Even under the most extreme conditions — including full-scale invasion, mass displacement of civilians, and systematic attacks on healthcare infrastructure — Ukraine has managed to maintain the functioning of its health system by relying on a robust digital backbone: the national Electronic Health System. With over 35 million patient records and more than 400,000 connected healthcare professionals, the system ensures secure medical data exchange, supports continuity of healthcare services, and enables real-time coordination across all regions of the country.

What began as part of a healthcare reform agenda before the pandemic has evolved into a nationwide system ensuring interoperability and efficiency under extreme conditions. Ukraine’s experience demonstrates how public digital infrastructure — when built with flexibility, national stewardship, and long-term vision — can sustain essential services even in crisis.

This presentation offers a powerful case study on how public sector digital transformation, driven by urgency, innovation, and determination, can operate under fire—and inspire international partnerships for the future of health data exchange in Europe.