Universal single digital medical record in Peru: from chaos to order in medical information

Abstract

The traditional Clinical Record, the one written on paper, little by little loses validity and in its replacement, the Electronic Clinical Record has been consolidating within the health community; its peculiarities and characteristics have played a decisive role in making its use more important in most health providers. The path and qualities of the Electronic Medical Record are entangled when it is observed that each provider uses a different platform for the collection of medical information and this condition reduces the use of information and its interoperability in various healthcare entities in front of to the need of the emergency. This article sought to collect information on the progress in the various latitudes regarding the issue and in this sense verified how Europe already has a long path walked; while in Latin America and Peru we still use dissimilar formats, the closest thing to an attempt to unify platforms. The main conclusion is the need for Peru to design and implement the Unique and Universal Digital Medical Record and become a pioneer in the use of the format that interoperates medical information throughout the region. This study is considered to have bibliographic, theoretical and descriptive characteristics, whose procedure includes the search, organization, systematization and analysis of a set of digital documents, the subject is the generalization of medical records, unique medical records and summaries 2014-2021. digital medical records. All information on the above topics found in databases such as Latindex, SciELO, Elsevier, etc. are considered as search and analysis units.