In October 2020, the Government of the United Kingdom reported that nearly 16,000 new coronavirus cases had been left out of the national count¹ 5 because of a mistake in transferring a very large Excel file—the type of error that a novice bookkeeper might make. The failure to include these cases in contact tracing effortswas linked to more than 125,000 additional cases and over 1,500 deaths ² in the world’s sixth largest economy.

This event illustrates three key points about digital transformation. First, information technologies can have a direct, life-or-death impact on public health. Second, slapdash, ad hoc implementations without an intentional and long-term vision and without all necessary elements and stakeholders cause serious harm. Finally, cutting corners on the public investment needed to properly implement these processes (with the right tools) ends up costing dearly, as does a poorly informed investment without strategic planning.

There is unanimous, global consensus at the highest political level about the importance of digital transformation.

Information technologies are part of 10 of 17 Sustainable Development Goals (SDG) in the 2030 agenda. In health, the commitment to the SDGs and 2030 agenda was confirmed in 2018 by more than 100 presidents and senior officials at the global conference in Astana, led by the World Health Organization (WHO) and UNICEF. In 2021, 49 countries and territories ratified the Roadmap for the Digital Transformation of the Health Sector in the Region of the Americas,and PAHO outlined 8 principlesto govern these processes.

Yet LAC still lags behind. In the field of health, only 11 countries in the region have laws that define and validate electronic health record systems, and only 14 of the 26 countries analyzed have a digital health strategy.⁴ Furthermore, LAC health information systems are isolated, fragmented, underfunded, and underused.

In light of these circumstances, countries have two main choices. The first is to move ahead as usual: adopting technological tools in fragmented implementations, without a comprehensive vision of how the technology can improve the sector’s work, to patch up immediate issues. The second is to strategically incorporate technologies, processes, and skills specific to the needs of each country, integrating the vision and participation of all involved. The latter approach requires making a long-term political and economic commitment to redesigning health systems.

Given the current severe economic crisis, it is possible some countries will consider sticking to their traditional approach. However, the harsh lessons of COVID-19 all urge a single course of action: embark on a digital transformation to create national health systems that are high quality, efficient, equitable, and promote the continual well-being of their population. For the region, progress toward universal health coverage will require increased public expenditure in upcoming years because of population aging, rising prices, and the growing availability of technology.⁵ It will be more important than ever to have a clear idea of how health resources are being spent, which will be impossible without quality information systems. To check rising costs, investments in digitally transforming health care can be key because they enable resources to be allocated more efficiently..⁶

This document covers each aspect of the digital health transformation process; shares evidence, practices, and specific recommendations; identifies the stakeholders that can—and should—participate; and lays out the practical elements each country needs in order to carry out this crucial process.