The coronavirus disease 2019 (COVID-19) pandemic revealed both the resilience and the limitations of Georgia’s health system. It highlighted the central role of primary care and rural physicians, while underscoring the urgent need to strengthen their capacity. At the same time, it demonstrated the critical and long-term potential of digital technologies to improve rural health services and reduce inequalities in access to care.
Launching a telehealth initiative
In September 2021, Georgia launched a 3-year telehealth initiative funded by the European Union and implemented by 4 United Nations agencies – WHO, United Nations Populations Fund, United Nations Children’s Fund and United Nations Office for Project Services – to mitigate the impact of COVID-19 through digital health solutions.
Initial assessments produced recommendations for strengthening Georgia’s health information systems, with a focus on governance, data quality and digitalization. The project also called for developing locally relevant, evidence-based care pathways, clinical guidelines and protocols for remote consultations in priority areas: noncommunicable diseases (NCDs), early childhood development, and sexual and reproductive health, including antenatal care.
In response, WHO designed a telemedicine model tailored to Georgia, aiming to improve equity and expand access to quality health services in rural and hard-to-reach areas.
Rural doctors at the centre
One of the project’s most visible achievements has been the equipping of 60 rural primary care clinics with state-of-the-art digital equipment. Selected villages received not only computers, digital ophthalmoscopes, dermatoscopes, otoscopes, electrocardiographs and a secure platform for information exchange, but also the training required to use them effectively.
Rural doctors were trained both in the technical use of the equipment and in updated approaches to NCD management, with an emphasis on communication skills. WHO-accredited telemedicine training combined technical instruction with soft skills, medical ethics and modules on the remote management of chronic diseases such as diabetes, cardiovascular conditions and chronic respiratory illnesses. Accreditation elevated the programme to recognize professional development, strengthened doctors’ confidence and ensured sustainability by aligning with Georgia’s continuing professional development standards.
“There are several villages around my own. I have offered to tutor their doctors on the use of telemedicine equipment. This way we can help more people and serve our communities better,” says Nina Davitadze, a family doctor from Khala village in west Georgia.
For patients in the 60 pilot villages and surrounding clusters, this means access to quality health care without the need to travel long distances. With support from trained village doctors, residents can now consult experienced dermatologists, ophthalmologists, cardiologists and otolaryngologists at central level, directly from their village clinics.
“Digital tools enable us to detect serious conditions – such as diabetes, hypertension, lung and cardiovascular diseases – remotely and at an early stage, often before patients even know they exist. For the 1400 residents of Khashmi village in east Georgia, who rely on our local clinic, access to specialist doctors through digital technology is invaluable. When people see that high-quality care can be delivered at the primary level using these tools, it strengthens not only their health, but also their trust in our work,” says Tinatin Tsikurishvili, a family doctor in Khashmi.
Building for the long term
Behind these visible achievements lies equally critical groundwork to secure telemedicine as a sustainable part of Georgia’s health system. WHO and its partners supported the development of strategies, structures, funding mechanisms and monitoring systems, while also modernizing public health services with digital tools to improve surveillance, data management and contact tracing.
“What is even more important in my view is that the project has supported the development of solid frameworks to support scaling up of such services in the future and to ensure their sustainability,” notes Silviu Domente, WHO Representative and Head of the WHO Country Office in Georgia.
“We supported the revision and development of necessary legal and regulatory frameworks for telemedicine in Georgia; revised the entire health information system and developed an action plan for its improvement and digitalization; put in place operational standards and clinical guidelines for health workers; provided recommendations for the payment of new telemedicine services; and developed a draft national digital health strategy as a long-term vision for telemedicine and digital health in Georgia.”
A future-ready health system
By combining infrastructure, training, legal and financial frameworks and continuous monitoring, WHO and its partners have helped Georgia to lay the foundations for a telemedicine system that is resilient, people-centred and future-ready. What began as a response to the pandemic is now shaping into a long-term transformation – turning telemedicine from a niche innovation into a cornerstone of health-care delivery.