TABLE 2.

Algorithm of Patient Evacuation

Step	Description	Roles and Responsibilities
1. Application submission	Patients or their representatives submit applications to MOH through one of the channels. They include direct submissions via the MOH website, submissions through oncologists, who coordinate with regional Health Departments, or through Ukrainian NGOs working with patients with cancer	Oncologists and NGOs: identification of eligible patients and assistance with application submission Patients: application submission. MOH: application reception and website maintenance
2. Application review	A designated group within MOH reviews applications and assesses patients' eligibility. Approved applications are forwarded to ERCC via e-mail or EWRS as evacuation requests. The ERCC team adds evacuation requests to the patient database, notifies health care authorities of UCPM MS/PS (Data Supplement, Fig S1), and facilitates communication between them, MOH, and the MedEvac Hub	MOH: application review, translation of medical records to English, and evacuation request submission EWRS: facilitation of communication between MOH and ERCC ERCC: evacuation request processing and communication with health care authorities of UCPM MS/PS, MOH, and MedEvac Hub CECIS and EWRS: patient database management
3. Patient selection	UCPM reviews evacuation requests in the database within 5-7 days and suggests appropriate EU institutions for treatment. The ERCC team communicates these offers to MOH, which reviews them and informs the patient	UCPM: review and selection of evacuation requests ERCC: communication with UCPM MS/PS and MOH MOH: review of EU institution offers and communication with patients
4. Evacuation preparation	After patient selection, ERCC starts planning their evacuation through the MedEvac Hub. Patients secure necessary documentation for crossing the Ukraine-Poland border, such as an international ID and, for men, a border-crossing permit (a disability certificate or a military ID with a note of unfitness for military service)	ERCC: coordination of patients' evacuation logistics Patients: preparation of documents for crossing the Ukraine-Poland border
5. Arrival at the MedEvac Hub	Patients arrive in Lviv, Ukraine, cross the border, and arrive at MedEvac Hub in Jasionka near Rzeszów, Poland (Data Supplement, Fig S1). The MedEvac Hub ensures preflight medical stability and provides 24/7 nurse care, including communicable disease screenings, vaccinations, and mental health support	GPMG and NGOs: financing transportation to Lviv WHO: EMS transportation funding from Lviv to Jasionka DG ECHO and PCPM: MedEvac Hub operation and medical service provision
6. Departure from the MedEvac Hub	Patients depart from the MedEvac Hub via weekly flights on a medical plane and then arrive at the host EU institution. Caregivers can accompany patients on board and at the MedEvac Hub; however, their postarrival accommodation is not guaranteed	ERCC, UCPM MS/PS, and EU: transportation financing
7. Treatment at the EU institution	Patients receive necessary medical treatment at EU institutions, facilitated by the activation of temporary protection status by the ERCC. This ensures that patients receive care in accordance with EU standards	ERCC: temporary protection status activation Health care authorities of UCPM MS/PS: treatment funding
8. Return to Ukraine	After treatment, patients return to Ukraine for continued rehabilitation and monitoring	Patients (occasionally UCPM MS/PS): financial coverage of return to Ukraine, including repatriation of mortal remains

Abbreviations: CECIS, Common Emergency Communication and Information System; DG ECHO, Directorate-General for European Civil Protection and Humanitarian Aid Operations; EMS, Emergency Medical Services; ERCC, Emergency Response Coordination Centre; EU, the European Union; EWRS, Early Warning and Response System; GPMG, Governmental Program of Medical Guaranties; ID, identification; MOH, the Ministry of Health of Ukraine; MS/PS, member states/participating states; NGO, nongovernmental organization; PCPM, Polish Center for International Aid; UCPM, Union Civil Protection Mechanism.