Is There A Doctor In The House? Yes, Just Use Your Mouse
Bob Hiam of HMSA unveils the nation’s first Website that puts live doctors online to diagnose medical problems and answer questions
By Alice Keesing
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It’s midnight. It’s the weekend. Your baby is spiking a fever. Your doctor’s probably happily asleep in bed. You know what a visit to the ER will be like, and cost. But can you safely wait until the morning?
As of Jan. 15, you can talk with a real, live - awake - doctor without even leaving home. It’s HMSA’s Online Care, and it’s the first system of its kind in the nation.
Think of it as the new kind of house call. For savvy Internet shoppers, the concept is not so strange. You access the online website, connect with a doctor and then pay with your credit card.
The folks at the Hawaii Medical Service Association say the new system is completely out of the box. Company CEO Robert Hiam has seen a lot of changes in his nearly 40 years with HMSA, but this one tops them all.
“I think it’s a real sea change,” he says. “I think it’s an opportunity to really grow medical practice in a different way. I think it’s got endless potential.”
It’s a bold new step for the state’s largest and oldest health insurer.
And while there are those who hail it as a revolutionary new step, the program is drawing its share of critics. The Hawaii Medical Association, which represents the state’s doctors, has yet to take an official position on the program, but individual doctors are speaking out about their concerns about this new physician-patient relationship.
The Hawaii Medical Board, which licenses Hawaii’s doctors, also has its questions, although executive officer Connie Cabral didn’t want to go into details as the board is still in discussions with HMSA about how to resolve those issues.
HMSA says the online service is not meant to replace those face-to-face visits with your physician, but it does see it as a great way for people to get immediate answers to their medical questions, in some cases eliminating the need for costly visits to the ER. It seems to be a natural for the parents of young children (who always get sick outside of regular office hours), but also for the disabled and those who live in rural areas or on the Neighbor Islands where it is becoming increasingly difficult to find even a primary care physician.
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Hiam believes this is just the beginning of a new paradigm in medical care.
The system could ultimately be linked with other technologies to bring high-quality, cutting-edge telemedicine to remote areas. Hawaii could link with specialists on the Mainland, or, indeed, anywhere in the world.
“It’s going to be exciting,” Hiam says.
Amidst the excitement over this launch, Hiam is one of the first to agree that HMSA is an organization that often ranks among those people love to hate. HMSA is in a constant stand-off with doctors (who say their reimbursements are too low), with employers (who say their rates are too high) and with critics (who say its policies are designed to deny care).
Hiam is realistic about the company’s role in the middle of the healthcare sandwich. He laughingly remembers a conversation he had with banker Mike O’Neill.
“He said ‘Banking’s tough, but I wouldn’t want to have your job,’ and then he says, ‘Everybody hates you - I don’t mean you personally, but the business.’”
“And I said, ‘Geez, I don’t think this makes me feel too good,’ ” Hiam says. “But when you think about it, if (both doctors and employers are complaining), then you’re probably in synch and doing the best you can. What if docs said, ‘Oh, we’re doing just great’? Then the employers really think they’re paying you too much. So it’s that kind of balance that, at the end of the day, is trying to do the right thing for our members.”
Given the terse environment and the pressures on the health-care system, HMSA board member Andrew Chang believes Hiam is the best person to have at the head of the nonprofit.
“I’ve been around for awhile and I’ve come across many CEOs in my time,” says Chang, who is assistant vice president of external affairs at Hawaiian Electric Industries. “Bob is exceptional. He’s got extraordinary personal qualities, but he’s also quite the visionary. He’s really the right guy at the right time. You can see those Montana values come through in him.”
Hiam did indeed grow up in Butte, Mont., and it really does-n’t take much imagination to put his 6-foot-plus frame in ranch hat and boots. As a kid, he worked summers on his uncle’s ranch, delivered papers and apprenticed in his dad’s electrical business. While attending Pacific Lutheran University in Tacoma, Wash., Hiam’s roommate left to visit a family member in Hawaii. Hiam decided to go along for the ride. He enrolled at the University of Hawaii, intending to spend a year before returning home.
“It’s just been a long year,” Hiam says with a laugh. After graduating from UH with a psychology degree, Hiam got a job with HMSA.
When he arrived at work that first day, fresh-faced and ready
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