Q. A lot is happening in the healthcare industry, including shortages of nurses and doctors and rising costs in general. What's your view on the state of healthcare?

A. This is a very exciting time in healthcare. There are major challenges facing us. It's a time when we are pushing the envelope in trying to improve quality and safety at the same time the resources are diminishing, both through the private sector as well as from the government. So it creates new challenges how we're going to make ends meet and continue to improve quality and safety.

Q. How are you approaching these issues?

A. Hawai'i Pacific Health has done a number of initiatives to try to address those issues. We've been working closely with the universities and encouraging them to increase their number of nursing graduates. At the same time, a new graduate needs a home and there are a lot of nurses that are graduating now that can't get a job, even though we need nurses, because we need experienced nurses. So Hawai'i Pacific Health hospitals are working with the universities trying to develop training programs on site so that we can take more new grads and train them ourselves so that we can get them into the pipeline and into the system and have the experienced nurses that we need to provide quality care.

Q. Are there enough entering nursing school to address the concern?

A. We still have a major shortage predicted and we're going to need to really ramp up our efforts, both in producing new faculty members, which is one of the limiting factors, so universities can accept more applicants who are qualified. They don't have enough faculty right now to teach all of those individuals who would like to go into nursing. At the hospital side, we need to develop more training programs to give experience to these new graduates. It's a nationwide problem, and part of it is the fact that faculty members in the universities do not get paid as well, I believe, as those who are actually working on the wards, so we need to provide incentives to create more faculty members so that they can teach more students so that we can produce more nurses to work on the wards.

Q. What's the future of healthcare here?

A. Healthcare is a major part of the state's domestic product. I think it's under-recognized as a major economic driver in the state. There are wonderful opportunities for our youth in Hawai'i for healthcare jobs, all kinds of technical jobs that don't require a college degree. Many of them can be done through a community college education. Many of these slots are not being filled by local youth because they're not going into those fields, just like nursing. We have shortages of medical technologists, ultrasound techs, radiation techs and those kinds of things. We've been also working with high schools. We have an intern program during the summer where we provide scholarships for high school students to spend some time in the hospital system, trying to encourage more of our youth to go into a healthcare career because there is a whole spectrum of opportunities, not just nurses and doctors, but technical positions, too, and service components of healthcare that are not being fully utilized by our youth. I hate seeing our youth going to the Mainland to find a livable wage when, if they fully understood, there are opportunities here in healthcare.

Q. The Hawai'i Pacific Health system includes Kapi'olani Medical Center, Pali Momi, Straub and Wilcox. When was it formed and why?

A. The four hospitals merged a little over six years ago and the reason that we did was healthcare reimbursements and the systems of healthcare were becoming so much more challenging. It's more and more difficult for a single smaller hospital to make it on their own, but by pulling the four hospitals together and having a larger number of beds and being able to pool our services so that we can have one human resources department across the four hospitals, one billing department, those kinds of consolidation, we've been able to take tens of millions of dollars in overhead out of the cost that we wouldn't have been able to remove for just a single hospital by itself.

Q. What are your responsibilities?

A. My major responsibilities are in the areas of policy and strategy. I oversee our five major clinical service lines. Those five areas are cancer care, cardiovascular disease, pediatric care, women's health services and bone and joint. The other areas that I oversee include marketing and communications, government relations, which includes both the local legislative process and administration and Department of Health, and also Congress. I work with our senators and congressmen in Washington, D.C., as well and stay on top of what's happening in the national political scene. I also receive philanthropy, which is becoming much more important. The resources that we have now, the reimbursements, continue to diminish and do not cover the cost of providing quality care any more. They used to, but over the last five, six years, reimbursements have continued to drop relative to the actual cost of providing care, and so we have to be creative about finding new ways to support our mission and continue to provide that quality care. One of the things that we're doing is really increasing our philanthropic efforts, to get those people who want to help invest in our healthcare system over the long term.

Q. How has healthcare changed since you entered the profession?

A. I started as a surgeon in private practice and also was on the faculty at the medical school, so I was teaching, doing research, as well as doing surgery. I actually left the practice of medicine in 1993 because I saw the need to fix the system of healthcare. I was disappointed in how we were able to provide quality services to patients 15 years ago. I'm happy to say that after 15 years in trying to be on the other side I'm finally seeing the light at the end of the tunnel. I've always been a systems thinker and someone who likes to tackle complex problems to try to improve and push the envelope towards what's best. From the time I left practice, I envisioned being able to create better quality and better coordinated care for patients to be more patient-focused.

Q. You also were appointed to a federal 9/11 committee. What was that about?

A. Sen. (Daniel K.) Inouye appointed me to a joint advisory commission of the Federal Communications Commission and the Commerce Committee. We had a group of about 20 people from throughout the nation working on information technology and ways to improve communication between both the public and private sector for times of disaster. Hurricane Katrina was a good example where patient records were lost and patients who were on chemotherapy, nobody knew what they were getting and what their treatment regimen was and it was really devastating to these patients. We're trying to prevent those kinds of catastrophes from happening in the future, the disruptions for whatever reasons, whether it be an epidemic or a terrorist thing or a natural disaster. This group finished its report and we just submitted it to Congress and I'm very excited about it. We're not able to release it to the public until it's been accepted by Congress, but I'm very excited about the work that we put out.

Reach Curtis Lum at culum@honoluluadvertiser.com.