A myriad of stakeholders came together Thursday for the Hawaii Island Health Care Conference at the Westin Hapuna Beach Resort to discuss the state of health care in Hawaii County.
Although no concrete solutions were derived from the conference, the recurring theme of collaboration was seen as a path forward to solving the complex issue of health care disparities.
Randy Kurohara, executive director of Community First Hawaii, set the theme for the conference, referring to the last one held in 2010 as a model and emphasizing the need to learn and understand what has been working, but also what needs to be improved.
“We need everyone to work together to make a difference. As the late Mayor Billy Kenoi said, ‘Not no can, but how can,’” he said.
Mayor Mitch Roth said the health care crisis is like a storm, and he noted the situation has gotten worse since the last conference, but that there is hope.
He said he views health care a lot differently since suffering a heart attack in January 2021.
“Thinking about where we are, with great distances to health care providers, we cannot afford delays,” he said. “We have a lack of adequate resources, particularly on the west side of the island. We have health care shortages that have lead to burnout. But we have incredible competency with the doctors, nurses and health care providers we have, and so many more.
“We have a great spirit of aloha. But on this island, I think we have (to figure out) how we can collaborate to make amazing things happen.”
Roth said it is a collective effort to make sure every resident has access to quality health care services and is able to live a healthy and thriving life on Hawaii Island.
U.S. Rep. Jill Tokuda reminded attendees that the health care crisis didn’t just happen, but has been building for many years and health care disparities have been an issue for generations.
She said statistics show those who live in rural areas such as the Big Island have worse health care outcomes and shorter life expectancies than those in urban areas. Shortages of physicians and lack of transportation options lead to those inequities.
Tokuda said low reimbursement rates and doctor shortages can no longer be used as an excuse, and must be addressed.
“Our people matter, and just because they live in a different zip code shouldn’t (prevent them from getting the) lifesaving access they need,” she said.
Dr. Lynda Dolan, president of Big Island Docs, acknowledged the fact that the island has an aging population of physicians.
“In our organization, we have hundreds of years of medical (experience). It’s a good thing, and it’s a bad thing. A few years ago, we organized a private clinic called Big Island Healthcare to create a landing spot for new physicians and matching them up with more senior physicians,” she said.
This win-win situation passes the knowledge of the aging physician population to a younger generation.
Dr. Whitney Limm, chief physician executive of The Queen’s Health System, said telehealth is an important component in reaching rural communities. He said Queen’s is a strong supporter of the University of Hawaii’s John A. Burns School of Medicine and residency program.
“Moving forward, we need to make sure we have people from the Big Island coming, getting their degrees, and coming back here. People want to be treated by providers who talk like them and look like them. That is something that is a priority for the health care system,” he said.
That theme was recurrent throughout the conference. The need for homegrown professionals and the need to get island youth interested in health care is critical.
Representatives from Hawaii Island Community Health Center, Kaiser Permanente, Hilo Medical Center and Kona Community Hospital spoke about the programs they have put in place to enhance health care, such as the integrated medical records system that is available to access patient records throughout the island. This system is critical to being able to provide continuity of care, especially within populations that are not in tune with their medical care.
Another issue discussed Thursday was licensing reciprocity, which would allow health care professionals licensed in other states to practice in Hawaii.
Health care literacy was another topic. Language barriers can lead to negative outcomes and repeated expensive hospital visits, speakers said. Being able to have not only interpreters, but advocates for marginalized non-English speaking patients could lead to better outcomes. In addition, there is a need for health care “interpreters” who can navigate the system and educate patients to be more proactive in their own care.
Richard Taaffe, CEO of Hawaii Island Community Health Center, agreed.
“There is no question. We have stories of people who are treated and sent home, but they don’t know the medication and consequently don’t take the medication and are back and readmitted to the hospital. It’s jut a revolving door,” he said.
Limm said the community needs health navigators tasked with the responsibility to be able to explain treatment plans to the underserved patients.
“We are in an incredibly diverse area of the world,” said Clayton McGhan, CEO of Kona Community Hospital and West Hawaii Region. “The language barrier is hard to navigate. This is an opportunity, because we have to start thinking ahead to what is going to inspire the younger generation to be a case worker. I think that’s where we need to focus.”
Taaffe agreed, noting the Hawaii Island Community Health Center is opening school-based clinics that will not only offer health care services, but also act as a recruitment center for youth.
The conference continued with breakout sessions for topics such as the role of philanthropy in supporting health care, health disparities, innovated partners in care, behavioral health and workforce development.
One other theme was recurrent throughout the conference: prevention.
“We need to be all about prevention. We need to look at hospital admissions as a failure of our system,” said Greg Christian, president of Kaiser Foundation Health Plan and Hospitals in Hawaii.