Health IT, at least on the Big Island, starts with fresh vegetables and gardening

by Mary Mosquera, Government Health IT

The first step for gaining patient buy-in for the use of health IT may start with fresh vegetables and gardening, a gateway to start thinking about and owning your health.

That's what the Hawaii Island Beacon Community did after brainstorming about how to gain the interest and engagement of individuals for electronic health records (EHRs) and health information exchange. The beacon started with non-tech community activities about wellness, healthy eating, exercise and gardening.

It’s a way to build trust, according to Jessica Yamamoto, Hawaii beacon’s community engagement manager.

[Infographic: The healthcare quality revolution on Hawaii.]

The Hawaii beacon is one of 17 model communities around the nation using health IT to improve individual patient outcomes, bolster population health and, in the process of both, lower costs.

It is focused on improving care for individuals on the Big Island with diabetes and other chronic conditions to avoid hospital re-admissions and help patients better understand and get involved in their care.

The beacon has funded 19 Healthy Eating, Active Living (HEAL) projects proposed by individuals and groups in a number of communities on the Big Island.

“We looked in the beginning at how do we insert ourselves in the community and not come up with the projects but allow communities to look at their own resources,” she recently told Government Health IT at beacon offices in Hilo, Hawaii.

The beacon put out a request for proposals that was open to businesses, non-profits and individuals to come up with wellness projects in their communities, such as gardening, roller derbies and tobacco cessation activities geared for families and individuals from children to grandparents.

Project leaders received health literacy training so they could help educate those participating in the activities.

[Site visit: Hawaii beacon infuses HIT, care coordination with strong sense of aloha.]

HEAL had another goal. “If we need to come in and talk about health information exchange, then they will listen to us. We have earned that trust by developing that relationship with the community,” Yamamoto said.

“Or communities can explain about the Hawaii beacon in ways that others listen,” she said.

The projects provide a path for individuals to start participating in their health and gain education and skills. “They’re having fun and being introduced to vegetables,” she said. The projects serve approximately 1,500 but indirectly touch as many as 15,000 people because other organizations in the communities are invited to events.

“We attend all their community events to make sure that they know that we support them. It’s interesting to see what a small amount of money can do to impact a community,” Yamamoto said.

Like other rural areas, many Big Island residents do not have nearby grocery stores but are often served by convenience stores, where most foods are processed and lack fresh produce, or fast-food restaurants.

One of the projects is a community-based garden, and in another, local farmers teach in the homes of Native Hawaiian families about how to build raised gardens. Another does screening for families from the Marshall Islands, a population on the Big Island that has shown to be at risk for diabetes and other conditions.

[Podcast: Listen to Senior Editor Mary Mosquera discuss visiting Hawaii's Beacon.]

“You’re promoting healthy eating and helping to sustain your family. And even within our projects we see collaboration,” Yamamoto said.

The HEAL contracts wrap up in early 2013. The $300,000 for the projects came from the beacon’s $16 million three-year grant from the Office of the National Coordinator for Health IT.

Hawaii beacon has also created a free online Health & Wellness Directory for people to find and promote healthy living resources and activities across the island.