This critical narrative review examines implementation barriers and facilitators, quantitative evidence, and rural representation in health information interoperability across Latin America and the Caribbean. A purposive corpus of 16 distinct sources was interpreted by evidence type, implementation stage, outcome unit, and rural reporting. Recurring themes included standards, governance, vendor dependencies, financing, workforce capacity, and institutional readiness. Technical demonstrations and participation counts documented activity but did not establish sustained clinical use or exchange success rates. Quantitative findings measured different constructs and units, so no pooled estimate was calculated. Rural evidence included reported connectivity barriers and an offline synchronization approach, but the reviewed corpus did not support a regional rural–urban effectiveness estimate. Future evaluations should report validated exchanges with explicit denominators, distinguish testing from routine use, and describe rural definitions and subgroup outcomes. This is a purposive narrative synthesis, not an exhaustive systematic review or meta-analysis. Within the reviewed corpus, missing rural subgroup outcomes represent an evidence gap rather than proof of poor rural implementation.
Keywords: Health information exchange; Interoperability; Latin America and the Caribbean; Implementation; Rural health