Digital Medicine During Wartime: How eHealth Is Transforming Ukraine’s Healthcare System and Where the Line Lies Between Progress and Risk
Time for Action analyzed how, over the years of medical reform and full-scale war, electronic healthcare eHealth has taken shape in Ukraine, what real changes it has brought for patients, doctors, and the state, and why the digitalization of medicine has become not merely a reform, but a matter of systemic resilience in times of crisis.
With the launch of medical reform, Ukraine set a course toward digital transformation of healthcare, which gradually evolved into a complex electronic healthcare ecosystem. Today, eHealth brings together data on more than 35 million patients, medical institutions, registries, IT systems, and digital services. Importantly, this process did not stop even after the beginning of the full-scale war. On the contrary, the war exposed a critical need for centralized data, rapid access to information, and depaperization.
Oleksandr Yemets, Head of the State Enterprise “Electronic Health,” directly notes that Ukrainian eHealth is being built “by the efforts of many actors – both within state subordination and civil society organizations”, and that its development continues even under the most difficult conditions. This is a fundamental difference from many peacetime reforms that stall at the first serious crisis.
One of the key shifts has been the systematization and centralization of medical information. In recent years, Ukraine has developed an entire network of electronic registries and systems, nine of which are administered by the State Enterprise “Electronic Health.” Among them is the Electronic Healthcare System (EHS), one of the most heavily loaded state IT systems, containing medical data of tens of millions of citizens. Alongside it operate electronic queues for endoprosthetics, the system for assessing individual functioning, automated ranking-based distribution into internships, a continuous professional development platform, state registries of medical devices and disinfectants, as well as systems still being implemented, including e-Blood.
Separately, systems administered by other state enterprises also operate: e-Stock, MedData, the monitoring system for socially significant diseases, ESEN, UDITS, ELISSZ. Together, they form the backbone of digital medicine, where data cease to be fragmented and begin to function as an integrated whole.
Against this background, public-private partnership becomes especially important, without which scaling eHealth would be impossible. The EHS is built as a two-component system: the state is responsible for the central database, regulatory framework, policy, and security, while private medical information systems provide functionality and services for doctors and patients. The system processes around 1,800 requests per second, has a data volume of approximately 600 terabytes, integrates 37 medical information systems, involves 400,000 medical workers, registers 27,000 medical institutions and nearly 19,000 pharmacies, and contains more than 4.6 billion electronic medical records.
Yemets emphasizes that the EHS is a relatively young system only seven years old yet within this time it has covered a path that took decades in some European countries. At the same time, he acknowledges differences between Ukraine and EU states: in France and Italy, patient portals and telemedicine are significantly more developed, and depersonalized data are actively used for analytics and forecasting.
Digitalization has affected not only the central level but also internal processes within medical institutions. The example of Okhmatdyt shows that depaperization is not about comfort, but about survival. The transition to ERP systems, electronic document management, and integrated MIS allowed the hospital to preserve all data even after a missile strike in July 2024. Management knew exactly how many patients were hospitalized and where each was evacuated. This is a vivid example of how digital solutions directly affect safety and crisis management.
At the same time, digitalization opens a new dimension patient control over personal medical information. Today, patient applications mostly exist at the level of individual medical information systems and are not fully interoperable. Yemets aptly compares this to banking apps, where one application shows accounts of only one bank. In 2025, the Personal Patient Cabinet is being launched at the level of the EHS central database. At the first stage, it will allow management of personal data, and in the future should provide access to medical records as well. This creates a new level of transparency and potentially prevents fraud when records may be entered into the system without the patient’s actual visit.
Equally important are open data, which have already become a tool for managerial decision-making. Since 2019, the National Health Service of Ukraine has been implementing dashboards, and today there are already 35, with annual audience exceeding 2 million views. Based on these data, managers compare institutional performance, patients find doctors and pharmacies, and the state plans the medical guarantees program. Chatbots, services, and applications, including “Likі.Control,” operate on the basis of open datasets.
A separate direction is artificial intelligence in medicine. Ukraine is already implementing state-level pilots, including digital vision screening using AI, where the CheckEye system automatically detects diabetic retinopathy. At the same time, AI assistants for doctors are gaining popularity, such as Tayra.AI, where “the doctor treats, and the AI assistant does the documentation.” Other tools, including AI Aivalut, help analyze consultation conclusions and compliance with treatment protocols. All these solutions reduce routine workload and allow doctors to focus on patients.
A critical response to staff shortages has been telemedicine. Since 2020, Ukrainians have received more than 48 million online consultations. In frontline and remote regions, telemedicine effectively replaces the physical presence of narrow specialists. Yemets emphasizes: “With telemedicine, data runs, not people,” and in wartime this means saved time and resources, including for the military.
At the same time, digital transformation exposes another problem human resources and education. According to research data, only two out of 111 medical educational programs met modern standards of digital competence. In response, in 2024 the Ministry of Health presented the Digital Competence Framework for Healthcare Workers, which defines what a medical professional must know in the digital era. In parallel, demand for education is being met by online courses and specialized training, particularly for healthcare management, where the focus is gradually shifting from “how to use the system” to “how to analyze data and make decisions.”
The extended conclusion of Time for Action is that eHealth in Ukraine has already ceased to be an experiment or an auxiliary service. It is the backbone of the modern healthcare system, supporting data, management, finances, and access to services. At the same time, digitalization is not a panacea. It requires trust, cybersecurity, trained personnel, and clear rules of engagement between the state and business. Ukraine has indeed made a significant step forward, but the next stage will be more challenging: from scaling to quality, from the number of services to their real value for patients and doctors. This is where the true test of digital medicine will take place.
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