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Insights
Extending the benefits of telemedicine to war in Ukraine
Two Wars: The Russian invasion and the attack on healthcare
Since the start of the conflict, Russia has destroyed nearly 100 healthcare facilities in Ukraine. Leaving sick children battling for their lives and doctors and nurses risking theirs. Northwell knows that attacking healthcare is one of the most devastating things that can happen to a population. That’s why we’re dedicated to not only telling these stories, but to raising health wherever it is threatened.
Current total donations
Current total donations
This amount represents the total donations received for Northwell's Ukraine Relief Fund, which are being directed to international relief partners such as Doctors Without Borders.
Matching donations
Matching donations
Northwell is not only donating 100% of the money received through its Ukraine Relief Fund, the system is sending an additional $175,000 to support relief efforts in other countries currently impacted by war.
First aid supplies
First aid supplies
This has been allocated to the purchase of individual first aid kits and tourniquets, which are in high demand. Northwell has sent more than 500 tourniquets to one hospital alone.
Current total donations
This amount represents the total donations received for Northwell's Ukraine Relief Fund, which are being directed to international relief partners such as Doctors Without Borders.
Matching donations
Northwell is not only donating 100% of the money received through its Ukraine Relief Fund, the system is sending an additional $175,000 to support relief efforts in other countries currently impacted by war.
First aid supplies
This has been allocated to the purchase of individual first aid kits and tourniquets, which are in high demand. Northwell has sent more than 500 tourniquets to one hospital alone.
Eric Cioe Peña, MD | Jonathan Berkowitz, MD
Northwell Health adapts its telehealth capabilities to the needs of Ukraine’s frontline health care workers
The health care demands during war are impossibly high. With Russia targeting Ukraine’s hospitals, clinics, maternity wards and other care facilities, the pressure upon the frontline medical staff is unrelenting. The World Health Organization has identified approximately 200 attacks on health care institutions as of early May.
Clearly, Ukrainian doctors and nurses need support. Real-time doctor-to-doctor consultations can assist the many physicians practicing outside of their comfort zone, such as general internists caring for trauma patients or surgeons staffing ICUs packed with critically ill patients requiring consults in areas of medicine traditionally covered by subspecialists – doctors with years of medical training post-residency.
While there is no playbook on how to use telemedicine during a war, we know the tremendous value that a second opinion or even a voice of reassurance can have, particularly for those in Ukraine operating out of makeshift hospitals.
Doing the right thing
Through our Center for Global Health, we reached out to partners linked to hospitals in Ukraine. This allowed us to better understand the needs on the ground. We quickly realized that the greatest support we could offer — beyond the supplies we were already sending — is clinical expertise.
We’d already improved our telemedicine technology to meet the needs of the Covid-19 crisis; we had all the pieces to quickly set up communication for our overtaxed peers in Ukraine. Northwell’s emergency telemedicine program and centralized Transfer Center provide patients in New York and beyond access to thousands of Northwell hospital-based specialists.
When the world expected Ukraine to fall in a matter of weeks, we began preparing to set up telemedicine consults in refugee camps in Poland. That shifted as Ukraine showed its resolve, refusing to fold. Instead, we evolved with the situation and refocused our efforts to build a countrywide telemedicine support system to reach medical staff throughout Ukraine.
In late April we deployed a 24/7 consultation and support service and reached out to Northwell staff for volunteers. The response was immediate, with more than 50 motivated and passionate clinicians offering their services in 50-plus subspecialties such as head and neck surgery, neurointensive care, orthopedic care, transplants and vascular surgery.
Benefits of telemedicine in a crisis
The chance of failure is always high when you are the first to attempt something, but our extensive experience in using telemedicine in a crisis amid Covid-19 helped us to quickly adapt to the needs in Ukraine.
We modified our existing infrastructure from the health system’s on-call management system and now Ukrainian physicians can simply hit a button to connect with a qualified Northwell expert on a laptop, a tablet or a mobile device. We have interpreters who can translate and transcribe the call and send documentation to the treating clinician.
We continue to actively listen so we can find the best way to help: We’re taking our Ukrainian partners’ advice on workflow, then updating the original concept — sometimes within a day or even hours. As we look to scale this system, front of mind is that we are partners with Ukraine and that we are here to help. Everything is done to build a seamless experience for the experts on both ends of the consult.
Our New York-based service line directors and leads are supporting all requests for specialists within the Northwell network. If there’s no volunteer available for an incoming telemedicine request, we’ll put it out to the Northwell call system, run by the Transfer Center.
A recent example: Andrew Salama, DDS, MD, experienced his first telemedicine consult on a Ukrainian patient with a blast injury that broke every bone in the individual’s face. Dr. Salama, chief of oral and maxillofacial surgery at Northwell, was working his usual shift when staff contacted him about the consult; he was grateful to provide his perspective to a surgeon on the case.
“I think that there was an appreciation that we were on this call together, from both sides,” he told us.
They discussed best approaches to surgery, both the timing and best entry point.
“We got into some nuances about what to do in the area,” Dr. Salama said. “We talked about which fractures need to be exposed and the mechanics of the surgery.”
Like the technology itself, how we measure success will evolve as time goes on. Early on, however, we can measure the value of that interaction in the moment that our Ukrainian partner’s eyes lit up. From skeptical to eager, the exchange transcended the language barrier and resulted in a genuine connection — and dozens of messages about the results of the surgery.
Beyond the mechanics and process, these consults provide a glimpse into the larger conflict and resulting atrocities. Before leaving the 30-minute session, the translator said: “I’m going to go cry now."
"It was very sobering,” Dr. Salama noted.
Chaplain Adrian Mazur explains the need for outreach and support for Ukrainian children displaced by the war.
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The head and the heart
This is the latest example of how Northwell is taking the talents and resources of its 78,000-employee health system to make an impact on global health. If the heart of our efforts in Ukraine is the Center for Global Health, the brains behind it is the central Transfer Center.
Following this initial phase, we plan to bring medical grade/high fidelity telemedicine systems, ones routinely used in hospitals in the U.S., to Ukraine to collaborate on higher level cases in the operating room, to aid in combat trauma and other procedures.
A lot of nuance goes into creating accessible systems and this team has demonstrated great agility to design real-time solutions around problems all the way around the world. Our mentality, from Covid-19 to Ukraine, has been: “Tell us what you need and we’ll build a product to fit it.”
This approach drove us during the pandemic to solve problems we didn’t know we’d have just days and weeks prior. Now we’re applying those lessons in Ukraine. We continue to focus on adaptability, knowing that the tool we use today may have to change tomorrow or the next month. We’re focused on new ways to give access to the vast resources of our health system.
Support Ukraine relief fund
In March, Northwell Health sent 18,000 pounds of supplies valued at $160,000 to Ukraine. The health system has established a Ukraine relief fund that will ultimately be directed to international relief partner Doctors Without Borders, and potentially others.
To contribute to the fund, visit Northwell's Center for Global Health.
Eric Cioe Peña, MD, director for Northwell’s Center for Global Health
Jonathan Berkowitz, MD, medical director for Northwell’s Transfer Center and the Center for Emergency Medicine
More about relief efforts in Ukraine
Northwell is accepting donations through its Center for Global Health (CGH), which was established in 2019 and has since assisted in healthcare emergencies across the globe.
Eric Cioe-Pena, MD, explains how learning from and educating international physicians about various treatments and surgical techniques can have a lasting impact.
To address health equity for New York’s Guyanese, health efforts abroad enhance cross-culture understanding.