Telemedicine in Times of Crisis-A SWOT Assessment Based on Romanian Healthcare Professionals' Perceptions

Background and Objectives: Unlike previous studies that have examined telemedicine primarily in pandemic contexts, this research adopts a dual-crisis perspective, assessing perceptions during both pandemics and armed conflicts. Recent health crises, including the COVID-19 pandemic and armed conflicts, have exposed vulnerabilities in health systems and underscored the need for evidence-based strategies to enhance resilience. Telemedicine has emerged as an essential tool for ensuring continuity of care, mitigating workforce shortages, and improving access for vulnerable groups. This study examines healthcare professionals' perceptions of telemedicine in Romania across two exceptional contexts-pandemics and armed conflict-focusing on applicability, systemic integration, and limitations. Methods: A cross-sectional descriptive survey was conducted among 409 healthcare professionals. Perceptions were analyzed using a SWOT framework and descriptive statistics (percentiles, median) to identify strengths, weaknesses, opportunities, and threats in both scenarios. Results: Perceptions of telemedicine were shaped by prior experience, with strong support for its use in both contexts. Strengths included adaptability and improved access, while weaknesses highlighted technical barriers, insufficient training, and the risk of clinical errors. Threats referred to poor coordination across facilities and cultural or language barriers. Opportunities highlighted the potential for digital infrastructure and integration into preparedness frameworks. Conclusions: Telemedicine is positioned as a strategic tool for strengthening national health resilience. Adaptive, context-sensitive policies, combined with investments in infrastructure and workforce capacity, are essential for integrating telemedicine into emergency preparedness and ensuring sustainable, inclusive responses to future crises. This dual-crisis approach represents the novelty of our study, demonstrating how telemedicine can serve as a strategic tool for resilience in both epidemiological and conflict-related emergencies.