The following media release was issued by the Hilo Medical Center:

After nearly a year of training and preparation, Hilo Medical Center (HMC) became the first public hospital in Hawaii Health Systems Corporation (HHSC) to convert to an Electronic Medical Record (EMR) system on May 1. The purpose of transitioning to the EMR system is aimed at improving patient care and safety and the hospital’s financial performance.

The new EMR system, named Health Connect by HMC employees, was produced by MEDITECH and will cost $3 million over the next 5 years. It enables the hospital to connect electronically with internal and external physicians and other service providers to ensure the best possible care for hospital patients. The system also streamlines operational activities to improve efficiencies, which translates into better collections and more timely reimbursements from insurance and government providers. In subsequent phases of the project, both sister facilities, Ka’u Hospital and Hale Ho’ola Hamakua, in the East Hawaii Region will be brought onto the system along with physician offices in the community.

“We are extremely proud of our staff for their efforts to transition HMC and the rest of our region into the EMR system,” said Howard N. Ainsley, East Hawaii Regional CEO of Hawaii Health Systems Corporation. “Our success would not have been possible without their commitment and willingness to embrace this significant change in our operations. I also want to thank the East Hawaii Regional Board for their support of this project,”

Throughout the course of ramping up for the transition, over 800 employees completed training and all physicians with hospital privileges attended the Health Connect training classes. The physicians now have around the clock access to the patient record including digitally stored Radiological images like x-rays, CT scans and MRIs, dictated reports, all laboratory test results, review of orders, nursing notes, medication, Emergency Department visit information, long-term care charts from home, office and everywhere in between. All departments except the Operating Room department have transitioned to the Health Connect system.

“While HMC has much to do during this transition and stabilization phase of the project, the feat accomplished by the project team and employees is no small achievement or undertaking,” said Money Atwal , East Hawaii Regional Chief Information Officer and Chief Financial Officer of Hawaii Health Systems Corporation. “ Hilo Medical Center will continue to push forward with the goal and vision of achieving meaningful use by 2011.”

Hilo Medical Center received an $800,000 grant from the HMSA Initiative for Innovation and Quality (HI-IQ) for the Health Connect project. The HMSA program is an effort to transform health care in Hawaii by funding innovative advancements in healthcare. The HI-IQ project provides $50 million available in financial assistance to help Hawaii hospitals implement technology solutions to make the state’s health care system more effective and efficient.

In addition, Hilo Medical Center is working to obtain incentivized stimulus funds that were made available through the American Recovery and Reinvestment Act (ARRA) to encourage a nationwide transition to Electronic Health Record. Hospitals like HMC’s Health Connect project that support improvements in patient care and outcomes are able to receive this financial support. In order to receive funds from the ARRA hospitals must meet certain criteria called “meaningful use” by 2011 and be near completion by 2013.

Meaningful use criteria includes:

• Using drug-drug, drug-allergy drug-formulary checking;
• Maintaining a problem list of active diagnoses based on ICD-9 or SNOMED;
• Maintaining active medication and medication allergy lists;
• Electronically recording advanced directives, patient vital signs and smoking status
• Implementing 1 clinical decision support rule for high-priority conditions
• Checking insurance eligibility and submitting claims electronically
• Providing patients an electronic copy of their health record.
• Performing electronic medication reconciliation.
• Electronically reporting quality measures to CMS.

Hospitals that have started on their EMR journey are eligible for stimulus funds while those who wait are at risk for reduced Medicare and Medicaid payments as well as government penalties for noncompliance. October 1, 2010 CMS will begin to increase hospital reimbursements based on the “meaningful use” incentive criteria. The estimates range up to in excess of $3-5 million of additional reimbursement for HMC.

Hilo Medical Center’s official Health Connect Baby is Myah Palisbo. (photo above, with family) She was born at 6:30 am on May 1. She is the first baby born into the electronic medical record system. Her complete record will accompany her throughout her care at Hilo Medical Center .

The Hilo Medical Center has released a timeline of the hospital’s emergency preparation on February 27th, the day that Hawaii scrambled under the threat of a tsunami that ultimately spared the islands from damage.

“Hilo Medical Center has an effective process and plan for responding to emergency situations like the recent tsunami event,” said Howard N. Ainsley, East Hawaii Regional CEO of Hawaii Health Systems Corporation. “It was very evident that our staff dedicates countless hours of training to ready the hospital on a moment’s notice.”

According to the Hilo Medical Center, personnel began to mobilize the moment they received notice of the approaching tsunami, in the early morning hours on Saturday.

2:30 am: Department of Health Hawaii District Health Office contacted Tracy Aruga , HMC Environmental Safety Officer/HAH’s (Healthcare Association of Hawaii) HI Island Area Coordinator. He reported to the Hawaii County Civil Defense Emergency Operations Center for a briefing on the situation

4:00 am: HMC Environmental Safety Officer/HAH’s HI Island Area Coordinator briefed Reggie Agliam, HMC House Supervisor, of tsunami event.  He also briefed the other East and West Hawai`i healthcare facilities.

4:18 am: HMC Environmental Safety Officer/HAH’s HI Island Area Coordinator connected to hospitals statewide including HMC via HAH’s Web Emergency Operations Center (WebEOC).

5:00 am: HMC Environmental Safety Officer/HAH’s HI Island Area Coordinator briefed Arthur Sampaga , HMC Emergency Management Coordinator, of tsunami event.

5:45 am: HMC’s Hospital Command Center (HCC) opened and manned by HMC Emergency Management Coordinator.

6:00 am: HMC assessed for staffing, logistical resources, and status of campus utilities such as fuel levels for emergency generators and medical gas/oxygen inventories; created a list of possible patient discharges to anticipate incoming tsunami casualties; and researched if there were any HMC home-care patients who lived in evacuation zone (none identified).

6:30 am: On-call administrator, Dan Brinkman , Regional Chief Nurse Executive, assumed leadership role of Incident Commander for the Hospital Command Center .

6:45 am: Hospital Command Center staffed with Command Chiefs and Section Leaders.

7:00 am: HMC participated in HAH statewide conference call.  Incident Action Plan developed for the first 4 operational hours. 

8:00 am: All department heads and charge shift personnel briefed at Command Center .

9:00 am: HMC’s Residency and Pediatrics Clinics on Mohouli Street secured in tsunami zone.

10:00 am: HMC participated in conference call with HAH for a statewide update on situational status.  IAP updated.

10:30 am: Complete assessment of up coming shifts and patient census performed in anticipation of prolonged event.

10:30 am-2:30 pm: HMC stood ready for approaching tsunami and its after effects.

2:00 pm: All clear given for tsunami threat. HMC Incident Commander terminated HCC operations.

Hilo Medical Center says that the hospital’s emergency personnel “had to assess the facility’s capacity and ability to care for and feed patients. The Maintenance Department checked and prepared emergency infrastructure to keep services going in the event a power outage would have occurred. The Pharmacy Department reported its supply of medication. The Operating Room rearranged the operating schedule. In addition, physicians were available to assure care. Departments that reported to the Hospital Command Center include: Nursing, Emergency, Imaging, Patient Services, Human Resources, Maintenance, Housekeeping, Bio-Medical, Dietary, Pharmacy, and Security.”

Dr. Robert Irvine, Chair of the East Hawaii Regional Board, reflected on the institutions’ readiness. “Our community and its hospital are in the hands of capable and well practiced team of emergency responders,” he said. “Preparing a hospital as large as ours is an enormous feat. I thank everyone involved.”

Hilo Medical Center is part of the Hawaii Health Systems Corporation, which also operates Hale Ho’ola Hamakua and  Ka’u Hospital.

VIDEO by David Corrigan

The official first step in improving trauma care on the island was taken in Waimea on Friday.

The inaugural meeting of the Big Island Trauma Advisory Council took place at North Hawaii Community Hospital. Hospital leadership, physicians and emergency first responders from all regions of the island met to talk about developing a systems approach for trauma care providers in Hawaii County.

According to the numbers, the need to improve trauma care, especially in the area of transport time, is evident.

Hilo Medical Center has been designated at the lead facility in this initiative.

In 2007, the Hawaii State legislature released funding through the Department of Health to organize the statewide trauma system, which facilitated the creation of the Big Island Trauma Advisory Council.

August 14, 2008 – Hilo, Hawaii
VIDEO by David Corrigan

Hawaii County Mayor Harry Kim’s recent heart attack forced the mayor to be flown off the island, and out of his own county, in order to receive the needed treatment on Oahu. In light of this news, Hilo Medical Center explains the current state of the hospital’s cardiac care, and how the hospital plans to be able to treat similar cases in just a few months.