Healthcare is a high-stakes, high-cost service that’s in need of urgent attention. While Hawaii is a leader in key areas of healthcare—including having the second-lowest percentage of uninsured residents in the nation—unsustainable cost increases and uneven quality of care issues are among the problems the state must address to ensure a healthy population and a system that functions optimally for consumers, providers, insurers, employers and others affiliated with the healthcare system.

Gaps in Hawaii’s healthcare system include:

• Insufficient preventive and primary care
• Lack of reliance on evidence-based medicine
• Limited use of electronic health records, use of patient registries, and information sharing
• Lack of transparency about quality and costs
• Insufficient attention to the concerns of patients, including making their health records available to them, inviting active participation in healthcare decisions, and providing access to after-hours clinical advice and care

Hawaii is experiencing a chronic shortage of primary care physicians, especially in rural and inner-city areas. The State is marked by health disparities associated with poverty, increasing rates of obesity and chronic diseases, and inadequate access to mental health and dental services for those most in need. At the same time, more than 13 percent of Hawaii’s economy goes to healthcare costs. The State purchases healthcare for nearly 40 percent of all residents and commits 25 percent of the state budget to health expenditures.

These gaps and costs have created an imperative for public and private entities to unite to address these issues and create solutions that will change the system. With the Supreme Court’s recent upholding of the Affordable Care Act, Hawaii has new tools and support to continue its effort to transform healthcare.