Children are the future - investments to improve the quality and accessibility of medical services at children's hospitals in Bialystok and Mukachevo

Despite the differences in the functioning of the public health care systems in Poland and Ukraine, health care units on both sides of the border face similar problems. Hospitals have been underfunded for years, which limits the availability of quality services. There’s a shortage of both equipment and medical staff. The situation has been exacerbated in recent years as a result of the COVID-19 pandemic. In addition, the armed conflict on UA territory has increased the needs of the health system in both UA and PL, particularly in areas where there is an increase in refugees. For more than a year, refugee children from UA have been admitted to the Bialystok Hospitals and today account for approximately 8% of the number of hospital admissions. Western UA health units are reporting an increase in patients. The situation calls for intervention and support of health care systems on both sides of the border. The project will be implemented in a specific area-children's hospitals. The UA partner, hospital in Mukachevo, is facing new challenges: in addition to an increase in the total number of patients, the number of patients in the trauma and orthopaedic and psychiatric wards has increased significantly. This trend is a direct result of the escalation of the armed conflict in UA. Children are experiencing the effects of war on an equal footing with adults: they are suffering from complex injuries, they are suffering from restricted access to health care units, they are suffering from psychological trauma. The trauma experienced by children due to the necessity to leave home, to integrate in a new environment, the information about the loss of loved ones causes psychological trauma that stays with them for many years. The analysis of the situation has shown that it is important to support hospitals to improve diagnostic and treatment processes. An additional defined problem is to ensure that health records are kept and made available in electronic form (EHR). Due to the increase in the number of patients, more and more diagnostic examinations in electronic form, the demand for IT infrastructure increases. A separate problem is making health records available to patients in countries with different legal systems. We are all aware that a huge number of today's refugees will return to their country and their obvious right will be to access health records even after several years. In the area of IT, cyber security in the area of health is an important problem. In response to the above-described problems, children's hospitals from Bialystok and Mukachevo have decided to jointly implement a project aimed at improving the quality of medical services provided in both facilities by: - establishing long-term cooperation consisting of the exchange of good practices of medical staff, creating a basis for medical consultations between the units - jointly developing a mechanism for providing access to EHR, which, in accordance with the law in force in both countries, will allow refugees to view their records after the end of the armed conflict and return to UA - improvement of the IT infrastructure by acquiring hardware and software and organising training on the functioning of modern hospital IT systems and cyber-security - upgrading of staff competencies in areas relevant to the needs of the units - retrofitting of medical equipment to the hospitals resulting from a needs audit conducted in both units The above-mentioned activities require a cross-border approach and cooperation between the units located on both sides of the border due to: - different competencies of the medical staff of the partners - the possibility of supporting UA medical staff in the psychological care of young Ukrainian patients at the hospital in Bialystok - the knowledge of the law and the HIS systems in PL and UA, which would allow solutions to be developed to enable access to the EHR by patients treated in both countries even many years after the medical intervention.