Wealth of Health recently covered a landmark change in how providers will be reimbursed. Beginning in October, the Centers for Medicare and Medicaid Services will link $850 million of payments to a new measure: patient survey results. The column introduced a cutting-edge concept, "Crosspitality," a term coined by Andrea Kates of the Business Genome project to describe the art and science of grafting hospitality practices from one industry onto another. She has shown that providers can markedly improve their patient ratings by adopting the elements of a great customer, client or guest experience from role models in other industries.

The state is already highly successful in bringing traditional Hawaiian core values into the visitor industry in a genuine way. Cultural specialists provide education on relationship to place, caring for the land, the importance of family and sincere respect of others enabling visitors to glimpse the unique beauty of the islands and our indigenous culture.

Several years ago, Global Advisory Services wrote a business plan for the Hawaii Tourism Authority on Health and Wellness Tourism. Ramsay Taum, president of the Hawaii-based Life Enhancement Institute of the Pacific, offered valuable guidance during this effort. Along with Office of Hawaiian Affairs Trustee Peter Apo, Taum’s efforts to advance the work of George Kanahele in collaboration with the Native Hawaiian Hospitality Association are well recognized in Hawaii’s visitor industry. He advocates cultural, place-based approaches to business that honor the customs, practices and protocols of local communities while integrating best practices to enhance community capacity with a view toward sustainability. Taum was able to adapt and implement his work for the recent Asia-Pacific Economic Cooperation meeting when he served on its cultural committee and emphasized the need to provide sense of place and hookipa (hospitality) training for the volunteer’s hosts.

There are existing challenges in our health care system and factors that can damper patient satisfaction. Taum says that those on the front line responsible for providing care often begin to feel that they are not necessarily serving patients, but rather systems where fiscal concerns take priority over the physical health and well-being. In turn, patients feel and sense the impersonal nature of the experience. Business practices necessitate a systems approach that relies heavily on data surveillance and management but it runs the risk of reducing a person’s identity down to numbers, dollars and cents. When identifying patients as customers, we immediately expose them to the expectations of the market. Patient who are sick just want to feel better and get healthy; they want to feel whole again.

Given that "hospital" is the root word in "hospitality," according to Taum, hookipa training should be a natural, especially if it results in a workplace environment that inspires and welcomes the spirit of aloha in an authentic way. Aloha is that overarching value that seeks to leave people whole, something that patients are inherently seeking. Appropriate hookipa training can help to enhance the relationships between patients and their health care providers, among providers and between providers and other stakeholders.

Now is the time to integrate lessons learned by our own hospitality and visitor industry into the way we serve those who receive health care in Hawaii. We have an especially unique opportunity to incorporate place-based and cultural-based approaches that honor customs, practices and values of the patient. Beginning in October, the ability to do so also will affect the bottom line. It is essential that the work be done in a sensitive way and according to protocol. If we can get it right, this initiative will improve not only patient care on the islands, but also serve to protect, preserve and perpetuate the Hawaiian culture.

Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.