialized medical services.
  
  
  
  The system was carried out over 6 months with a higher incidence of acute respiratory illness in children between 0 and 5 years in nine primary care hospitals in Bogotá. Nineteen (n = 19) pediatricians were trained by a group of engineers that supports the system permanently. The reduction of patient transfers was compared with previous reports of the National Statistical Department in Colombia.
  
  
  
  The system reduced both the number of patient transfers to higher level hospitals by 83% and the waiting times for patient transfer, improving healthcare in pediatric patients at a reasonable cost, affecting more than 700 patients. At the same time, a decrease of about 17% in the use of antibiotics was observed, which is an important current public health issue.
  
  
  
  The use of telemedicine improves the efficiency of public health resources, even in big cities such as Bogotá, reducing the number of unnecessary patient transfers and the optimization and appropriate use of medicines.
authors.affiliation: 1 Computer Imaging and Medical Applications Laboratory, Universidad Nacional de Colombia , Bogota, Colombia .|2 Facultad de Ciencias Médicas, Universidad Espíritu Santo, Ecuador .
authors.forename: Christian
authors.initials: C
authors.lastname: Cifuentes
authors.affiliation: 1 Computer Imaging and Medical Applications Laboratory, Universidad Nacional de Colombia , Bogota, Colombia .
authors.forename: Eduardo
authors.initials: E
authors.lastname: Romero
authors.affiliation: 1 Computer Imaging and Medical Applications Laboratory, Universidad Nacional de Colombia , Bogota, Colombia .
authors.forename: Javier
authors.initials: J
authors.lastname: Godoy
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003105:Colombia; D005260:Female; D019983:Guideline Adherence; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007318:Inservice Training; D008297:Male; D010360:Patient Transfer / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000379:methods* / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000628:therapy; D017216:Telemedicine / Q000379:methods* / Q000706:statistics & numerical data*; D013997:Time Factors; D014944:World Health Organization
chemical_list: D000900:Anti-Bacterial Agents
keywords: Home Health monitoring; e-health; pediatrics; telemedicine