The main challenge the health sector is facing nowadays is the lack of professionals.
The lack of radiologists is enormous high, which is a worldwide phenomenon. It is due to the migration of radiologists to Western-European countries, and due to the increasing number of tests and images. The lack of IT-connections between the institutions results in the repetition of tests and patients are under unnecessary radiation exposure.

The superfluous transport of the patients increases insurance costs in both countries.

The isolated operation hinders the development of professional and scientific relations.

The project partners are struggling with the above problems. Therefore the hospitals’ managements have the goal to work together and support each other.

The task is to develop cost-effective and sustainable solutions.
The development is reasonable because the EU wants to achieve the highest level of e-Health in the health care.

The subject (goal) of our tender, the Teleradiology is in accordance with it.
In general, it is typical that only a relatively greater radiological institution can accumulate knowledge in the extent that is required for modern imaging diagnostics. The Slovakian partner institution works with a smaller number of cases, so the staff of an institution with more professional experience may be needed on special fields. It can be realized with the creation of the teleradiology system and by signing a long-term agreement between the parties.

Direct objectives:
• Common patient care in the region.
• Reduction of labor shortages.
• Knowledge sharing between a large county hospital and an important city hospital of the region
• Development of relationships in education and science

Instrument: teleradiology between the parties

Creating the possibility of teleradiology:
• Reduces the lack of professionals
• Shorter waiting times
• Cooperation between the two hospitals supports the elimination of problems caused by temporary or permanent lack of professionals
• Reduces radiation exposure
• Environmentally friendly solution

Indirect objectives:
• Reducing the radiation exposure of patients
• Minimizing the negative environmental impacts
• Providing possibilities for consultation
• Continuing training
• Improving the quality of health care

Long-term impact of the project:
• Increase of patient safety
• Ensuring equal access to higher levels of care
• Increase the knowledge level of professionals
• Development of closer cooperation between the partners
• Involvement of other institutions in the region
• Joint research
• Harmonization of education
• Cross-border specialization
• Reduction of radiation exposure of residents in the two regions.
We create electronic link between the hospitals and develop the infrastructure on hardware and software side. Findings and imaging tests can be sent between them. Teleradiology will be developed.
Hungarian partner will develop the used PACS system for new functions of teleradiology. For teleradiological view the computer workstation of the medical doctor is essential. The medical records can be made only at dedicated monitor. In lack of proper equipment validity of diagnostic information may be lost. The workstation computer must have large memory cache, video memory, high processor speed. Ten workstations will be purchased with the above criteria. Will develop PACS with two new function: cardiac option and real time 3D reconstruction. These fuctions are necessary to make all the reconstruction jobs fast and uniform. It makes post-processing from the raw data , the reconstructed images are not stored on the PACS server, so a lot of storage capacity can be saved. Since it is an automatic process, doctors can save time and energy. Patients can get proper diagnosis and treatment sooner.

For the Slovakian partner the system of the technical and software tools will be established to handle information as image and to use for archiving, communication. The PACS, with the STN EN 12052 (DICOM) standard, receives, transmits, stores and retrieves digital images and related information from several multimodal imaging sources and communicates the information via network.
The PACS must be switched to the HIS system based on HL7 (NIS / HIS - in Slovakia, Košice Promis® Prosoft), enabling the processing of electronic applications (DICOM Modality Worklist Management) and it can be operated separately. The PACS provides - in DICOM format - the authorized and identified users with medical documentation in visual form and the information can be transferred via these networks (WAN / Internet).

By establishing teleradiology the interested parties can gain following benefits:

- Human resource is optimized by TELERADIOLOGY. Effective utilization of free radiological capacities on both sides.
- Access to subspecial evaluations, which means in certain areas the possibility of evaluations from a more experienced radiologists with license for both parties.
- Cross-border "friendships" are formed.
- Cost savings can be reached with the concentration of resources.
- Shorter waiting times for the patients
- Professional support, consultation possibility
- Possibility of professional cooperation.
- The employees can learn from each other, the „four eyes principle” can be carried out by a second review of the records. In a lot of cases the consultation possibility leads to a more precise diagnosis

Joint development:
The project is realized in a joint development. The hospitals in Miskolc and Királyhelmec have signed a long-term cooperation agreement on 07.03.2016. After the release of the tender the development of a concrete project plan was started by the partners. They have determined the tasks together harmonizing both with their own strategic plans and with the objectives of the tender invitation. They have jointly specified the equipments and softwares that are necessary for the implementation and ensure on both sides of the border the establishment of a system at the same level of development and quality. 

Joint implementation:
The implementation of the project takes place in close medical professional and IT cooperation between the partners. After purchasing the systems they take part in common trainings and they introduce the system in collaboration. The involved professionals learn by teaching each other.
Joint project management:
In the project management organization employees of both the Hungarian and Slovakian partners are involved.

Joint financing:
The financing is jointly realized, the financial assets are shared by 68-32%.between the Hungarian and Slovakian partners

Main pillars of the implementation:
• Specific objective of the project is to develop cooperation between the Hungarian and Slovakian partners, the activities are subordinated to it and follow each other in a logical order.
• Electronic contact between the institutions
• Data storage devices in a sufficient quantity
•  workstations for making medical records
•  User trainings (Hungarian partner: 110 doctor and professional staff; Slovakian partner: 30 doctor and professional staff )
• Continuous training, education of successors
• The go-live of the system takes place in the last 3-4 months of the project
• Regular monitoring of the realized development

One of the main reasons for the realization of the project in a cross-border form is that the two regions are struggling under common problems and the economic and health trends are very similar. In addition, the health care institutions in the border regions count more seriously on cooperating partner institutions from the neighbouring countries while creating a rational patient management and eliminating duplications. Both the Hungarian and Slovakian experts show in the health care growing demands for joint programs and for professional cooperation.
The project helps to develop in the near future a unified heath care region where the barriers of providing health care services are reduced. The cross-border relations are strengthened with the project since they set up sustainable development and structures for utilization that function even after the project realization.
The project can improve the health status of the population in the region and improve the quality of life with more rational organization of health care service. The concentration of resources can lead to cost reduction and to sharing and accumulation of experience and knowledge.

The project synergie with European Union Strategy for the Danube Region:
o develop people to people contacts
o develop the Knowledge Society through common activities
o step up institutional capacity and cooperation

The Economic and Social Development Programe of Košice region for the years 2016-2022
Strategic Objective. 5 Strengthening regional identity by supporting of social development for human rights
Specific objective no. 5.2 Improve the health status of the population