Abstract
The development of telemedicine in rural and remote territorial communities has gained strategic importance under the digitalization of healthcare, persistent geographical inequality in access to care, shortages of medical personnel, and the challenges created by martial law. The purpose of the study is to systematize scientific and regulatory approaches to telemedicine development in such communities, compare international and Ukrainian experience, and identify its economic, organizational, and social significance. The review of contemporary sources shows that telemedicine produces a measurable economic effect by reducing transport, time, and logistical costs, partially substituting in-person contacts, lowering the need for interhospital transfers, and improving the use of limited healthcare infrastructure. For rural and remote communities, its value also lies in broader access to consultations and specialist care, faster contact with physicians, and greater continuity of observation. At the same time, the social effect is not automatic: where digital infrastructure is weak, internet coverage is unstable, and digital competence remains low, telemedicine may reproduce existing barriers rather than remove them. Its effectiveness, therefore, depends not only on technology itself but also on the implementation model, institutional support, staff preparedness, regulatory arrangements, and the integration of remote services into the overall patient pathway. Telemedicine should be treated as an instrument of healthcare digital transformation that combines economic effectiveness, improved accessibility of medical care, and the potential to reduce social inequality. For Ukraine, its development has particular importance for healthcare resilience under martial law and in the period of post-war recovery.
References
1. Maita, K. C., Maniaci, M. J., Perelman, D., et al. (2024). The impact of digital health solutions on bridging the health care gap in rural areas: A scoping review. The Permanente Journal, 28(2), 189–201. https://doi.org/10.7812/TPP/23.134
2. Kolluri, S., Stead, T. S., Mangal, R. K., Coffee, R. L., Jr., Littell, J., & Ganti, L. (2022). Telehealth in response to the rural health disparity. Health Psychology Research, 10(3), Article 37445. https://doi.org/10.52965/001c.37445
3. Verkhovna Rada of Ukraine. (2017, November 14). Pro pidvyshchennia dostupnosti ta yakosti medychnoho obsluhovuvannia u silskii mistsevosti [On increasing the accessibility and quality of medical care in rural areas] (Law No. 2206-VIII). https://zakon.rada.gov.ua/laws/show/2206-19 (in Ukrainian)
4. Ministry of Health of Ukraine. (2015, October 19). Pro zatverdzhennia normatyvnykh dokumentiv shchodo zastosuvannia telemedytsyny u sferi okhorony zdorovia [On approval of regulatory documents on the use of telemedicine in healthcare] (Order No. 681). https://zakon.rada.gov.ua/laws/show/z1400-15 (in Ukrainian)
5. Ministry of Health of Ukraine. (2022, September 17). Pro zatverdzhennia Poriadku nadannia medychnoi ta/abo reabilitatsiinoi dopomohy iz zastosuvanniam telemedytsyny na period dii voiennoho stanu v Ukraini abo okremykh yii mistsevostiakh [On approval of the procedure for providing medical and/or rehabilitation care using telemedicine during martial law in Ukraine or in certain localities] (Order No. 1695). https://zakon.rada.gov.ua/laws/show/z1155-22 (in Ukrainian)
6. Tsou, C., Robinson, S., Boyd, J., et al. (2021). Effectiveness of telehealth in rural and remote emergency departments: Systematic review. Journal of Medical Internet Research, 23(11), Article e30632. https://doi.org/10.2196/30632
7. Butzner, M., & Cuffee, Y. (2021). Telehealth interventions and outcomes across rural communities in the United States: Narrative review. Journal of Medical Internet Research, 23(8), Article e29575. https://doi.org/10.2196/29575
8. Velayati, F., Ayatollahi, H., Hemmat, M., & Dehghan, R. (2022). Telehealth business models and their components: Systematic review. Journal of Medical Internet Research, 24(3), Article e33128. https://doi.org/10.2196/33128
9. Wang, S., von Huben, A., Sivaprakash, P. P., et al. (2025). Addressing health service equity through telehealth: A systematic review of reviews. Digital Health, (11), 20552076251326233. https://doi.org/10.1177/20552076251326233
10. Simpson, D., Ahmad, K., Mosharaf, M. P., Nasir, B. F., Kondalsamy-Chennakesavan, S., McGrail, M., Wallis, K. A., & Alam, K. (2025). The economic value of virtual primary healthcare services for rural populations: A systematic review. Health Policy and Technology, 14(5), 101067. https://doi.org/10.1016/j.hlpt.2025.101067
11. Lahutina, K. O. (2020). Telemedychna merezha v Ukraini [Telemedicine network in Ukraine]. Yurydychnyi naukovyi elektronnyi zhurnal, (2), 38–41. https://doi.org/10.32782/2524-0374/2020-2/8 (in Ukrainian)
12. Kvitka, S., & Myrhorodska, M. (2024). Tsyfrova transformatsiia systemy okhorony zdorovia: Faktory vplyvu na yakist zhyttia naselennia [Digital transformation of the healthcare system: Factors influencing quality of life of the population]. Aspekty publichnoho upravlinnia, 12(1), 14–21. https://doi.org/10.15421/152402 (in Ukrainian)
13. Kvitka, S., & Shebanov, V. (2025). Tsyfrovizatsiia systemy okhorony zdorovia v silskykh terytorialnykh hromadakh Ukrainy: Intehrovanyi pidkhid [Digitalization of the healthcare system in rural territorial communities of Ukraine: An integrated approach]. Aspekty publichnoho upravlinnia, 13(2), 75–84. https://doi.org/10.15421/152522 (in Ukrainian)
14. OECD. (2023). The COVID-19 pandemic and the future of telemedicine. OECD Publishing. https://doi.org/10.1787/ac8b0a27-en
15. Telehealth and health information technology in rural healthcare. (2024). Rural Health Information Hub. https://www.ruralhealthinfo.org/topics/telehealth-health-it
16. Rush, K. L., Seaton, C., Li, E., et al. (2022). Rural use of virtual care: A scoping review. International Journal of Environmental Research and Public Health, 19(3), Article 1206. https://doi.org/10.3390/ijerph19031206
17. Haque, S. N., DeStefano, S., Banger, A., Rutledge, R., & Romaire, M. (2021). Factors influencing telehealth implementation and use in frontier critical access hospitals: Qualitative study. JMIR Formative Research, 5(5), Article e24118. https://doi.org/10.2196/24118
18. Keelara, R., Sutherland, E., & Almyranti, M. (2025). Leading practices for the future of telemedicine: Implementing telemedicine post-pandemic (OECD Health Working Papers No. 173). OECD Publishing. https://doi.org/10.1787/496a8ffe-en
19. Novak Lauscher, H., Blacklaws, B., Pritchard, E., Wang, E. J., Stewart, K., Beselt, J., Ho, K., & Pawlovich, J. (2023). Real-Time Virtual Support as an Emergency Department Strategy for Rural, Remote, and Indigenous Communities in British Columbia: Descriptive case study. Journal of Medical Internet Research, (25), Article e45451. https://doi.org/10.2196/45451
20. Ärlebrant, L., Dubois, H., Creutzfeldt, J., & Edin-Liljegren, A. (2024). Emergency care via video consultation: Interviews on patient experiences from rural community hospitals in northern Sweden. International Journal of Emergency Medicine, 17(1), Article 109. https://doi.org/10.1186/s12245-024-00703-4
21. Huda, R. K., Chowhan, R. S., Arora, S., Seervi, D., Verma, S., Singh, J., Kalra, S., Choudhary, A., Sangwan, R. K., Khetan, M., & Babu, B. V. (2025). Perceptions of healthcare workers and patients on the implementation of telemedicine in hard-to-reach areas: A qualitative study from Rajasthan, India. Digital Health, (11), 20552076251331874. https://doi.org/10.1177/20552076251331874
22. de Almeida Lamas, C., Santana Alves, P. G., de Araújo, L. N., et al. (2025). Telehealth Initiative to Enhance Primary Care Access in Brazil (UBS+Digital Project): Multicenter prospective study. Journal of Medical Internet Research, (27), Article e68434. https://doi.org/10.2196/68434
23. Dismore, L., Frew, K., Wakefield, D., Bryan, C., Swainston, K., et al. (2025). Remote and rural communities face inequalities in access to specialist palliative care, could telemedicine enhance care? A qualitative study of patient, carer and healthcare professionals’ experiences of video consultation. Palliative Care and Social Practice, (19), 26323524251380632. https://doi.org/10.1177/26323524251380632
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