Case Study

Hilo Medical Center (Access Passport)

As the Big Island’s leading provider of nationally recognized 4-star care, Hilo Medical Center (HMC) delivers a full range of services and programs. Their 20-acre campus consists of 276 beds located throughout the 137-bed acute hospital, 20-bed behavioral health unit and a 119-bed long-term care facility.

They have 1,200 employees and a medical staff comprised of 250 physicians, physician assistants and advanced practice registered nurses, representing 33 specialties. As a medical center, HMC has a network of nine outpatient clinics offering primary and specialty care. The hospital is a Level III Trauma Center, which includes the second busiest emergency room in the state that provides 24-hour care to nearly 48,000 patients annually.

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Enhancing Procedural Consent Processing

For the past several years, Hilo Medical Center has used Access’s solutions to capture electronic patient signatures on registration packets. This has served Hilo well, but as the hospital got ready to upgrade its HIS to MEDITECH’s 6.15 EHR, administrators wanted to find a web-based e-forms platform that would extend the benefits of paperless forms and process automation throughout the facility. They chose Access Passport. “Now that we’ve seen the flexibility of the system, we can go after other efficiencies.”

Procedural consents are the first clinical forms that Hilo decided to apply Access Passport to. Previously, a nurse retrieved a consent form and hand wrote in two explanations of the patient’s upcoming procedure—one in clinical language and another in layman’s terms. The patient then signed their name. The physician was also supposed to sign the form simultaneously, but in practice, this was difficult to ensure. When this second signature was obtained, the form was sent to the offsite HIM office for scanning into the patient’s record.

Now, the goal is for the nurse to use Access Passport to complete the procedure descriptions. In the designed workflow, the nurse will then present the e-form to the patient and the surgeon who both apply their electronic signatures. The form is then sent automatically into the patient’s chart in MEDITECH.
Kris Wilson, director of information systems and project management office at Hilo, explained the benefits of Access Passport in transforming the process.

“Access Passport removes the paper chase we used to have with procedural consents and makes it easier for us to obtain patient and physician signatures simultaneously at the bedside, which helps with compliance,” said Wilson. “As the form goes straight into MEDITECH, the information is available immediately instead of us waiting for the form to go to the offsite HIM office for scanning. Instead of having hundreds of variations of paper forms, we just have one electronic one that we can customize as needed.”

Boosting Back Office Workflow

In addition to using Access Passport to enhance procedural consent capture and processing, Hilo has converted its new hire/employee action form into an electronic version. Previously, an HR staff member filled in a hard copy and signed it. The document then went to department and senior managers for review via interoffice mail, before being sent on to the HR director, CFO and CEO for further approval. It was then sent back to the offsite HR office in another envelope for processing.

With Access Passport, the originator completes 25 fillable fields and applies their electronic signature. The e-form is electronically routed to the department and senior managers. Once they’ve affixed their e-signatures, Access Passport automatically routes the document to the HR director, CFO and CEO concurrently. Once they’ve electronically signed it, the e-form is routed back to HR for final processing.

“Now that we’re using Access Passport, employee action forms don’t get stuck on people’s desks and avoid traveling around in archaic, unreliable manila envelopes,” Wilson said. “The HR team can see exactly where they are in the process, and it’s easier for department managers and executives to pull up the e-form in Passport and apply their electronic signature. We’ve cut turnaround time from over three weeks to as fast as one or two days.”

Partnering with Access and Integrating with MEDITECH

As Hilo has expanded the scope of its e-forms and e-signatures project, it has worked hand-in-hand with Access to create what Wilson calls “incredibly robust forms and workflows.” She believes that this relationship is helping the hospital advance its goal of becoming fully paperless.

“From the start of our e-forms project, through implementation and to post-deployment support, the entire Access team has been very helpful and responsive,” Wilson said. “When I email them, I always get a quick reply—and you don’t always see that from vendors. We need more collaborative partnerships, and that’s exactly what we’ve found with Access.”
Another important part of the project is the integration between Access and MEDITECH’s respective systems. As the hospital updated its EHR to the latest version, it was vital that e-forms continued to flow into patient records without interruption, and this proved to be the case.

“The integration between Access and MEDITECH solutions continues to be solid,” Wilson said. “It’s helpful that the two companies work so closely together.”

Hilo is planning to extend Access Passport to other clinical workflows and administrative processes, including travel request and leave of absence forms.

The sky is the limit with Access Passport,” Wilson said. “We can apply it to any process in the hospital that requires multiple inputs and signatures to make that workflow faster and more efficient. Now that so many people have seen how easy it makes processing the employee action form, they want to use Access Passport for everything.”

Wilson believes that every hospital could benefit from Access Passport, both in clinical and back office areas.

“With Access Passport, it’s easy to design forms and you can customize them to get exactly what you want,” she said. “The user experience is straightforward and administrative departments like HR don’t need to buy 40 signature pads to use it. In fact, they don’t need any additional hardware at all.”


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"Now that we’re using Access Passport, employee action forms don’t get stuck on people’s desks and avoid traveling around in archaic, unreliable manila envelopes. We’ve cut turnaround time from over three weeks to as fast as one or two days."


Quick Facts

Location: Hilo, Hawaii 

Integration: MEDITECH 6.x EHR

Focus: Paperless eForms and clinical device and system integration

Departments: Admissions, clinical floors, HR, back office

Access solutions: Intelligent E-Forms, Electronic Signatures, Process Automation, Enterprise Integration, Access Passport


Procedural consents are completed at the bedside with Access Passport on mobile devices

Patient and clinician signatures are captured simultaneously to help meet compliance standards

Paperless employee action eForm cuts turnaround time from three weeks to one or two days

Close relationship with MEDITECH ensured smooth eForms transition when upgrading EHR