Leaders in Healthcare Archives - Pacific Edge Magazine

Coralie Chun Matayoshi

Sep 5, 2019

What prompted the switch from law to humanitarian aid?

I have served as a volunteer and worked with volunteers my entire life, and I feel a deep sense of commitment to helping others. I started my career as a trial attorney with the U.S. Department of Justice Antitrust Division in Washington D.C. In private practice, I did pro bono work and led public service projects as president of the Young Lawyers Division. As executive director of the Hawai‘i State Bar Association, I promoted access to justice, alternative dispute resolution and even mobilized volunteer lawyers to help Hurricane Iniki victims.

I love new challenges, and when the opportunity arose to serve the largest humanitarian service organization in the world, I felt a longing to expand my reach to the broader community. The mission of the Red Cross is to prevent and alleviate human suffering in the face of emergencies by mobilizing the power of volunteers and the generosity of donors. I feel blessed to be able to use my best talents to make a difference.

What’s something people may not know about the American Red Cross?

We are chartered by Congress to respond to disasters big and small—one every eight minutes nationwide, and every four days in Hawai‘i—and provide emergency communication between deployed military service members and their loved ones in times of crisis. We work side by side with firefighters, police, civil defense and military to fulfill this humanitarian mission, yet we are not a government agency and receive no funding from the federal or state government for disasters. Instead, we rely on the generosity of the public to provide critical services to our community.

You’ve been CEO of the Hawai‘i region for 16 years. How has Hawai‘i’s disaster preparedness needs changed during that time?

A lot has changed—storms are more severe (e.g. hurricanes, floods, wildfires), there are ever-increasing threats to our homeland (e.g. 9/11, the Boston Marathon bombing) and the serious consequences of multiple deployments are being felt (e.g. PTSD, multiple amputees).

So in addition to responding to bigger and more frequent disasters, our focus is on prevention—installing free smoke alarms, preparing keiki for disasters, teaching people lifesaving skills and how to escape home fires—and building resilient communities where neighbors come together to prepare and take care of one another.

We are also doing more to support military service members and their families through reconnection workshops, suicide prevention and veteran support. More and more, we are communicating preparedness information through social media and through our Emergency, First Aid, Pet First Aid and Hero Care apps.

Hawai‘i has weathered several natural disasters over the last couple of years. What strengths or weaknesses were revealed and how do you plan to use that knowledge going forward?

Hawai‘i is the most isolated population on the face of the earth, yet many of us are not prepared. When—not if—a Category 5 hurricane strikes our islands, there won’t be enough shelter space, so people need to prepare their homes to shelter in place. Those living on the coastline, atop mountains or in high rises may be in worse shape, and small businesses need a backup plan. Storms are only going to get worse, so the time to get ready is now.

You deployed to New Orleans after Hurricane Katrina. How often are you on the front lines?

Although we are on call 24/7, 365 days a year, we rely heavily on volunteers who comprise 95 percent of our workforce. Volunteers are the ones who respond to everyday disasters. When larger disasters strike—like the Japan earthquake and tsunami, Marco Polo fire, Kīlauea eruption and Hurricanes Lane and Olivia—we are all working nonstop. I always know that it’s something serious, like a tsunami coming, when my disaster director calls me at 1 a.m., and we all head to the office. This is our pledge—to be here whenever and wherever help is needed.

Tom Delaney

Sep 5, 2019

You’ve been with HDS since 1985. How has the organization evolved over the last 30 years?

We have leveraged technology to improve the efficiency, flexibility and quality of the products and services HDS provides to our customers. Our systems and processes have evolved continuously over the last 25 years to provide capabilities that were unanticipated when I first started at HDS. We have seen changes in the dental benefit marketplace where employers increasingly want products specifically designed to their requirements.

Our members trust us with their oral health. I take pride in the systems we have implemented with our local IT development team to apply extensive review of the dental services rendered to our members. This ensures that the dollars spent on their oral health care are used in an efficient and effective way.

What’s the most valuable lesson or piece of advice you’ve drawn upon over the course of your career?

Early in my career, one of my mentors advised me to solve problems from the inside out. First, I try to understand the business challenge. Second, I try to understand the detailed behavior of the underlying application or process. Third, I try to test potential solutions against both the business needs and the underlying technical constraints to arrive at an optimal solution. I have found this to be extremely useful when solving technical challenges. Now that I deal with more operational issues, I have found it to be an equally useful technique.

What’s new at HDS Foundation?

HDS Foundation works with various nonprofits and organizations across the State of Hawai‘i to increase access to oral health care in underserved communities, improve oral health education and prevent oral disease.

One of HDS Foundation’s recent projects is a pilot program with the Hawai‘i State Department of Health and the University of the Pacific to incorporate teledentistry on Hawai‘i Island and Maui. Teledentistry provides a way for underserved communities to access dental care at schools, transitional housing communities, nursing homes and other community sites. Other projects include incorporating oral health education into community programs for keiki and seniors and providing local community health centers with the resources to expand access to dental care and serve more people.

What are some of the biggest ways technology is changing dentistry?

Technology has always improved the way dentists perform various treatments. Digital imaging and tools to increase the efficiency and predictability of dental procedures are among the new technology dentists are using these days. For HDS, we’re focused on security. Conversations with our members have been circling around the strategies we employ to keep their personal health information confidential. Our small team of developers and security experts diligently improve the ways in which we secure member data and maintain privacy. They train every single HDS employee on cybersecurity, conduct daily assessments and tests against our systems and have created a strong culture of cybersecurity and awareness.

What’s your favorite part of the job and why?

The best part of my job is getting to see large projects move from conception to implementation. HDS is a small organization by most standards, but this does not dampen our commitment to provide our customers with the best possible dental plan in Hawai‘i’s marketplace. To deliver on this commitment, our organization must be constantly improving. I have the good fortune to lead a team of dedicated and creative professionals. This has enabled us to continue to innovate and improve the dental plans we offer.

What advice would you give someone looking to get ahead in your industry?

My introduction to the insurance industry was through designing and developing computer systems. By working with business people who are experts in their areas of responsibility, I was able to piece together a broad understanding of how all the individual pieces of an insurance company connect and interoperate. This knowledge is invaluable in my current leadership position here at HDS. I don’t believe this is the singular path for someone who is looking to get ahead in the insurance industry, but it worked for me!

Dave Underriner

Sep 5, 2019

You spent 35 years with a competing health system on the mainland. What made you join Kaiser Permanente Hawai‘i?

My previous organization worked very hard to develop an integrated healthcare system. We were successful in many ways, but the ongoing challenges of living in both the value-based model and fee-for-service world posed ongoing conflicts. We managed these conflicts, but it limited our ability to optimize our potential to serve and create consistent high quality and affordable health care. We saw that Kaiser Permanente, one of our competitors, didn’t have these conflicts. The KP model is designed to deliver integrated care and service focused on the member and patient. I also liked KP’s strong focus on community health and community service.

When I had the opportunity to consider joining Kaiser Permanente Hawai‘i, it seemed like a good fit. It turns out the timing was great because we are currently celebrating our 60th year in Hawai‘i. I’m proud to be part of an organization that has done so much for the community for so long and is committed the health and future of Hawai‘i.

Kaiser was ahead of its time in terms of its integrated model of care. Can you give an example of how Kaiser’s infrastructure inherently incentivizes value-based healthcare delivery?

Our integrated model of care incentivizes doing what is best for the patient. When people get sick, we have great doctors in just about every specialty to treat them, and we also know that if we can catch disease early, survival odds and quality of life are greatly improved. That’s why we focus on prevention and keeping members healthy.

Our medical group, HPMG, has systems and structures in place that improve the care and safety of our patients across the entire care continuum. This ability to focus on wellness, screenings and early intervention all the way up to high-end acute care is truly the strength of our integrated approach.

I could give many examples of how our physicians and clinical teams work to make this happen. One example is an innovative lung cancer screening program. We started screening high-risk patients for lung cancer several years ago. We had to talk some of them into getting screened because they had no symptoms. As of April 2019, we’ve completed initial screening on 898 patients out of 1,855 total referrals and found 22 cases of lung cancer and 1 mesothelioma.

What are some of your biggest goals or undertakings as president of the Hawai‘i region?

We are very excited to be expanding care options for residents of West O‘ahu. We’re just starting construction of a $60 million medical office in Kapolei. The 40,000-square-foot facility will really be state of the art. It will offer primary and specialty care, lab and diagnostic imaging, wellness classes and many more services. This is an amazing win for the community, and we expect to start seeing patients at the new facility in 2021.

We’re also looking beyond the walls of our facilities at public health and the health of our entire community. Because of our integrated model of care, we know the value of teamwork. We approach our philanthropy with the same unique model. Our community giving and community health work brings together government agencies, private businesses, nonprofit organizations and individuals, creating partnerships and opportunities to work hand in hand to create thriving communities. Our approach is holistic and systemic, addressing the root issues related to health care to ensure the changes we strive for today will benefit Hawai‘i residents tomorrow and for generations to come.

An important part of this is our partnership with our employer groups to engage their employees and take charge of their health. Healthy employees are good for business. Since employers see their employees almost every day, they have tremendous influence on their employees’ habits and healthy choices. Our team can help with classes, healthy workforce trainings and digital tools to encourage employees to lose weight, quit smoking or manage chronic conditions. A boss or business owner has a vested interest in keeping his or her team healthy, on the job and at work.

This is true for us as an employer as well. Our employees are incredible and do tremendous work every day in service to our members and patients. Their commitment to our mission and vision of caring for Hawai‘i’s people like family is what makes us a successful organization. We need to continue to support their important work and engage them as we continually improve our care and service. Our ability to recruit and retain great people is one of our top priorities.

What are some lessons that Kaiser Permanente Hawai‘i has learned or is implementing from other locations in Kaiser’s nationwide network?

We are very fortunate to be part of an industry-leading healthcare system. Kaiser Permanente now takes care of more than 12.3 million members—more than 250,000 here in Hawai‘i. We have an amazing breadth and depth of knowledge from our colleagues and medical centers across the country. Couple that with local decision-making based on what is right for the individual patient and you have the best of both worlds with the patient in the center.

Let’s face it, no one wants to be in the hospital longer than they have to. Kaiser Permanente providers on the mainland were having great success shortening the time patients had to stay in the hospital after joint replacement, so we imported those workflows and processes from our colleagues: things like adding mandatory pre-surgery education classes, same-day physical therapy care and home PT within 24 hours of discharge. Within an 18-month period, we increased the number of patients who were able to go home after only one night in the hospital to over 80 percent. Previously, it had been under 10 percent.

Our very successful teledermatology program was piloted in other Kaiser Permanente regions before we brought it to Hawai‘i. Patients now have the convenience of sending images of suspicious moles or spots via their smartphone to their doctor. In most cases, it is reviewed by a dermatologist within a few days, and follow up is scheduled when needed. Talk about helping people get the care they need when and where they want it!

You’ve been in this industry your entire career. What would you have done if a career in health services administration were off the table?

That’s a hard question. Every day for the past 36 years, I’ve looked forward to coming to work with the understanding that, through our physicians, employees and volunteers, we are going to affect the lives of so many in our community. The opportunity to serve and support the incredible people who do this everyday is amazing.

I have an undergraduate degree in forest products from Oregon State University and had considered working in the forest products industry. But my father was a healthcare leader and so I had grown up around health care. As I considered career paths after graduation, I found my passion was health care and I am so glad I made that choice.

Laura Esslinger

Sep 5, 2019

You have a wealth of prior health plan experience, including working with rural and indigenous populations. What insight are you bringing to this role from low-income populations on the mainland?

Twenty-five years working with Medicaid programs has taught me that every state has a unique blend of needs and that the communities we live in are the foundation for individual health. A key reason I chose to work in Hawaii is the strong sense of community which is similar to what I experienced in my last role in New Mexico. Our health plan provided health care coverage statewide which included serving 23 Native American tribes and the Navajo Nation. Native American values influenced how the overall community viewed the importance of family, tradition, healing and connection to the land. Both New Mexico and Hawaii believe strongly that health care is a right and expect that community voice will help define how care is delivered. The diversity of my career experience gives me a larger toolbox of best practices from which to draw from but the choice of what strategies will help improve care within a specific community is driven by those who are living in that community.

What have been the biggest turning points in healthcare over the course of your career?

As a child, I grew up in the era of indemnity insurance but my first employer provided coverage was through a managed care plan. I entered the workforce at a time when Medicaid managed care was first expanding. Along the way, policy changes expanded the breadth of managed care government programs to include children’s health insurance, Medicare Part D prescription drugs, long term services, Medicare/Medicaid integration, and ACA expansion populations. I was part of maturing health plans from primarily administrative entities to include capabilities for care management and social service coordination. Now health plans are expected to convene and collaborate with a wide variety of community organizations towards the goal of improving the overall health of the community. We have evolved from taking control to facilitating care in the community. Finally, the expectations of consumers have changed with a new generation that expects convenient care and electronic communication. Today, health plans are much larger entities who are community minded and rely on big data analytics to target interventions proactively.

Tell us about Waiwai Ola. How common is this type of community investment program among health insurers and what kind of feedback or results have you seen?

While it is not uncommon for health plans to do charitable giving, for an organization our size to commit 6.4 million dollars in a two-year period is significant. For AlohaCare, this is the beginning of a now annual process to set aside a portion of our net income to reinvest in the communities we serve. We are an independent, non-profit so there are no shareowners to satisfy and 100% of these funds are awarded in Hawaii. Waiwai Ola is a unique community reinvestment program that seeks to inspire and incubate ideas to improve how care is delivered. We believe that those who provide care in the community have valuable insight as to how to solve problems within their communities.

We received overwhelmingly positive feedback about Waiwai Ola, from primary care providers/organizations, their community partners, our team members and even our own health plan members. Our hope is that together we find ways to improve the health of individuals and communities.

We are starting to see success with our Waiwai Ola awardees. With Waiwai Ola we are able to work directly with local community organizations to improve health outcomes at a community level. For example, in Dr. Theresa Wee’s program in Waipio, families underwent a training program to prevent and treat childhood obesity. In the first cohort of families, 42% of participants decreased their BMI and 38% decreased in fat; all 100% of participants felt better about making healthy eating decisions for their family. In rural Hana, Hana Health was able to conduct 119 behavioral health screenings for teens and young adults, and then provide access to telehealth or on-site services. With its Waiwai Ola award, West Hawaii Community Health Center was able to provide 74 students with behavioral health services in the Kealakehe area, as well as start a paramedicine program to proactively reach out to those in Kona that have difficulties accessing care or who do not access care at all.

AlohaCare also continues to do traditional charitable giving. Last year we gave funding to more than 65 community organizations offering a wide array of non-medical services such as food, education, employment and peer/family support. Our team members also give generously to Aloha United Way and other charitable campaigns while having fun working together to benefit the community.

Health insurers across the board have been looking at prevention as a way to control costs. What does that look like for AlohaCare?

High costs in health care mean that individuals are sick, in pain and families are not enjoying wellness. Some people view prevention as a series of screenings for early identification of problems. We expand the definition to focus on improving health outcomes and overall wellness for our members. This population health approach means addressing not only medical needs but also behavioral and social. While cost-savings are important to taxpayers, our primary focus is on our members’ health and wellness. When our members are healthier, that also puts less financial and capacity stress on our healthcare system, especially in rural areas where there are fewer providers and healthcare facilities.

Our model of care is high touch and member-centered, which means that we place our members’ needs first. Each of our 65,000 members has a care manager who helps them access services and get needed care – everything from assisting them with finding a provider, to coordinating transportation and reminding them about follow up care. Members define their goals and we help facilitate their success. Sometimes this means helping locate housing and food for their families. We believe this preventive approach helps keep our members healthy and we know that is also reduces unnecessary emergency and hospital visits.

What are your thoughts on the direction and evolution of the Affordable Care Act?

It’s been five years since major ACA provisions were implemented and overall it has helped to reduce the number of uninsured Americans. However, across our country insurance affordability and disparities by geography, race, ethnicity and income continue to be problematic. In Hawaii, we are fortunate that our State committed to an employer mandate pre-ACA (the Hawaii Prepaid Health Care Act) and to Medicaid expansion via ACA. Only four percent of our residents are uninsured (Kaiser Family Foundation, Health Insurance Coverage of the Population) but we need to focus on bending the health care cost curve so we can continue to serve as many people as possible with our limited resources. Increasing total cost of care and provider shortages are real threats we must address together. Health insurance reform does not reform health care delivery. Improving our healthcare system to support whole-person health requires partnership and the contributions of everyone in our community. Our health care system will be healthier if our communities are healthy.

2019 Healthcare Leaders

Sep 5, 2019

Between pervasive healthcare reform, an aging baby boomer population and the wave of new technology sweeping the landscape, we’re at a pivotal moment in the business of improving the health of our communities. Read on for a glimpse into the world of healthcare in Hawai‘i.

Rupa Wong, M.D.

Sep 4, 2019

What first inspired you to start blogging about your life as a physician, wife, mother and entrepreneur?

Initially I saw it as a way to educate lay people and other doctors about pediatric ophthalmology and strabismus. You’d be surprised how many times my patients have been told by physicians—even by ophthalmologists!—that strabismus surgery is not an option for them. But as I started posting, I realized I could share even more about my journey.

Being at an academic center throughout my training, there was very limited exposure to the private practice side of medicine—how to run a business, manage staff, secure a loan, build your patient base, deal with insurance companies—all things I never learned in training but learned quickly through experience. There’s such a large group of millennial physicians who now turn to social media for advice about these topics.

With these posts, though, came something unexpected. I started receiving a lot of messages from young women who were craving a mentor. They look at my profile and feel reassured that it’s possible to be a surgeon, a mom, a wife and a business owner. So it’s part education, part mentorship, part inspiration, part girl power!

You’re also an influencer with nearly 30,000 Instagram followers and counting. How has this medium impacted your business?

Social media has deepened my connection with my patients and added another layer to our relationship. Patients who I’ve been seeing for years, long before my IG account, will tell me they liked my post on “mom guilt” or that that they learned something from my post about premature babies’ eyesight.

How much of your time and focus is devoted to producing content and engaging with your followers?

I spend a lot of time returning direct messages and producing content for IG, YouTube and my blog. I think of my IG account as a micro blog, and I spend time editing my posts to reflect that. I don’t outsource the work. This is my authentic voice, and I think for it to remain authentic, I have to be the one to do it. It’s a balancing act, of course, between engaging with my followers and being present for my family, since almost all of this stuff is done after work hours.

Tell us about AHSM. How did the idea come about and what role did you play in its launch?

The Association for Healthcare Social Media is the first 501(c)(3) nonprofit association committed to positively influencing public health and health care through social media. A group of us saw a rise in people turning to social media for answers regarding their medical conditions, and we wanted to provide a forum to dispel misconceptions and inaccurate health information while also teaching healthcare providers how best to utilize social media in medicine.

What other projects do you have in the pipeline?

My husband would say too many! I’m organizing a conference in December called Pinnacle, which seeks to address the challenges facing women physicians in private practice. The conference will provide women physicians with practical advice and strategies in an era of continued gender pay disparity and discrimination in the workplace.

I’m also starting a mommy-and-me clothing boutique with two friends called Aryana Clothing. We’re sourcing block-print fabrics from India and aim to create coordinating clothes that moms actually want to wear. We will be launching in mid-July at the Surfjack!

“Social media has deepened my connection with my patients and added another layer to our relationship.”

What’s the best piece of advice you’ve ever received or a lesson you learned the hard way?

My father always says, “The worst thing someone can say is no.” People have an aversion to the word “no” and will sometimes shy away from situations to avoid hearing it. But so what if they say no? I just take that as an opportunity to move on and explore other options.

Shooting for the stars has served me well in negotiations in my personal life and business. (I got The Royal Hawaiian to throw in my wedding cake for free.) If you don’t ask, then you’ve said “no” for them.

Your husband and business partner is originally from Hawai‘i, which explains the decision to move here and start a private practice. What were some of the adjustments you faced in terms of your medical practice or professional life?

I was not prepared for the feeling of community that I encountered here, personally and professionally. I’m used to patients coming to see me because of my pedigree—where I went to college, med school and residency. Here, things are more personal. Patients will get referred because you saw their auntie or their neighbor’s wife. That can make it tough for outsiders to become established, but once you are part of the community, there’s nothing better.

What’s something your followers don’t know about you?

I was a pageant queen in my formative years!

What’s your favorite part of your job?

I love being able to make a difference in people’s lives. Sometimes it’s performing surgery to straighten a misaligned eye. Sometimes it’s prescribing glasses or patching therapy or diagnosing a rare condition. That privilege of someone entrusting me with their or their child’s vision is humbling.

Hawaii’s Healthcare Leaders

Sep 12, 2018

Between pervasive healthcare reform, an aging baby boomer population and the wave of new technology sweeping the landscape, we’re at a pivotal moment in the business of improving the health of our communities. Read on for a glimpse into the world of healthcare in three distinct sectors of the industry.

Mark Wasielewski

President

Diagnostic Laboratory Services
Cheryl Takitani-Smith

Chief Financial Officer

Hawaii Dental Service
Emmet White

President & CEO

Arcadia Family of Companies

Emmet White

Sep 12, 2018

How has the senior living industry evolved since you started your career and how have you navigated those changes?

In mid 1995 when I began my employ at Arcadia, there were fewer options for older adult living communities. Arcadia became the first accredited Continuing Care Retirement Community, now also referred to as Life Plan Communities, providing guaranteed lifetime care in Hawai‘i. At that time, residents who moved in were in their 60s and 70s. Today most older adults want to age in place and remain at home for as long as possible. For those who do live at 15 Craigside and Arcadia, most move in their early 80s.

Arcadia has grown into a family of seven companies, striving to provide a spectrum of care and services that addresses the many and differing needs of our kupuna and their families. In addition to Arcadia and our sister Life Plan Community, 15 Craigside in Nuuanu, we manage two adult day care/day health centers. We also seek to meet the strong desire of many older adults to age in place at home with Arcadia Home Health Services and with a new Life Plan Community that we call Arcadia At Home.

The Arcadia Foundation and our family of companies are able to assist residents in our Life Plan Communities who have exhausted their resources as well as older adults in the greater Hawai‘i community. Besides offering operational expertise in older adult care and older adult living, our nonprofit status and tax exemptions enable us to reach out in many meaningful ways with financial assistance.

How would you sum up the state of Hawai‘i’s aging industry?

According to the U.S. Census Bureau, Hawai‘i’s older adult population is growing four times faster than the total population. Hawai‘i residents enjoy the greatest longevity in the country, and it’s estimated that by 2020, one out of four people in Hawai‘i will be 60 years and older. That means increased need for diversified older adult services to care for and serve Hawai‘i’s kupuna.

What’s the greatest issue facing healthcare providers in Hawai‘i and what is your personal outlook on that issue for the future?

One of the greatest issues we face is employee recruitment and retention. The Hawai‘i State Department of Labor and Industrial Relations announced in October 2017 that the seasonally adjusted unemployment rate for September 2017 was 2.5 percent, compared to 4.2 percent for the United States. This low unemployment rate brings challenges in recruiting talent to many businesses throughout the state. Many companies are having difficulty recruiting entry-level, support and frontline jobs.

Many companies now use various online and social media tools to recruit applicants. Indeed, Facebook and LinkedIn are just some of the methods we use today. Attracting and then teaching and honing skills and competency require both traditional and creative methods in our present and future workplace.

The other struggle is finding the right candidate for the job. Ensuring organizational fit is a key factor when evaluating applications. In addition to the interview, companies pre-screen applicants, clearly define job requirements and company culture, explain mission and values, and set up panel interviews.

Retaining good employees is an additional and very important area of focus for companies. In this regard, companies are increasing pay to ensure pay levels are competitive and establishing attractive benefits to retain good talent.

What’s the greatest misconception people have about retirement communities?

Many folks have reservations and uncertainties about how living in an older adult community could impact life as they know it. There is no doubt that moving from your home into an older adult community will be a change, and misconceptions can abound.

A primary misconception is that one will lose his or her independence. In fact, moving into an older adult community affords residents more independence. One is able to select the level of care that enhances the independence they desire. Living in a private apartment, for example, has all the comforts of home as well as the option to transition seamlessly from independent living into an assisted living program if, at any time, more care is required. The 24-hour staff on site offers complete peace of mind, even if you don’t need them.

Another misconception is that older adult living communities are only for people who are sick and dying. This couldn’t be further from the truth. Older adult living communities are very much for the independent and active person. It’s far more convenient to stay active in an older adult living community than when living on your own, isolated in your own castle!

A third misconception is that care at home is very affordable. Many people believe that growing old in your current home will add little or no additional costs to what you’ve always been paying, but you will eventually need help taking of the house and yourself. While you may be able to rely on family to a degree, do you really want to add this responsibility to your family? When you start adding everything up, an older adult living community is sometimes a cost savings in the long run.

People also think that moving into an older adult community means you won’t see your family as often. But older adult communities not only encourage loved ones to visit, they allow you to spend quality time with your family without the worry that you’re burdening them with household chores.

“A common misconception is that older adult living communities are only for people who are sick and dying. This couldn’t be further from the truth.”

What advice do you have for those whose loved ones are entering old age or who are concerned about their own future as it relates to aging?

Consider these questions before deciding to age in place. Would you rather be alone most of the time or do you want easily available access to companions and social activities? Aging in place can be a solitary experience, and a retirement community is able to minimize such solitude.

If you and your family decide that aging in place is the best choice, will you still have reasonable access to senior organizations, volunteer opportunities or other social activities outside your home? Isolation can be a serious health risk for seniors.

Is your home aging-friendly? Bathroom renovations, zero-step entries, improved lighting, widened doorways and other modifications can be costly.

About 70 percent of us will need long-term care at some point in our lives. Does your budget support around-the-clock home care if it becomes necessary?

When you’re no longer comfortable or confident in the driver’s seat, what will you do about transportation? Lack of easy access to transportation can result in escalating problems, including isolation and missed medical appointments. How will you get around after you need to hang up the keys? Most older adult living communities offer some type of transportation service.

Would you rather not worry about home maintenance and repairs? The prospect of a lifestyle with diminished homeownership responsibilities motivates many to make the move to an older adult living community.

Is help nearby if you need it? Are your adult children and other loved ones living nearby, where they can help with hiring, screening and scheduling caregivers for you in your home? An older adult living community manages the care you receive in the community, from amenities in an independent living arrangement to services throughout the continuum of care.

Do family and friends worry about your safety? Older adult living communities offer around-the-clock security staffed by people who’ll know you by name and watch out for you.

Do you ever worry about becoming a burden to your family? The move to an older adult living community takes care of that. In fact, residents often say their move is a gift to their adult children, who can thereafter be confident that Mom and Dad are safe and happy, with a sound plan for the what-ifs in life.

What options are available for those who would prefer to age in place?

For the older adult’s most preferred stay-at-home alternative, consider a newer concept taking root in the world of senior living. Members of a Life Plan Community Without Walls receive guaranteed lifetime care and access to a long-term care bed at 15 Craigside or Arcadia if or when this care is needed. They also have access to a menu of services that includes care coordination, home maintenance, fitness training, housekeeping, an emergency response system and personal care.

As part of their benefits, members enjoy priority access to 15 Craigside and Arcadia. They may participate in group activities like exercise classes, games, educational programs and other activities that are normally exclusive to residents. Members can also take advantage of the amenities at 15 Craigside and Arcadia, including the dining rooms, gyms, pools and event venues. Whether members choose to visit the communities regularly or just occasionally, there’s always an opportunity to develop friendships with residents and employees. The member services manager becomes a welcome connection to an enhanced quality of life for older adult living.

Devote quality time to discussing your options for older adult living with your spouse, kids and friends. There’s a new world of excitement, quality living and special satisfaction in the golden years. Don’t pass it up!

Mark Wasielewski

President

Diagnostic Laboratory Services
Cheryl Takitani-Smith

Chief Financial Officer

Hawaii Dental Service
Emmet White

President & CEO

Arcadia Family of Companies

Cheryl Takitani-Smith

Sep 12, 2018

How has the industry evolved since you started your career and how have you navigated those changes?

Searching for a phone booth to confirm directions for an out-of-office meeting, listening to cassette tapes of recorded meetings on a Walkman and sharing computers across multiple employees was the standard in 1990. That’s how we did business 30 years ago, right here in the same office. Today, analytics and the availability of mass information offer quicker and better decision-making, increased efficiency, improved understanding of patient and provider needs and cost-reduction opportunities. Advancements in technology have created new solutions like teledentistry, which has enabled oral health practitioners to expand their reach in the community, reducing barriers to care for those in more rural areas.

Being able to quickly adapt to these changing times and embrace new solutions has allowed our leadership team to position the company for the future. Imagining where the next generation of healthcare leaders will take us in the next several decades and beyond is truly exciting.

What are some of the challenges and opportunities that lie ahead for the dental industry?

Ensuring everyone in Hawai‘i has access to dental benefits and care continues to be one of the biggest challenges to improving Hawai‘i’s oral health. People skip visiting the dentist for a variety of reasons: fear, cost, time, lack of dental coverage and even because they don’t realize how important dental care is. A Hawai‘i Department of Health study, supported by our HDS Foundation, confirmed children in Hawai‘i have the highest prevalence of tooth decay in the nation, so being able to address the reasons why people don’t visit the dentist—even when they have insurance—remains a challenge.

The advancement of technology continues to change dentistry for the better as well as improve the customer experience. For instance, the rise in 3D resin printing is redefining custom dental solutions for patients, and not just when creating orthodontic appliances, such as braces and clear mouth aligner trays, but also for day-to-day general dentistry needs. Since this technology is available to the public, taking a do-it-yourself approach to adjusting the alignment of your teeth without the guidance of a professional has unfortunately been gaining popularity—sometimes producing unexpected and dangerous results. This is why elevating the value of receiving proper dental care is an opportunity to shift behavior towards safer and more effective methods of oral health management.

Despite new technologies and procedures, consumers will continue to look for higher quality services and a better integration of their dental and medical care.

“Some of the biggest moments in my career were the result of high-risk decisions that paid off with large rewards.”

What does it take to be an effective leader?

Communication. If you can’t communicate your vision, strategies and goals to your team, it’s almost impossible for them to understand your expectations and carry out your vision. Effective leadership means that you can communicate, facilitate and inspire your team to efficiently reach goals together. Leaders should be willing to share their ideas, mentor others and help everyone in the team grow and achieve their fullest potential. Allow individuals to be creative and take certain risks by experimenting. Listen, be open to new ideas and have an insatiable appetite to learn and grow.

What strengths do you bring to the table in your capacity as CFO, and how are they similar or different from prior leadership?

HDS was on the brink of closure when I joined almost 30 years ago. The leadership team and I had to make quick, difficult decisions to ensure the survival of the company—and that was just my first couple months on the job! Over the years, I’ve had to balance the organization’s need to be frugal and maintain affordable dental plans while inspiring our teams to do whatever it takes to grow the company into a thriving organization for the community. My curiosity and passion for solving problems have consistently led me down interesting paths. Now, as CFO, strategizing, brainstorming and forecasting have become crucial in my ability to find creative and effective solutions for the company.

What’s the most valuable lesson you’ve learned over the course of your career? The most difficult lesson?

The most valuable lesson I’ve learned throughout my career is to recognize, appreciate, support and reward the team. No matter what the project is, it’s important to recognize that we’re stronger together than we are individually. Cultivating my team to be flexible and willing to pitch in with whatever is necessary has enabled us to reach goals that we never thought were possible.

Another lesson I’ve learned is that being flexible and hiring skilled staff with strengths that balance my own weaknesses is crucial to developing an efficient, balanced and successful team.

We are like a family. We disagree like a family, we support each other like a family and we all know that we wouldn’t be able to accomplish what we have without each other.

Last but not least, although success will come with hard work and dedication, you must also find the ability to balance your career with taking time for yourself and your health. Block time out on your calendar to do something you love, and don’t check your emails or answer your phone while you’re doing it! Make memories with the ones you love and don’t talk about work at the dinner table. Simply put, find happiness and joy in something besides work. Even if you have to schedule it into your Outlook calendar, ensure that you make time to have fun, laugh and shed the stresses of the day.

What advice do you have for up-and-comers in the community? What can people do to get ahead?

Dream big, be willing to take risks and, above all, put your heart into everything. Don’t play it safe. Often, fear and pride cause people to make safe decisions, which can stunt growth. There are points in my tenure when we made some difficult decisions. Of course not every decision resulted in success, but learning from these failures ensured my future decisions were more informed, allowing me to pick myself up and move forward with even more passion. When I think about some of the biggest moments in my career, they were often the result of measured, high-risk decisions that paid off with large rewards. Be passionate about the work that you do—the recognition and rewards will soon follow.

Mark Wasielewski

President

Diagnostic Laboratory Services
Cheryl Takitani-Smith

Chief Financial Officer

Hawaii Dental Service
Emmet White

President & CEO

Arcadia Family of Companies

Mark Wasielewski

Sep 12, 2018

How has information technology changed the healthcare industry in Hawai‘i?

The industry has been moving from paper to electronic medical records as well as electronically connecting different healthcare entities. The transition to paperless has been a long, grueling process throughout the industry because it required changing many workflows throughout operations. The process was most difficult in direct patient care areas, such as physician offices and patient care areas in hospitals, since procedural changes in these areas may directly affect patient outcomes.

I feel Hawai‘i is close to on par with the rest of the country and the world with the integration of healthcare technology and is ready to move into the next generation of electronic health records (EHR). Integrated EHR allows us to share data with different healthcare entities, improving patient care and reducing waste such as redundant laboratory testing. DLS, for example, allows physicians and hospitals to access our computer system to research patient laboratory results that may have been ordered by another physician, helping patients save money and giving physicians a more complete picture to better care for their patients.

How else is DLS utilizing the electronic health record?

The goal of the healthcare industry is to keep patients healthy, and for DLS, it is a key strategic initiative to do whatever we can to help our communities reach this goal. As an example, DLS currently uses data to address patient population issues such as diabetes. We work with insurance companies to identify target areas in which a community or population may not be managing diabetes well, and together we develop strategies that can be implemented to help these patients.

“The best path to success is for the silos to come down between insurance companies, hospitals, doctors, and patients, and for all of us to work together with the aligned incentive of managing our patients in an effective manner.”

How involved is DLS in prevention-based initiatives?

DLS currently works with insurance companies to encourage patients to have their past-due screening tests performed. We work with physicians and reach out to patients by sending them laboratory orders on the physicians’ behalf. This can be effective, but many of these orders are not completed.

We’ve had better success through manual processes, such as personally calling patients and mailing out the orders. Ultimately this is a money-losing process for DLS, but we know preventive medicine is key to improving the health of our patients.

What have been the biggest turning points in healthcare over the course of your career?

The laboratory industry’s move from paper to electronic was the first. This was a cultural change, just like it has been throughout other areas of healthcare. The learning curve for the computerized systems slowed down operations significantly, and the original systems had numerous flaws. Systems have come a long way since then, but there’s still room for improvement.

More recently, the move towards automation has revolutionized the laboratory industry. There is a national shortage of testing personnel, and the industry needed to find a solution. Labs throughout the world moved manual processes to more automated machinery, which has resulted in fewer errors and more efficient processes. DLS takes every opportunity to automate due to the continuous decline of licensed personnel.

What’s your take on consolidation within the industry and the move toward an outcome-based payment model?

Healthcare throughout the country has two common issues: lack of money to sustain our current patient care models and the need for improvement in patient outcomes. Outcome-based payments are a theoretical way to force the industry to work together and change. There have been successes and failures throughout the nation as we continue to learn best practices. I feel we need to learn what we can from these successes and failures and continue to implement strategies that work. The best path to success is for the silos to come down between insurance companies, hospitals, doctors and patients, and for all of us to work together with the aligned incentive of managing our patients in an effective manner. I personally see this beginning to happen in the communities we serve, and DLS is doing our part to support the efforts in any way needed.

Mark Wasielewski

President

Diagnostic Laboratory Services
Cheryl Takitani-Smith

Chief Financial Officer

Hawaii Dental Service
Emmet White

President & CEO

Arcadia Family of Companies

What prompted the switch from law to humanitarian aid?

What’s something people may not know about the American Red Cross?

You’ve been CEO of the Hawai‘i region for 16 years. How has Hawai‘i’s disaster preparedness needs changed during that time?

Hawai‘i has weathered several natural disasters over the last couple of years. What strengths or weaknesses were revealed and how do you plan to use that knowledge going forward?

You deployed to New Orleans after Hurricane Katrina. How often are you on the front lines?

You’ve been with HDS since 1985. How has the organization evolved over the last 30 years?

What’s the most valuable lesson or piece of advice you’ve drawn upon over the course of your career?

What’s new at HDS Foundation?

What are some of the biggest ways technology is changing dentistry?

What’s your favorite part of the job and why?

What advice would you give someone looking to get ahead in your industry?

You spent 35 years with a competing health system on the mainland. What made you join Kaiser Permanente Hawai‘i?

Kaiser was ahead of its time in terms of its integrated model of care. Can you give an example of how Kaiser’s infrastructure inherently incentivizes value-based healthcare delivery?

What are some of your biggest goals or undertakings as president of the Hawai‘i region?

What are some lessons that Kaiser Permanente Hawai‘i has learned or is implementing from other locations in Kaiser’s nationwide network?

You’ve been in this industry your entire career. What would you have done if a career in health services administration were off the table?

You have a wealth of prior health plan experience, including working with rural and indigenous populations. What insight are you bringing to this role from low-income populations on the mainland?

What have been the biggest turning points in healthcare over the course of your career?

Tell us about Waiwai Ola. How common is this type of community investment program among health insurers and what kind of feedback or results have you seen?

Health insurers across the board have been looking at prevention as a way to control costs. What does that look like for AlohaCare?

What are your thoughts on the direction and evolution of the Affordable Care Act?

Between pervasive healthcare reform, an aging baby boomer population and the wave of new technology sweeping the landscape, we’re at a pivotal moment in the business of improving the health of our communities. Read on for a glimpse into the world of healthcare in Hawai‘i.

What first inspired you to start blogging about your life as a physician, wife, mother and entrepreneur?

You’re also an influencer with nearly 30,000 Instagram followers and counting. How has this medium impacted your business?

How much of your time and focus is devoted to producing content and engaging with your followers?

Tell us about AHSM. How did the idea come about and what role did you play in its launch?

What other projects do you have in the pipeline?

“Social media has deepened my connection with my patients and added another layer to our relationship.”

What’s the best piece of advice you’ve ever received or a lesson you learned the hard way?

Your husband and business partner is originally from Hawai‘i, which explains the decision to move here and start a private practice. What were some of the adjustments you faced in terms of your medical practice or professional life?

What’s something your followers don’t know about you?

What’s your favorite part of your job?

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