Fragmentation of Health Information Systems and National Challenges: An Analysis of Peru's Situation

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Peru recently approved the National Telemedicine Plan for 2026. However, its implementation faces several critical issues. First, the allocated budget (S/ 41.9 million) is deemed insufficient to cover equipment acquisition, continuous staff training, and infrastructure maintenance. Furthermore, because this plan relies on multiple investment sources rather than a dedicated budget line, it suffers from financial instability. Technologically, health information system fragmentation is highlighted as a major problem. By law, all healthcare providers in Peru should use an interoperable electronic medical record (Historia Clínica Electrónica). This requires adopting the international standard FHIR (Fast Healthcare Interoperability Resources), leading to initiatives like the official 'FHIR Guide' and concept proof events such as 'Conectatn'. Despite these efforts, the process has stalled due to changes in authorities, resulting in continued reliance on paper records or non-interoperable local systems. Moreover, while telemedicine platforms (like Teleatiendo) are promoted, data generated there is often not properly recorded in the electronic medical record, leading to clinical acts without legal backing. These situations cause duplicate patient records, increase administrative burden, and critically undermine the user's right to portability of their medical history. This fragmentation is not merely a technical issue but a structural challenge affecting the entire national healthcare delivery system and equitable access rights.