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The Virtual Cavalry: Telehealth & Crisis Response

by Elsie Ramsey, Dr. Jarone Lee, Dr. Bob Arnot and Marianna Petrea-Imenokhoeva

The Virtual Cavalry: Telehealth & Crisis Response
The Virtual Cavalry: Telehealth & Crisis Response

For a sector that experts used to call a “closed market”, the humanitarian aid economy has undergone enormous growth in the last several years. Jump-started by the acute need produced by the pandemic, relief work’s integration of telehealth gives numerous sectors the ability to export vital services at home and across continents.

In “The Age of Insecurity: Coming Together as Things Fall Apart” Astra Taylor argues that today’s typical disaster highlights the universal nature of unnecessary suffering, transcending binary divisions of haves and have-nots. Without question, the scale of recent emergencies – COVID, wildfires, super storms, armed conflict– demands the alliances that we are seeing telehealth spark between medicine, technology, government agencies, and regional NGOs.

Born during the Ukraine-Russia conflict, Health Tech Without Borders joined the medical/tech mashup with a social media call to action that produced a formidable volunteer corps whose efforts facilitated over 62,806 telehealth visits in the most impacted regions before September of 2022. What we learned during this first deployment about the care spectrum, patients, technology, and ground conditions led to an inventory of vital building blocks that we hope will advance the practice of a new generation of humanitarian aid.

Operating Instructions

Perhaps our most surprising revelation was this finding: high-tech telecommunication tools aren't always better. Of those 62,806 telemedicine visits completed by HTWB, Doctor Online, and Telehelp Ukraine (from March to September 2022), 98 percent involved only text between the physician and patient within a secure telehealth platform. Also, don’t leave home without checking these boxes:

  1. The Clock is Ticking: any chosen telehealth solution must deploy as quickly as possible to meet the rapid pace of an unfolding crisis.

  2. Hearts and Minds: the local population must adopt the solution, making strong ground partners who can establish trust and promote it within the community indispensable.

  3. Name Recognition: patients and clinicians must be aware of existing telehealth services through effective digital community organizing.

  4. Here, There & Everywhere: telehealth must be deployed in various crisis zone settings, from isolated areas with little or no infrastructure to large urban centers. Locations for the volunteer providers must be established with connectivity to telehealth platforms that will be used in the war zone.

  5. Cultural Sensitivity: telehealth providers should be aware of and adaptable to the local context, language barriers, and varying health and digital literacy.

  6. Usability: digital tools must be easy to use, work in low-bandwidth situations, and include the ability to connect by text, audio, and video.

  7. Flexibility: the solution must be agile to adapt to the changing needs of the crisis and the evolving capabilities of the local healthcare workforce.

  8. Security and Safety: the systems must be safe and secure for both providers and patients; and it must be prepared to withstand a military cyber attack, power outages, or damage to physical infrastructure (including the internet).

Access our full summary here.

Delivering Expertise

The intersection between social media and humanitarian aid has given relief efforts a dynamic broadcast tool and closed the distance between isolated populations and online users. Often referred to by tech enthusiasts as democratized aid, the tremendous outpouring of interest from platform users underscores the public’s desire to do more than donate money in response to crisis situations.

HTWB’s work is fueled by this spirit of generosity and public-mindedness, harnessed through a knowledge marketplace that unites diverse organizational, geographic, and contextual silos. Such an expertise funnel gives anyone who wants to help – students, experts, companies, researchers - the opportunity to use their superpower in a hyper-focused, accountable way. A volunteer translator, for example, could know they’ve advanced on the ground connectivity in Pakistan.

This dedication to promoting intellectual synergy further extends into our programmatic offerings: In addition to connecting patients with providers, HTWB’s brain-trust powers clinician to clinician consultations so local providers have medical decision support. And the Helping Healers Heal program delivers mental health support to local professionals treating victims of war-related trauma. The bottom line: we use the powerful tools we already have - human and technological - instead of starting from scratch.

Looking Ahead

As much as we have to feel optimistic about, there are some critical missing pieces that undermine telehealth relief’s overall impact. At the top of our wish list is a machine medical translator. Right now, we are slowed down by the necessity of translating clinical language into numerous foreign languages and dialects. And ethical concerns continue to cause complexity in regard to patient data sharing over mobile networks.

To fully leverage telehealth’s potential, we need to continue to ease the anxiety around sensitive information exchange with universally adopted technical safeguards and regulations. As the technology improves, our brain-trust must keep pace, attracting new volunteers to relief efforts and ongoing care services around the world. Though telehealth is established in Latin America, Africa, Asia, and the Caribbean, the majority of implementations involve isolated responses, not long-term sustainable care. To get there, telehealth must possess the agility to meet the unique needs of austere regions and the resources to establish a permanent presence.

As long as the field continues to innovate collaboratively, we believe it can happen.



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