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Tuesday, May 9, 2000

By Ken Ige, Star-Bulletin
Radiologist Dr. Raoul Hagen views digital X-rays on Tripler's new system.

VA hopes more
use new clinic

Pill power gets boosted by automation

By Gregg K. Kakesako


More than 100,000 veterans reside in the islands, but the Department of Veteran Affairs says that only 11,000 of them have signed up for medical care.

Gabriel Perez, associate director of the Spark M. Matsunaga Veterans Affairs medical and regional office center, hopes all that will change with the opening of its $21 million ambulatory care clinic near the VA's new headquarters at Tripler Army Medical Center.

The new three-story building on the makai side of Tripler will be dedicated May 31. It houses a dental clinic with three dentists, one full-time dental hygienist, three dental assistants and lab technician.

Other services included in the 92,300-square foot clinic are a state-of-the-art pharmacy and radiology center, laboratory, eye and prosthetics, women's health, and mental health.

Work was completed a few weeks ago and "we are now in our shakedown cruise," Perez said.

One of the reasons the VA may have such a low participatory rate, Perez added, is because Hawaii is a state where much of its population has medical insurance and "we are in competition with other health care providers."

"The other reason is because many people didn't know where we were located. We were in the federal building and parking was a problem there."

Perez likes to refer to the new Tripler complex as "four jewels in a crown."

Last year, the VA moved its headquarters into what was once Tripler's E-Wing hospital ward, completely gutting its four floors. The $13 million renovation doubled the square footage of the VA, increasing it to 89,400.

The complex is part of VA's four-part Matsunaga medical center. The headquarters' complex includes the VA's administrative operations as well as the offices that provide veterans' benefits and services.

Besides the new medical clinic and administrative VA offices, the Matsunaga center also includes a $14 million, 60-bed nursing home, rehabilitation center and primary care offices. To better serve the veterans, the VA also built a $13 million five-story 600-vehicle parking structure in 1997.

Perez noted that all military personnel who were honorably discharged, regardless of length of service, are eligible for medical benefits. The type of benefits vary and the service member needs to register with the VA to determine his or her eligibility.

Ron Yonemoto, special VA assistant, added that "if more veterans enroll in Hawaii, it will mean the VA here could get more funds to serve an even larger population."

The Matsunaga Medical Center is named after the former U.S. senator -- a member of the 100th Battalion and the Military Intelligence Service -- who died in 1990. Work on the $61 million center began five years ago.

The Honolulu VA, with assistance from U.S. Veterans Initiative Inc., plans to use buildings and property at what was once Barbers Point Naval Air Station to care for homeless veterans. Plans call for the establishment of transitional housing that will provide 118 beds for homeless veterans. US Vets recently received a $565,000 grant to work on the homeless project.

On the neighbor islands, a 16-bed VA post-traumatic stress disorder residential rehabilitation program is operated in Hilo.

By Ken Ige, Star-Bulletin
Brenda Kiyuna, left front, and Cheryl Kanno work with Tripler
Hospital's new Opti-Fill II machine, which bottles pills mechanically.
Pills are tracked via bar codes, which Kiyuna is reading.

Pill power gets
boosted by automation

By Gregg K. Kakesako


More than 55 percent of the prescriptions filled at the new Spark Matsunaga Veterans Affairs clinic is done by automation.

And the goal, according to James Miyashiro, VA's chief of pharmacy service, is to try to do nearly 80 percent of its operations using its state-of-the-art $490,000 automated prescription bottle filler system. Only Kaiser has the state's other automated system.

In addition to its new pharmacy, the new $21 million VA clinic, to be dedicated May 31, has a radiology center where X-ray film is a thing of the past.

All X-rays are digitized and available to viewed by technicians or doctors on a television monitor within seconds anywhere in the three-story clinic. The VA says no local clinic or hospital can boast of such technology.

In the pharmacy, more than 200 prescription drugs can be counted and dispensed into individual bottles as they move on a robotic conveyor system.

Miyashiro said manually a pharmacist can handle about 125 prescriptions during an eight-hour shift. The process involves labeling the bottle, counting out the pills, recording the prescription and then checking it before dispensing the medication.

"This machine can do up to 250 prescriptions an hour," said Miyashiro, a 1961 Iolani School graduate.

He estimated that his pharmacy by mid-April was averaging more than 1,000 prescriptions a day.

The process begins with the automatic selection of the right size bottle. The machine then prints a label and applies it to the bottle, picks the right medication, fills the bottle with the number of pills prescribed, and then caps the canister.

At the end of the conveyor belt the bottles are scanned and checked against the pharmacy's data base.

All of the prescriptions written by VA doctors are sent electronically to the pharmacy and the patient never has to bother with a written prescription.

Neighbor island VA patients can get their prescriptions filled by phone and Miyashiro estimates that it takes about two days to fulfill those requests.

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