When Russia invaded Ukraine, Jarone Lee, MD, MPH, FCCM, like so many others, wanted to help the Ukrainian people. But beyond donating money or supplies, Dr. Lee realized his unique combination of skills could help in a different way.
When Russia invaded Ukraine, Jarone Lee, MD, MPH, FCCM, like so many others, wanted to help the Ukrainian people. But beyond donating money or supplies, Dr. Lee realized his unique combination of skills could help in a different way.
Dr. Lee, vice-chair of SCCM’s Leadership, Empowerment, and Development (LEAD) Program, is an attending critical care and emergency physician at Massachusetts General Hospital (MGH) and an associate professor at Harvard Medical School. He is a faculty member in MGH’s Center for Global Health and is a member of a Massachusetts-1 disaster medical response team through the U.S. Department of Health and Human Services’ National Disaster Medical System. He was also involved in the U.S. National Emergency Tele-Critical Care Network, created in the early days of the U.S. COVID-19 pandemic with help from several SCCM members.
When crisis broke out in Ukraine, Dr. Lee coupled his experience as a critical care physician responding to disasters all over the world with his recognition of how vital telemedicine had become during the COVID-19 pandemic in the United States. With two other founding partners, Dr. Lee launched Health Tech Without Borders (HTWB), a global nongovernmental organization aiming to provide digital and telehealth assistance during the Ukrainian crisis.
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| Jarone Lee, MD, MPH, FCCM |
“We were trying to figure out how best to support Ukraine,” Dr. Lee explained. “Many volunteer MGH clinicians, with partnerships with boots-on-the-ground nongovernmental organizations, went over to provide support. There were many others who couldn’t travel, but they could easily help through virtual care, so we decided to try to find a way to help through telehealth.” Dr. Lee’s founding partners are Marianna Petrea-Imenokhoeva, MS, a telemedicine expert in Romania, and Hicham Naim, PharmD, MBA, a pharmacist, strategist, and humanitarian in Switzerland. Also part of the core group are Olga Gershuni, RN, a Ukrainian nurse, and Bob Arnot, MD, a former chief correspondent for NBC News.
HTWB put out a call for physicians who spoke Ukrainian or Russian so that translation services would not be necessary. Ultimately, the organization ended up with hundreds of physicians ready to serve. Since February 2022, when the conflict began, through September 2022, HTWB has provided over 62,000 telemedicine consults directly to Ukrainian patients. HTWB partnered with multiple existing telehealth platforms, including one in Ukraine called Doctor Online, to provide the consultations, which are conducted mostly via text chats.
Based on the questions HTWB volunteers have fielded from healthcare professionals, the organization added a second component to its mission—peer-to-peer educational lectures. After the war broke out, Ukrainian medical professionals needed more education on physical and mental injuries sustained in conflict zones.
For the first series, HTWB collaborated with two burn surgeons, Colleen Ryan, MD, and James Jeng, MD, who developed a nine-lecture series delivered by experienced burn surgeons and nurses on war-related burn care. About 80 to 100 Ukrainian clinicians attended each session. Next up was an ongoing lecture series on rehabilitation medicine for war casualties. This past summer, experts from around the world have started working on a series about providing mental health services in conflict environments to both clinicians and patients.
Other educational topics requested “usually track with the news, unfortunately,” Dr. Lee said. “We got a request to cover radiation poisoning after the scares with the nuclear power plants. Then, after the Mariupol attacks, they were worried about chemical warfare, so we were asked to provide chemical warfare-related education.”
Dr. Lee has also been instrumental in SCCM’s efforts to help Ukraine. He connected the Society with Global Outreach Doctors and Global Response Management for Society members who want to help. SCCM is collecting donations through its disaster relief fund to send to Ukraine and is providing free education to regional clinicians, translating training materials into Ukrainian and Polish and helping deliver medical supplies and humanitarian aid. SCCM has also provided $800,000 in grants to help keep Ukrainian hospitals and ICUs operational. HTWB continues to help SCCM identify hospitals that need donations of money and/or supplies. Dr. Lee also connected SCCM to Dr. Arnot, who was a guest speaker on an SCCM webcast in January 2022 on how physicians should speak to the media in the COVID-19 era.
In addition to providing consults and educational series, Dr. Lee and his team have added a third pillar to HTWB’s goals—working to provide and improve the digital technology backing up telehealth. They are talking with a wide variety of tech companies on how to support the program. For instance, they have met with Microsoft about its mixed-reality headset called HoloLens. Dr. Lee imagines Ukrainian clinicians and volunteer surgeons using HoloLens so they can both see the patient in real time, allowing the volunteers to give direction and feedback. In collaboration with Microsoft, they have created a chatbot that can support frontline clinicians in tasks that have well-documented protocols, such as applying a tourniquet.
“Depending on what the tech product is, I think by leveraging what’s already out there, maybe even modifying it a bit, we can support many people caught in unexpected disasters,” Dr. Lee said. On the flip side, though, high-tech gadgets are not always the priority, he said. “We have focused so much on high-tech fancy video in the U.S. with telemedicine. That’s not what is needed. We just really need a platform and a way of connecting people to communicate,” he explained. “Most of our consults in Ukraine have been purely text chat-based. That could be because it is a conflict zone with less bandwidth, but I don’t think so. I think that people now very much enjoy just being able to chat in an asynchronous way.”
When Dr. Lee and his partners launched HTWB, they imagined it would be needed for only three to six months. “We were hopeful that we would not even need to make this sustainable,” he said. “We would close it down and move to something else we can help with, but it appears that the need is ongoing.” That need reaches beyond Ukraine, as people in other countries are now appealing to HTWB for assistance, too. “We’re getting asked to support in many other places in the world. I think there’s a lot of need for our services.”
HTWB is based out of Switzerland. In August 2022, the organization was able to begin collecting tax-deductible donations in the United States. Until then, it had been relying only on volunteers and in-kind donations. Now, fundraising has begun to support and expand its efforts. “With these crises in Ukraine and many others around the world, we critical care physicians have, in many ways, a duty to serve them and help them however we can,” Dr. Lee said. “The technology itself is not as important—the technology is just the connector of people in crisis.”
