Healthy partnership in Pahoa: Hilo Medical Center’s pact with Puna clinic aimed at reducing ER visits

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Puna Community Medical Center announced a new affiliation with Hilo Medical Center that will bring more health care to Pahoa.

Puna Community Medical Center announced a new affiliation with Hilo Medical Center that will bring more health care to Pahoa.

Leaders of the two organizations signed a memorandum of understanding that “will lend health care expertise and financial support to the conveniently located walk-in medical clinic that provides urgent care services to Pahoa and the surrounding Puna community.”

“We’ve already leased the space to make it available for expansion,” said Dan Brinkman, CEO of the East Hawaii Region of Hawaii Health System Corporation, referring to two additional storefronts within the Pahoa strip mall where the clinic is located.

Hilo Medical Center has the resources to subsidize “some of their care” at the Puna clinic, he said.

Hospital officials hope the partnership will reduce the number of unnecessary emergency room visits at Hilo Medical Center.

Thirty-one percent of the hospital’s emergency department patients treated in 2015 were from Puna. Of the 14,620 Puna patients, 4,671 “had minor health issues that could have been cared for adequately at Puna Community Medical Center.”

It’s three to four times more expensive to treat patients at the ER than at the clinic, Brinkman said.

State Sen. Russell Ruderman said the only way to get to the ER from Pahoa “is on the deadliest highway in the state, which is frequently closed for six hours at a time for accidents.”

Physicians for PCMC’s expansion could come from the Hawaii Island Family Medicine Residency Program, which recently produced its first three graduates. As new physician-residents enter the specialty training program, Brinkman said, they might serve alongside PCMC health providers and increase the number of patients who can be treated daily.

“They will essentially become another training site for the residents,” Brinkman said. Hopefully, some of the residents will want to stay after completing their residencies, he said, noting that a couple of residency physicians already have expressed interest in that possibility.

The first order of business for the new partnership, Brinkman said, is to increase the Puna clinic’s capacity.

“Then the next piece of business is raise some money and make something happen,” he said, referring to PCMC expansion.

“It’s my hope that it grows into a small, full-service hospital,” Ruderman said. “Puna has as much population as Hilo and yet you can’t find a hospital or an ER.”

The Pahoa clinic’s board chairman, Ralph Boyea, said in a statement that “the need for our community is larger than our present capacity.”

“This is really necessary, especially since Puna is so underserved,” said state Rep. Joy San Buenaventura, who along with Ruderman and other dignitaries attended Friday’s announcement festivities at the clinic. She said legislators are “thrilled” with the new PCMC-Hilo Medical Center affiliation.

Brinkman emphasized that the hospital and clinic were careful to ensure that each can maintain its independence. PCMC, he said, will remain a nonprofit and won’t become part of the state-run hospital.

Boyea said it will benefit the clinic to have access to the medical expertise of Hilo Medical Center, as well as business administration expertise.

The board started considering the possibility of affiliating with Hilo Medical Center a year ago.

“As our dialogue and due diligence progressed over a period of about six months, it became evident that an affiliation with Hilo Medical Center could be a win-win,” Boyea said.

One of the stated goals of Puna Community Medical Center, a nonprofit started in 2009, is eventually to expand into a $30 million hospital.

PCMC has a 65-year lease, granted by the Department of Land and Natural Resources in 2014, on 5 acres of land in Pahoa along Highway 130 “for the construction of an expanded facility, which will include an emergency room.” The clinic received a $750,000 planning grant from the Hawaii Senate Ways and Means Committee to develop the ER.

“We are looking to expand and utilize that space. Exactly what is built there and when is what this new board will figure out,” Brinkman said.

So far, PCMC has spent $100,000 of the grant for a Pahoa hospital feasibility study.

Boyea said PCMC board members will soon be reviewing the study’s results before deciding how to proceed with expansion plans.

“We want to make sure that whatever we do is sustainable,” Boyea said.

Brinkman said it’s important not to predict what the future holds because it can cost about $1 million per bed to build a hospital.

How soon might such a facility be built?

“My dream would be less than five years,” Boyea said.

“We’re all very proud of PCMC,” Ruderman said. “Because it’s truly a home-grown facility.”

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