Flight halt forces state
medical providers to alter
neighbor isle aid

---

By Lyn Danninger
ldanninger@starbulletin.com

It's been mostly business as usual for Honolulu's health care providers and hospitals for the past two days.

But area hospitals have had to make some adjustments, especially to accommodate neighbor island patients.

Both Medevac helicopter flights handled by the U.S. Army for Oahu and neighbor island air ambulance flights were cleared Tuesday by the Federal Aviation Administration for medical emergency transport.

"On Tuesday we didn't receive any calls for Medevac flights, but (yesterday) we were able to respond quickly to send out a helicopter to pick up a soldier injured in a motor vehicle accident and transport him to Queen's," said Capt. Stacy Bathrick, spokeswoman for 25th Infantry Division Light, the group that mans U.S. Army Medevac flights.

For Hawaii Air Rescue, the only private air ambulance service in Hawaii, serving the neighbor islands, things have been a little busier.

"Already we've handled five emergency neighbor island flights," said Sandy Apter, president of the company.

Non-emergency and elective treatments and surgeries have been postponed for neighbor island residents who were scheduled to come to Oahu for medical care, hospitals say.

Technology has also been put to greater use.

Both Kaiser Permanente and Kapiolani Health say they have put into action contingency plans prepared in the event of a disaster related to Y2K. "When Y2K was going to happen we came up with a lot of protocols so now we are using those as guidelines," said Kaiser spokeswoman, Jan Kagehiro.

Both organizations have made greater use of telemedicine equipment to treat some neighbor island patients.

Kapiolani's traveling perinatology clinic routinely travels to the Neighbor Islands to see women experiencing high risk pregnancies.

While yesterday's clinic scheduled to go to the Big Island was canceled, the Kapiolani perinatologist was able to assess patients using a fetal tele-ultrasound connection to Hawaii Radiologic Group in Hilo. The device allows ultrasound images to be transmitted between computers at facilities anywhere in the world.

"Usually we use the fetal tele-ultrasound on an as-needed basis so today this was for moms who had been scheduled to see us," said Pat Oda, Kapiolani communications director.

Kaiser Permanente also made use of telemedicine to accommodate its neighbor island patients. One of organization's oncologists has been using teleconferencing capabilities to connect with Kaiser's neighbor island clinic patients.

"So far it's been going very well," said Kaiser spokeswoman Jan Kagehiro.

But there have been some challenges. About 90 percent of all laboratory tests performed on the neighbor islands at Kaiser clinics are usually sent to Oahu by plane for diagnosis and screening.

Kagehiro said routine lab tests are being deferred at Kaiser's Big Island and Maui clinics.

More urgent testing is being referred to private laboratories on the neighbor islands.

But even private laboratories that provide the majority of neighbor island services are teaming up.

"At this point, our competitors have been very helpful. We agreed to work together," said Ed Hope, marketing director for Diagnostic Laboratory Services Inc.

"In Kona and Maui we don't have testing facilities so in those areas, Clinical Laboratories of Hawaii agreed to help. Other than that, we are pretty much holding our own," Hope said.

Access to supplies and prescription drugs is also an issue for the neighbor island health care facilities.

"As far as medical and non-medical supplies, our neighbor island (clinics) have enough to last about a week, so it's not critical. For the moment, we are trying to limit supplies of drugs to seven-day prescriptions," said Kaiser's Kagehiro.

Hospitals say they have also received an unprecedented number of offers to donate blood.

But with the exception of Tripler Army Medical Center, area hospitals purchase their blood supplies from the Blood Bank of Hawaii. It's the only facility accredited to accept blood donors, said Kagehiro.

All the public offers have strained the blood bank's facilities so Tripler has been helping out, said Margaret Tippy, the facility's public information officer.

"On Tuesday morning we got a call from the blood bank. They had collected 136 units of blood that could not go out on a flight for testing in Washington.

"We were able to test all 136 units of blood," she said.

But even Tripler has limits on the number of blood test kits it has available if the pace of blood donations continue. It's likely the Hawaii Air National Guard will lend a hand, she said.

"I was told that the Hawaii Air National Guard will take the blood samples and fly them to the mainland so all the blood collected since Monday can be tested," she said.