Hilo Medical expanding cardiac care

  • HOLLYN JOHNSON/Tribune-Herald Echocardiographer Reina Sako sits at the ultrasound machine at the Cardiology Clinic at Hilo Medical Center.
  • HOLLYN JOHNSON/Tribune-Herald From left, Dr. Hiro Makino, Lisa Shiroma, assistant hospital administrator, and Michelle Chow, cardiology nurse, stand in the stress test room of the Cardiology Clinic at Hilo Medical Center.

A year after opening its outpatient Cardiology Clinic in a new first-floor space, Hilo Medical Center is continuing its efforts to treat patients closer to home.

HMC will bring on two new interventional cardiologists next year. Dr. Carl Juneau begins in January, and Dr. James Smith will come in August.


While general cardiologists take care of primary cardiology needs, assistant hospital administrator Lisa Shiroma said interventional cardiologists have additional training and can actually perform procedures.

“So (doctors) don’t only treat you in the clinic, but they can actually take you to our (heart catheterization) lab, and they can do diagnostic studies for you and our goal, eventually, once we have at least two interventional cardiologists on board, is to provide interventional cardiology services here, which is going to be a big step for our community and it will help keep patients here on the island,” Shiroma said.

The cath lab can currently diagnose but is unable to treat emergent patients.

In diagnosing, cardiac nurse Michelle Chow said they look for blockages and how extensive the blockage is.

“Then if we have to treat you, with stents or even a bypass, we have to send you to Honolulu for that,” she said.

HMC has offered diagnostic services on and off over the past decade, but it has been offered, again, for nearly a year.

According to Shiroma, more than 100 patients have sought diagnostic services in the last year. Being able to diagnose, means they know what to treat, she said.

“Whether it’s critical or not, then we can actually make the decision of if we’re going to send you off island or can we treat you here.”

But when doctors are able to treat major heart attacks at the hospital without having to transfer patients off the island, it “saves a lot of time, saves a lot of heart muscle and you can save people’s lives,” Hiro Makino, one of clinic’s three temporary cardiologists.

“You have a 45-year-old with two kids having a massive heart attack at 3 a.m., we can go in and open up the clogged artery and basically save their lives and prevent major heart damage,” he said. “So that is the major, biggest advantage once we can start this program. So we hope to get that started by early next year and start doing acute emergencies.”

That’s a great benefit to the community because right now, if someone has a heart attack, said Makino, it can take six or seven hours to get the patient to Oahu.

Within that time, “most of the damage is done already,” he said. “So we can make a major difference in people’s lives in Hilo.”

Shiroma said HMC hopes to start performing stent procedures in 2019.

HMC received $1.5 million from the state legislature during its 2018 session to help bring the interventional cardiac catheterization program online, and will seek additional funding for the program in the upcoming biennium budget.

“The ongoing support and advocacy of Sen. Kai Kahele and Rep. Mark Nakashima have made much of our progress possible,” hospital CEO Dan Brinkman said in an emailed statement.

“This upcoming legislative session marks the beginning of the state’s biennium budgeting. Hilo Medical Center will be requesting $1.5 million the first year and $1 million next year to help us meet our commitment to our community, performing interventional cardiac catheterizations to stop heart attacks in progress.”

Shiroma said the funding will be used for the HMC cardiac catheterization lab, recruitment efforts, training and equipment.

“This is really to get the program started, but I think after that third year, we should have a pretty sustainable program,” she said.

“We’ll have the cardiologists on board, we’ll have the services already defined and established, so we believe we will be able to be sufficient after that.”

According to Shiroma, the goal is to have four general and interventional cardiologists on staff.


The clinic itself continues to grow in its new space, and has seen an 11 percent growth. According to Shiroma, there are currently 3,800 patients, with more than 600 coming through in October alone.

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.

Leave a Reply

Your email address will not be published. Required fields are marked *


By participating in online discussions you acknowledge that you have agreed to the Star-Advertiser's TERMS OF SERVICE. An insightful discussion of ideas and viewpoints is encouraged, but comments must be civil and in good taste, with no personal attacks. If your comments are inappropriate, you may be banned from posting. To report comments that you believe do not follow our guidelines, email hawaiiwarriorworld@staradvertiser.com.