Study: healthcare digitalisation in Belarus remains an imitation

Gazetaby.com concludes its series of publications (please find parts one and two here) devoted to a study that became a response to an article published by one of the state-run media outlets under the rather pompous title “Belarusian Healthcare System Secures Its Human Resources, Strengthens Its Infrastructural and Technological Foundation, Expands Exports, and Goes Digital.”

The article states, among other things, that “the country’s healthcare sector is becoming increasingly active on the external market, offering its services abroad and strengthening its export positions. At the same time, we see digital transformation gaining momentum in the sector, with the introduction of electronic services, the development of telehealthcare, and the creation of patient- and physician-friendly digital platforms.”

The research team examined what is really meant by “digital transformation gaining momentum”, while one of the team’s participants, Stanislav Solovei, a physician and a leader of the Independent Healthcare Workers’ Union, shared his insights into the actual situation in contemporary Belarusian healthcare with Eagle Owl.

“To start with, I’d like to outline what healthcare digitalisation means in today’s world. For example, it is when a surgeon in Strasbourg performs an operation on a patient in a New York hospital.

“It is the broad deployment of AI, when a physician talks to a patient and AI records the whole conversation, doing all the ‘paperwork’ for the physician, who can simply check the notes later.

“It is a doctor-patient decision-making system where AI analyses test results and looks for new medicines or treatment methods. Or records an operation protocol, saving time for the surgeon.

“And this is the kind of healthcare digitalisation that Belarus does not have. Many healthcare institutions, particularly outside the capital, see digitalisation merely as a matter of having a number of computers. And with such a ‘concept’ of digitalisation, any further discussion becomes rather pointless.

“The next question is whether the version of Windows installed on those computers is properly licensed or pirated — not to mention the security risks involved in answering that honestly.

“Or take centralised databases such as those in Germany, Estonia, or many other developed countries. These databases contain prescriptions, sick leave certificates, and other documentation. And, of course, great attention is paid there to the protection of such sensitive personal data. A physician has access to a patient’s case history, which gives a full picture of what was wrong with them, what happened, what medicines they took, and when they last saw a doctor.

“In Belarus, such databases may exist, at most, in a few local healthcare institutions. And the current target pursued by the healthcare authorities is to bring the share of clinics using AI-assisted software to 5 per cent.

“We are lagging so far behind in this area that officials do not really understand what digitalisation is. For them, digitalisation means having a computer on a physician’s desk, along with a printed prescription that must then be stapled or glued into a paper file.

“Another issue concerns the wages of those who maintain digital technologies and the funding available for their deployment. Both are modest, so people have little interest or incentive to introduce these technologies, or they simply lack the capacity to do so.

“If we are to talk about why healthcare needs digitalisation in principle, I would highlight a couple of points.

“Firstly, it reduces the physician’s paperwork burden, leaving them more time for each patient. In Belarus, paperwork accounts for about 20 per cent of a physician’s working time.

“Secondly, it is more convenient for the patient, who, when seeing a doctor in, say, Vitebsk, does not have to recount the whole history of their illness and what happened to them, for instance, in Homyel a year earlier. Of course, no system can store everything, but it can keep a relevant body of information. The same applies to prescriptions: you go to a pharmacy with a digital card that allows you to obtain your prescription medicine.

“Thirdly, all of this makes the system itself, as well as the processing and monitoring of statistical data, much more efficient. For example, it becomes possible to identify why the number of post-operative complications is higher in one hEagle Owlospital than in another — perhaps because the former has obsolete equipment that needs replacing. In this way, the quality of healthcare improves.

“Another issue I would raise is AI-assisted decision-making in healthcare. A digital system can help a physician avoid mistakes, which unfortunately do happen, even though eliminating them entirely is impossible. But this is not about AI replacing physicians; it is about AI serving as a powerful tool for them.

“Undoubtedly, AI can also make mistakes, and we know that. But my personal view is that digital applications make — and will continue to make — mistakes much less frequently than your average physician. However, responsibility ultimately lies with the physician, because they are the ones who make the final decision, even when assisted by AI. Nevertheless, when the decision-making process involves two ‘heads’, as the saying goes, the risk of medical error is significantly reduced.

“So the task of digitalisation is to ensure that a patient receives the most effective medical care possible. Which means that if the Belarusian authorities are genuinely interested in this outcome, they will have to engage in healthcare digitalisation in practice rather than merely in reports and loud statements.”

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