Hawaii is a state that could potentially use telehealth to address the mal-distribution of medical resources and substantially increase access to specialty care. Hawaii consists of seven inhabited islands. The majority of the population and thus the medical resources are on Oahu with the neighbor islands having limited resources. Specialty care is either provided by periodic visits by specialist to the neighbor islands or patients incurring the cost of plane and ground transportation to come to Oahu. Telehealth projects in Hawaii have attempted to improve access and reduce cost, but the programs usually closed one the funding was exhausted. Most projects were externally funded and not infrequently, there was local competition for funds. Projects tended to be relatively small and often did not fully mature due to provider resistance, support costs and integration into larger programs. However; over the last 10 years, Hawaii has developed the technical backbone for telehealth through the State Telehealth Access Network (STAN).



An informal telehealth committee formed in the summer of 2007 to explore options to better collaborate on telehealth with the goal to improve care and increase the probability that clinical telehealth activities would be sustainable. The formation of this committee was initiated by Hawaii Medical Service Association (BCBS Hawaii), Hawaii’s largest health plan and lead to funding for a one day symposium through the HMSA Foundation. Others involved in organizing the event were: University of Hawaii (Telehealth Research Institute, Telecommunications and Information Policy Group, and State Telehealth Access Network); Queen’s Medical Center; Hawaii Pacific Health; Shriners Hospital; Hawaii Health Systems Corporation; Pacific Islands Chapter of the American Telemedicine Association; and Northwest Regional Telehealth Resource Center.

On November 15, 2007, a full-day symposium was convened with key stakeholders involved in telehealth in Hawaii. The intent was not just to share knowledge, but to identify critical needs, explore common interests and mutual benefits, and lay the foundation for a working community collaborative. By engaging all stakeholders to create a common vision and agenda, the symposium sought to harness institutional and individual energies that will be much more powerful together than separate. The event was professionally facilitated to focus discussion on producing an actionable plan to better organize telehealth in Hawaii through a collaborative effort. This entity would seek to integrate activities, provide synergy, assist in seeking funding, and address issues related to policy, legislation, reimbursement, and sustainability through integrating telehealth into business strategies and clinical practices.



There was a clear mandate from the participants of the symposium that Hawaii needed better structured clinical coordination of telehealth activities to provide the scalability and sustainability of the services. This goal not only requires collaboration among the major stakeholders and rural end users, but also an organization and resources to mature the collaborative effort. The Telehealth committee has taken the summarized output from the symposium and is exploring funding opportunities to establish a clinical coordinator for telehealth in Hawaii. The coordinator would facilitate the development of a state plan for telehealth, a business plan to sustain the collaboration among institutions going forward and a central location to grow and support telehealth in the Hawaii.

© 2007 Hawaii Telehealth Collaborative.
Telecommunications and Information Policy Group