Hybrid telehealth outcomes at Latin America’s first fully digital hospital
Abstract
Background: NCDs are the leading cause of premature mortality, hitting hardest in middle-income countries with fragmented health systems. Long-term real-world evidence from Latin America remains scarce, and most available studies rely on short follow-up or inadequate statistical control, limiting interpretability. This study evaluates longitudinal clinical and behavioral trajectories under a structured hybrid care model in a high-risk multimorbid population.
Methods: Retrospective pre-post observational study using electronic health records linked to a telemonitoring platform at a tertiary centre in Medellín, Colombia (n = 319; ≥3 years follow-up). Participants had hypertension, type 2 diabetes, and/or dyslipidemia. Within-patient changes were assessed using paired tests, McNemar/Bowker tests, and mixed-effects models. Multiple testing was controlled using false discovery rate (q-FDR). All findings were interpreted as longitudinal associations.
Results: Median age 63 years, 73.7% women, 96.9% multimorbidity. Therapeutic target achievement rose from 21.9% to 52.7% (95% CI 47.1–58.3). Weight decreased 4 kg, systolic BP 6 mmHg, diastolic BP 5 mmHg (all q-FDR<0.05). High cardiovascular risk declined 8.8 percentage points, with 29.2% reclassified to lower-risk strata. Adherence improved ∼34 percentage points. Reductions observed in diabetic ketoacidosis and myocardial infarction. Three-year mortality was 2.5%.
Conclusions: Sustained hybrid care was associated with meaningful improvements in cardiometabolic control, adherence, and risk redistribution in a real-world high-risk population. Findings support: expanding hybrid models for chronic disease management; integrating digital and in-person care pathways into policy; and strengthening surveillance through longitudinal real-world data. This study also offers a replicable methodological framework for rigorous digital health evaluation in middle-income settings.
Key messages: • A hybrid care model at Latin America’s first digital hospital achieved therapeutic target doubling and cardiovascular risk reclassification in 29% of high-risk multimorbid adults over three years.
• A scalable hybrid telehealth model improved adherence by 40 percent and shifted nearly one third of patients to lower cardiovascular risk categories.
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BibTeX
@article{bedoya2026hybrid,
title = {{Hybrid telehealth outcomes at Latin America’s first fully digital hospital}},
author = {K Saldarriaga Bedoya and E Buskens and C Carvajal Espinosa and GR Ariza S and Ml Lahr and H Moncayo},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1193},
url = {https://doi.org/10.1093/eurpub/ckag169.1193},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Hybrid telehealth outcomes at Latin America’s first fully digital hospital
AU - K Saldarriaga Bedoya
AU - E Buskens
AU - C Carvajal Espinosa
AU - GR Ariza S
AU - Ml Lahr
AU - H Moncayo
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1193
UR - https://doi.org/10.1093/eurpub/ckag169.1193
AB - Background: NCDs are the leading cause of premature mortality, hitting hardest in middle-income countries with fragmented health systems. Long-term real-world evidence from Latin America remains scarce, and most available studies rely on short follow-up or inadequate statistical control, limiting interpretability. This study evaluates longitudinal clinical and behavioral trajectories under a structured hybrid care model in a high-risk multimorbid population. Methods: Retrospective pre-post observational study using electronic health records linked to a telemonitoring platform at a tertiary centre in Medellín, Colombia (n = 319; ≥3 years follow-up). Participants had hypertension, type 2 diabetes, and/or dyslipidemia. Within-patient changes were assessed using paired tests, McNemar/Bowker tests, and mixed-effects models. Multiple testing was controlled using false discovery rate (q-FDR). All findings were interpreted as longitudinal associations. Results: Median age 63 years, 73.7% women, 96.9% multimorbidity. Therapeutic target achievement rose from 21.9% to 52.7% (95% CI 47.1–58.3). Weight decreased 4 kg, systolic BP 6 mmHg, diastolic BP 5 mmHg (all q-FDR<0.05). High cardiovascular risk declined 8.8 percentage points, with 29.2% reclassified to lower-risk strata. Adherence improved ∼34 percentage points. Reductions observed in diabetic ketoacidosis and myocardial infarction. Three-year mortality was 2.5%. Conclusions: Sustained hybrid care was associated with meaningful improvements in cardiometabolic control, adherence, and risk redistribution in a real-world high-risk population. Findings support: expanding hybrid models for chronic disease management; integrating digital and in-person care pathways into policy; and strengthening surveillance through longitudinal real-world data. This study also offers a replicable methodological framework for rigorous digital health evaluation in middle-income settings. Key messages: • A hybrid care model at Latin America’s first digital hospital achieved therapeutic target doubling and cardiovascular risk reclassification in 29% of high-risk multimorbid adults over three years. • A scalable hybrid telehealth model improved adherence by 40 percent and shifted nearly one third of patients to lower cardiovascular risk categories.
SN - 1101-1262
SN - 1464-360X
ER -