HMSA plans $50M investment in health care

The funding over three years will go partly toward setting up electronic records systems

Isle hospitals, doctors and patients are expected to benefit from a $50 million Hawaii Medical Service Association investment over the next three years.

Big spender Here's how Hawaii Medical Service Association plans to spend $50 million over the next three years: $30M To fund innovative ideas to improve patient care and outcome. $20M To buy electronic medical records systems for the association's member physicians.

Bob Hiam, HMSA president and chief executive officer, announced the funding yesterday for an Initiative for Innovation and Quality (HI-IQ), saying it is envisioned as "a catalyst to continuously advance quality health care in Hawaii."

"It has the potential to transform health care in the islands," said Michael Stollar, HMSA vice president of corporate communications.

The two-part initiative includes:

» $30 million to fund innovative ideas from HMSA's 17 participating acute hospitals for projects to improve patient care and outcomes. About $10 million in grants will be awarded each of the three years.

» $20 million to help about 1,000 of the association's member physicians acquire electronic medical records (EMR) systems. HMSA will pay no more than half the cost, up to $20,000 per physician.

An EMR system not only can dramatically improve patient care, it can reduce errors and duplication and "provide true efficiencies in the delivery of care," Hiam said.

"As we all learned from Hurricane Katrina, EMRs are vital when disasters strike because they provide continued access to medical information for people in active treatment, whether paper files are lost or destroyed or people are relocated," Hiam pointed out.

Surveys show the primary barrier to an EMR system for independent physicians is cost, said Creighton Arita, president and chief executive officer of TeamPraxis, a community-based organization that helps doctors manage changes in the health care industry.

Fewer than 10 percent of doctors are using electronic medical records, Arita said.

The national average last year for a system was $30,000 upfront, plus $1,200 a month, according to the Medical Group Management Association, he said.

Hiam said combined investment income and reserves will be used for the HI-IQ funding -- the largest outlay in HMSA's history for a health improvement program. Health plan dues will not be involved, and future dues rates will not be affected, he said.

Hospitals will receive annual funding for quality-improvement projects in relation to the amount of services they provide for HMSA members, he said.

The Queen's Medical Center, Kaiser Permanente, Hawaii Pacific Health hospitals and Kuakini Medical Center either have installed or are installing electronic medical records systems.

About 60 percent of Kuakini Health System's electronic records system has been implemented, and the rest will be finished by next year, said Gary Kajiwara, Kuakini president and chief executive officer and HMSA board member.

He said there are many projects hospitals can propose to improve patient care and safety, such as establishing isolation rooms, reducing medical errors, acquiring new instruments or equipment, and adopting bar-code methods for administering medicine to patients.

Hurricane Katrina also underscored the importance of physicians and hospitals building redundancy into everything in case of damage or loss, he said. For example, more than one site is needed to store EMR data.

Stollar said the RAND Research Report Card on Quality Health Care in America reported that Americans receive the care recommended for them only about half the time. Hawaii does better, but significant improvements are anticipated with the HMSA initiative, he said.

Arita and Rachel Raquino demonstrated an electronic medical records system, describing numerous advantages for preventive patient care and safety.

For instance, an electronic record will show at a glance if a patient over age 40 is past due for a mammogram, Raquino said. "That level of care doesn't exist in the paper world."