Digital transformation and Family and Community Medicine in Ibero-America: consensus, challenges, and proposals from an ethical and humanistic perspective

Abstract

Introduction: Digital transformation is rapidly reshaping Primary Health Care (PHC) through the incorporation of technologies such as telemedicine, artificial intelligence, and clinical information systems. While these tools offer opportunities to improve access, continuity, and efficiency of care, they also raise challenges related to equity, governance, regulation, and the preservation of the therapeutic relationship. Objective: To identify regional consensus on the integration of emerging technologies into Family and Community Medicine (FCM) in Ibero-America through a multinational Delphi process. Methods: A consensus study conducted within the framework of the IX Ibero-American Summit of Family and Community Medicine (Montevideo, 2025). A three-round Delphi methodology was applied with experts in Family and Community Medicine, digital health, and health systems management from 19 Ibero-American countries. The dimensions analyzed included telemedicine, artificial intelligence, health information systems, digital equity, and ethical governance. Consensus was defined as ≥85% agreement in the third round. Responses were analyzed through thematic review and peer validation. Results: Regional consensus was achieved on seven conceptual foundations, ten strategic proposals, and ten recommendations aimed at strengthening digital transformation in PHC. Key agreements included the incorporation of digital competencies into medical education, the development of specific regulatory frameworks for emerging technologies, the promotion of interoperability and cybersecurity, the implementation of hybrid models of care, and the reduction of access gaps among vulnerable populations. Participants also agreed that technology should complement clinical judgment rather than replace the physician–patient relationship. Conclusions: Family and Community Medicine is strategically positioned to lead an ethical, equitable, and person-centered digital transformation across Ibero-America. The consensus achieved provides a roadmap for governments, academic institutions, health systems, and scientific societies seeking to integrate emerging technologies while preserving the core principles of Primary Health Care.