Monday | December 11, 2017
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‘We are somebody’: Puna residents get the attention of health care providers during forum in Pahoa

The East Hawaii Regional Board of Directors of Hawaii Health Systems Corp. showed Puna community members Thursday night that the district’s health care is one of its top priorities.

“We feel very strongly there aren’t enough services out here,” Dr. Daniel Belcher, board chairman, told approximately 100 people who attended a forum at the Pahoa Community Center.

Belcher told Puna residents something they already know well — “your infrastructure definitely hasn’t kept up” with population growth.

The forum was hosted to acknowledge statistics showing that 40 percent of Hilo Medical Center emergency room visits are made by people from Puna.

“Thank you, everybody, for creating something to finally recognize that we are somebody,” said audience member Emily Naeole.

HHSC Regional CEO Dan Brinkman made clear that HHSC is listening to Puna residents and values their planning input.

“When we decide what to do with health care, we have to consider the needs of our stakeholders,” Brinkman said.

That means asking the people of Puna what’s most needed and what they want the future of their health care to look like in their community.

Suggestions included dialysis, radiology, pressure chambers and increased attraction of physicians and other health professionals.

“Where is health care?” Brinkman said.

“Hilo!” a man in the audience responded without hesitation.

“It is,” Brinkman replied. “And maybe we can do something about that — but we need to plan.”

About 3,000-4,000 patients from Puna who visit the Hilo Medical Center ER could be treated in Pahoa, with “just a little improvement” at Puna Community Medical Center in Pahoa, Brinkman said.

PCMC plans to expand its urgent care clinic, with Hilo Medical Center funding space for that expansion.

“If you guys can do the care cheaper and better here, isn’t that the best use of the taxpayer dollar?” Brinkman asked.

Continued expansion of PCMC in Pahoa “must be sustainable health care,” he said.

The HHSC board and PCMC must consider where a new hospital might go in Puna, what it should look like, what services it might offer and what services it could afford to offer. Those, Brinkman said, are “a lot of big questions.”

“That ball has started to roll,” he said. Already, a market assessment was funded by a planning grant. “There are still dollars there to do the design and maybe a blueprint of that.”

He said it’s unlikely the blueprint can be done by July 2018, but “I think it’s feasible by the end of 2018.”

During the question-and-answer session, Puna resident Rene Siracusa said she thinks it’s important to “speed up the process and attempt to have things here for when another disaster hits,” such as Tropical Storm Iselle.

Planners want to take a gradual approach, adding services without causing financial harm to the new facility or to Hilo Medical Center. To start with, Brinkman said, additions at PCMC will include lab services, X-rays to guide treatment of simple fractures, added space and extended hours.

Right now, the population isn’t high enough to support a full, new hospital. But population growth estimates suggest it could be within a few years.

Already, Brinkman said, the PCMC urgent care clinic uses “every inch of that space — and I mean inches.”

“We have to be very careful that what we build we can sustain,” he said. “But we don’t let our wishes get beyond our pocketbook. But, on the other hand, you don’t want to ignore the needs.”

Planners are looking at whether there could be mental health services in Pahoa, if two locations make more sense than one and whether X-rays could start radiology off and then later possibly add an 8-slice CT scanner.

Brinkman told audience members that Hilo Medical Center has been recognized among the top 20 percent of hospitals in the country.

“I’m very pleased and very proud,” he said.

Brinkman was interrupted by audience member Bo Breda of Pahoa, who called out, “Best emergency room I’ve ever been to! And I’ve been to ERs all over the country!”

Brinkman, to chuckles, emphasized that Breda was not planted in the audience by meeting organizers.

“I grew up in New York, where you wait hours,” Breda said after the meeting. By contrast, Hilo Medical Center staff are “so organized, they are so quick, they’re just really impressive for a small hospital.”

Brinkman said telemedicine has improved so much that PCMC might be able to have specialists available by appointment.

“The world opens up for you, and I think that’s not a pipe dream,” he said.

Puna has a wealth of alternative care practitioners, he said, and they should be acknowledged and included in the overall health system.

Tom Elliot of Ainaloa said during a meeting break that he never saw the same heart specialist twice in four years at Hilo Medical Center and wishes they’d stay longer and get to know patients.

A visiting specialist from Honolulu asked him to take a stress test and he ended up needing a quadruple bypass.

“He saved my life, as far as I’m concerned,” Elliot said. “… I can’t say enough good things about Hilo, the people in the cardiology department are incredible.”

Email Jeff Hansel at jhansel@hawaiitribune-herald.com.

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HHSC also released financials for its hospitals during the meeting at Pahoa Community Center.

• The 276-bed Hilo Medical Center reported 48,377 clinic visits at its eight clinics: 48,523 emergency department visits at the hospital, 8,840 admissions to the hospital, 4,947 surgeries and 1,050 births, with $170 million in revenue and a payroll of $115 million for 1,187 employees.

• At 21-bed Ka‘u Hospital, there were 65 admissions, 2,750 emergency visits, 4,600 clinic visits and $8.3 million in revenue, with a payroll of $6.3 million for 60 employees.

Hale Ho‘ola Hamakua in Honokaa has 77 beds and reported 226 admissions and 2,253 emergency room visits, with revenue of $17.6 million and a payroll of $10.1 million for 109 employees.

• Puna Community Medical Center in Pahoa, which has become affiliated with Hilo Medical Center but remains a separate nonprofit, reported its urgent care services currently include illness treatment, minor injury care, pediatrics, physicals and immunizations. PCMC has 12 full-time and part-time staff members and sees an average of 18 patients per day. A total of 6,519 patients were treated by PCMC in 2016.

 

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