The role of telemedicine in the context of the COVID-19 pandemic in Colombia.

Background: With the onset of the COVID-19 pandemic in Colombia, telemedicine (TM) became a key strategy to sustain healthcare delivery for both acute and chronic conditions. This study aimed to describe the utilization and characteristics of TM during the pandemic in Colombia. Methods: We conducted a retrospective, descriptive study using administrative and clinical records from a major Colombian health insurance provider covering approximately 15% of the national population. We analyzed all TM consultations between March 2020 and June 2021, assessing sociodemographic, geographic, and clinical characteristics. TM users and the overall insured population were described, and primary care unit (PCU) locations were georeferenced. Results: A total of 10,016,931 individuals were enrolled in the health insurance plan, of whom 2,633,564 used TM services during the study period. TM users were predominantly female (62.8%) and aged 19-45 years (55.3%). Most belonged to low-income groups (64.9%) and were affiliated with the subsidized income level group. The most frequent diagnosis was COVID-19 (28.3%), followed by general symptoms and unspecified conditions (19.4%). Telemedicine was used nationwide, with higher concentrations in central and northern departments such as Antioquia and Bogotá. Conclusion: During the pandemic, telemedicine was widely adopted across Colombia and reached large segments of low-income populations, suggesting its potential to support healthcare access in diverse settings. While our descriptive design does not allow for causal claims about effectiveness or equity, these findings highlight the value of TM as a complementary healthcare delivery model. Continued investment in digital infrastructure, workforce training, and primary care networks will be essential for its long-term integration into Colombia's health system.