Hawaii becomes hub for Pacific-wide teleradiology network

A telemedicine and teleradiology network connecting healthcare facilities in the vast Pacific basin to a hub in Hawaii is set to begin operations Jan. 29.

The project's eventual goal is to link the medical infrastructure in Hawaii with all the hospitals and clinics on 14 remote Pacific islands: Majuro, Ebeye, Kosrae, Pohnpei, Chuuk, Yap, Rota, Tinian, Saipan, Guam, Palau, American Samoa, Tonga, and Fiji.

Pugua' International and Pupulu International, two Honolulu-based communications and consulting firms, have the responsibility for all technical aspects of the ambitious network.

"We're installing a network that all those facilities will be able to use to provide remote healthcare," said Norbert Perez, president of Pugua' International.

Perez, a retired AT&T and Bell Laboratories telecommunications engineer who designed both the hardware and software, expects the network to considerably reduce expensive emergency medical evacuation of nonemergent cases and to provide a higher population base for resident physicians. His goal is to make Hawaii the technical healthcare hub of the Pacific.

The project, called "Punaewele Ola Kino" - Hawaiian for "Health Network" - is driven by the escalating expense of healthcare in the Pacific.

"The cost of healthcare continues to soar, principally because of lack of technical intervention and adoption of technology-based networks, particularly in our remote Pacific basin chain of islands," said Perez. "Our telemedicine network will bring the cost down to a manageable level for all the hospitals and facilities by expanding Hawaii's resource base."

The island of Guam is an example. Last year, the government of Guam alone spent well over $40 million on medical evacuation of over 700 patients, Perez said. Most of those cases were not actual emergencies but were evacuated in the interest of caution, due to the relative basic nature of some Pacific emergency departments.

A screening process made possible by teleconsulting, whereby an attending physician in Guam can confer with a physician in Hawaii, will serve to reduce the evacuation numbers while enhancing medical services for the people of Guam, he said.

The new medical network will use dedicated T1 pipelines between islands and dedicated ISDN lines for videoconferencing and digital radiologic images, thus ensuring a higher level of security and reliability, according to Perez.

"We're not interested in using the Internet as a resource because of the security problems and the technical bottleneck expected soon," he said.

The January activation ceremony will spotlight the initial interconnection of physicians at Castle Medical Center in Kailua, Hawaii, with the hospital in either Majuro or Pago Pago, American Samoa.

Punaewele Ola Kino is funded by grants from the Harry and Jeanette Weinberg Foundation, the same Foundation that previously wired every hospital and medical center in Hawaii.