Objectives are: describe the status of telemedicine and its Latin American development: Argentina, Bolivia and Colombia; identify the stages, adoption barriers such as cultural, organizational and technological changes. The research was qualitative, descriptive with cross-sectional case studies: Argentina: Austral and Italian Hospitals, Bolivia: Obrero and Odontológico UDABOL Hospitals; Colombia four health institutions. Interviews and observations were applied in Argentina and Bolivia; questionnaire: In Colombia; interviews with experts. The digital transformation in health requires a clear business model and strategy, maturity in management practices, development of a digitaculture and knowledge management seeking interoperability and organizational agility. Argentina and Colombia incorporated telemedicine, requiring increasing the productivity of available resources; in Bolivia the situation is less satisfactory.