Big Island hospitals and doctors are finally seeing the pieces of a $16 million federal stimulus award come together.
Big Island hospitals and doctors are finally seeing the pieces of a $16 million federal stimulus award come together.
The end result of the program will be more hospitals and doctors’ offices using electronic health records. Kona Community Hospital will be the last of the island’s three large hospitals to integrate such a system, with a target start date of Nov. 1, but it’s also the first of the state hospitals doing so with a program the state purchased. Hilo Medical Center purchased its own program.
Hawaii County was one of 17 communities across the country, and the only completely rural location, to receive one of the Beacon Community program awards, Dr. Alistair Bairos said. Bairos is the Care Redesign Manager for the project, overseeing efforts at Kona Community Hospital, Hilo Medical Center and North Hawaii Community Hospital to hire care coordinators, people who will work with patients as they are being discharged to make sure those patients understand doctors’ instructions, how to take medication and have follow up appointments, if needed, with their primary care doctors.
One of the program goals is to reduce the rate at which patients are readmitted to the hospital after discharge. An elderly patient, for example, may be treated by a hospitalist at the hospital, given new prescriptions, in addition to the prescriptions the patient is already taking, and may go home confused about which medications to take. That person may then end up back in the hospital in less than 30 days. But Hawaii’s readmission rate is already significantly lower than the national average, Bairos said. The national figure is about 20 percent, while Hawaii’s average is 8 percent. Kona Community Hospital’s rate is 10 percent.
Another goal, he said, is improving patients’ experiences with the hospital. He noted Kona Community Hospital does as well as North Hawaii Community Hospital on many patient survey measures. But on patient satisfaction, “both Hilo and Kona don’t do nearly as well as North Hawaii,” he said. “There are things we need to improve on.”
Kona hospital got $170,000 to hire care coordinators. Bairos said the funding will run out next year, but hospital and Beacon representatives hope insurance providers will see the benefit the coordinators provide and offer funding to keep the positions in place.
Hospitals are also moving to electronic health records and tying in to a Health Information Exchange. Laurie Bass, Beacon’s Health Information Exchange and Health Information Technology manager, said the exchange will make patients’ records available to any doctor, where ever the patient is being seen.
When talking about the exchange, Bass uses herself as an example of how patients may benefit. Bass is allergic to penicillin and if she were taken to a hospital unconscious, a physician may give her a dose of the drug. That, she said, could kill her. Having an electronic record any doctor may access will prevent that from happening, she said.
“It will increase the care you’re given by the physician,” she added.
The electronic records may also decrease the need for patients to fill out the same forms at multiple doctors’ offices, because their health history will be accessible through the exchange. Such records will also decrease medical care costs, Bass said.
Hilo Medical Center purchased one program for electronic health records and has its program up and running, Bass said, as does North Hawaii Community Hospital. Kona Community Hospital will be the next of the Hawaii Health Systems Corp. hospitals to implement electronic records. Hospital staff are supposed to begin using the records Nov. 1, CEO Jay Kreuzer said.
A recent study, published in the journal “Health Affairs” reported such records do not decrease health care costs. Costs aren’t really the driving force behind Kona Community Hospital’s move to the electronic records, though, Kreuzer said.
“We’re doing this for better patient care, not necessarily to save money,” he said. “It’s a lot of work by physicians and staff to get this up and running.”
One of the reasons federal officials selected Hawaii County, one official said in 2010, was that 40 percent of doctors here were already using electronic medical records. Some physicians still have concerns about making the switch.
“A good electronic medical records program should allow the doctors to have high efficiency and effectively (work) with their patients,” Dr. Barry Blum said. “A badly designed program doesn’t allow this. The present program at Alii Health has not met the expectations of many of its doctors.”
Alii Health Center’s program is time consuming to use, he said, and retrieving information is difficult. The center will be replacing the program, Blum said.
A final component of the Beacon program is working with community organizations, awarding contracts to promote active living and quitting smoking.