As War Upends Ukraine’s Health System, Telemedicine Rises to Fill the Gaps
New capacities in delivering remote care strengthen long-term health system resilience
Dr. V., a surgeon in Ukraine, vividly remembers the day the call came from a colleague in another city. A patient had arrived with gallstones and urgently needed surgery, but no one there had the required expertise. Could Dr. V. help?
“There was no time for me to make a trip to the hospital the patient was at,” he recalls. “I decided to use [the] recently installed telemedicine platform. I was able to join the surgery in real time, see the issue, and assist my colleague in conducting the surgery remotely.”
The challenge of treating patients in the absence of needed specialists is not unique to the hospital that contacted Dr. V. The Russian invasion has severely disrupted Ukraine’s health sector as thousands of health providers — often the most highly trained — have become internally displaced or fled the country. As of March 2023, more than 1,151 medical facilities had been damaged or destroyed, according to Ukraine’s Ministry of Health. People often hesitate to leave their homes to seek care, and a new category of patients has arisen due to air strikes — what Dr. V. described as “complex cases with explosion and burn injuries.”
Amidst this crisis, telemedicine has become an essential tool for reconnecting people to health care. Thanks to digital technologies that enable doctors to meet remotely with patients, view medical imaging results on a screen, and consult via video conference with specialists located elsewhere, many Ukrainians are continuing to receive high-quality care despite the constraints of the war.
“After the first remote examination, I realized how safe and convenient this is,” says a woman whose doctor is monitoring her pregnancy via telemedicine.
The telemedicine equipment and licenses used were donated to Ukraine’s Ministry of Health by foreign companies eager to assist the war-torn country. The ministry welcomed the donations, and the USAID Local Health System Sustainability Project (LHSS) helped the ministry create a standardized process to check and safely deploy the various technologies by systematically assessing, testing, selecting, and deploying them.
To ensure the solutions are being used appropriately, LHSS holds training sessions and provides 24/7 technical support for patients and health providers using the technologies. As of March 2023, LHSS had supported training for over 1,000 medical workers in nearly 300 health facilities, resulting in more than 3,000 sessions with patients.
A new way of receiving care
One of these telemedicine solutions was the remote surgery tool Dr. V. used. The technology uses advanced cameras, monitors, software, and a secure network to allow an off-site specialist to watch a live surgery in progress, see vital signs from the patient, and provide direction in real time to the surgeons in the room.
Although Dr. V. was skeptical of the equipment at first, thinking that mastering a new technology would be time-consuming and overwhelming, he revised his thinking once he began using it to save the lives of patients he’d never even seen or touched.
Patients, too, are accepting this new way of receiving care.
“It has become extremely inconvenient and often unsafe to go to medical appointments since the full-scale Russian invasion of Ukraine,” said a pregnant patient who used remote fetal monitoring at a district hospital to connect with an obstetrician. “To minimize the security risks, my obstetrician gave me an electronic device through which I can get examined from my home. The device connects to my smartphone, and once the examination is completed, the results are sent directly to my doctor’s phone.”
The patient added, “I was hesitant at first, because I did not quite understand how one can get examined from home. But after the first remote examination, I realized how safe and convenient this is.”
Ukraine’s health system continues to face extraordinary challenges. Over the coming year, LHSS will gradually transfer the job of supporting use of the donated telemedicine solutions to a local entity. By supporting this localization, LHSS aims to ensure sustainability for Ukraine’s telemedicine program throughout the war — and in the post-war period that will follow.
Note:
To avoid jeopardizing the safety and security of the health provider and patient interviewed for this article, their names and locations have not been disclosed.
