Diapositiva 1

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Telemedicine regulation, a Colombian Experience
Jorge A. Vélez B., MD and Andrés A. Navarro N.,MSc
Colombian Telemedicine Centre Ltd.
Marcela Giraldo MD, MSc
Colombian Ministry of Social Protection.
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Background

• Health care habilitation and acreditation process
• Telemedicine plan and governmental prospect
• Connectivity Agenda
• PAHO support
• Local Telemedicine developments

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Description

• Hypothesis Is it possible that national
  regulations from Latin America and the Caribbean
  lead towards a regional regulation, which permits
  to foster telemedicine and telehealth
  applications, as a strategy to increase health
  care coverage and access?

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Objective

• This regulation is addressed to define the
  habilitation/accreditation conditions for the
  health care institutions that deliver services in
  the telemedicine modality.
• To establish the obligatory matters related with
  delivery institutions, reference centers and
  others aspects on medical data messages and
  digital signs authentication.

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Methods

• Description of the regulation method applied for
  telemedicine and telehealth
• Methodological description for implementation and
  follow-up.
• Regulation impact and results assessment.
• Regulations advances on accreditation/habilitation
  processes for health care professionals and
  hospitals involved in telemedicine and telehealth
  services.
• State-of-the-art of technological infrastructure
  and the requirements for telemedicine and
  telehealth implementations for the region.

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Contexts of application

• Referral centers
• Description of process
• Telemedicine Providers centers
• Description of facility

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Technical instrument components

• Handbook of Technological and scientific
  standards for habilitation of providers for
  health care delivery on Telemedicine modality
• Additional critera in habilitation procedures for
  referral institutions
• Areas
• Human resource
• Equipment and maintenace
• Priority assistance procceses
• Clinical record and assistance records
• Services interdependency
• Risks follow-up

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Habilitation instrument
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Minimal references values for image management
Image Image Image Characteristics Image Characteristics Image Characteristics Image Characteristics Image Size Image Size Image Size
Category Modality Pixels Pixels Bits Bits Imagewithout compression(KBs) Typical Compression Factor Comprised Image(KBs)
Category Modality Width Height Dig. Alm. Imagewithout compression(KBs) Typical Compression Factor Comprised Image(KBs)
Macrophotos External (dermatology) 1524 1120 24 24 5.001 27 185
Microphotos Pathology 800 600 24 24 1.406 20 70
Radiology CAT 512 512 12 16 512 8 64
Radiology MNR 256 256 12 16 128 4 32
Radiology Ultrasound 512 512 6 8 256 10 26
Radiology Nuclear Medicine 128 128 8 8 16 10 2
Radiology Digitalized films RX General 2048 2500 12 8 5.000 10 500
Radiology Frame Grabber 512 512 12 8 256 8 32
Radiology Digitalized films Mammograms 4096 4096 12 8 16.384 10 1.638
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Discussion

• We believe that is necessary to establish a
  framework to promote the national and regional
  policies construction, in consistence with the
  demand from each country. This framework should
  consider the following matters
• It should be formed by laws and regulations from
  each country,
• It should group the efforts and advances related
  with regulations,
• It should consider the assessment from the
  application of former regulations.
• It should emphasize on developing standards on
  medical education via telemedicine and
  interoperable telemedicine network

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Further work

• Extend and enhance the Colombian experience to
  the whole region
• Bring other experiences in the field
• ATALACC should be the promotor of a regional
  regulation

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Thanks Obrigado javelez_at_colombiantelemed.org