A dreadful lack of urgency, transparency and up-to-date technology plague the system that provides oversight of physicians in Hawaii. And the state must take meaningful steps to bring the system into the 21st century and better protect patients.

As Star-Advertiser reporters Rob Perez and Dana Williams detailed in a three-part series that began Sunday, the state is slow to act in cases in which physicians lost their credentials in other states for misconduct.

The findings showed those physicians were able to keep their licenses — for years in some cases — until the Hawaii Medical Board took action, its hands tied by sluggish investigation by the state Regulatory Industries Complaints Office (RICO).

What’s worse, the state’s website largely keeps consumers in the dark about the out-of-state discipline and other key information on physicians.

To better protect the public, the state should:

» Take swift action to suspend licenses of doctors who lose privileges in another state.

The Department of Commerce and Consumer Affairs (DCCA) is working with the Hawaii Medical Board on proposed legislation to expedite the disciplinary process when the board has evidence of a doctor being sanctioned in another state. A 2013 law that allows the board to summarily suspend a physician’s license to deter a public-safety threat does not specify out-of-state discipline as a trigger.

» Overhaul its website to allow consumers easy access to information on physician backgrounds.

To give consumers a more complete picture, the DCCA should include all past disciplinary matters rather than delete them five years after corrective action is taken. Criminal convictions also should be added.

» Consider including more public members on the medical board, which currently has only two nonphysicians on its 11-seat board; and give the board the ability to consider expunged convictions in considering licenses.

» Join the Interstate Medical Licensure Compact, which allows for expedited licensing for doctors who want to practice in multiple states, including via telemedicine, and offers a quicker discipline process when a doctor is sanctioned in another compact state.

In their analysis, the reporters found that more than half of reciprocal discipline cases weren’t resolved for at least two years after the doctor was sanctioned in another state. In some cases, the process dragged on for at least five years.

Hawaii’s 2013 law — or an improved version of it — should be robustly used by the medical board to automatically suspend the sanctioned doctor. It seems duplicative that RICO conducts its own lengthy investigation in such cases. Full vetting by another state’s medical board should be reason enough to take action locally, in the interest of public safety.

Among the more egregious cases was that of Dr. Robert Ricketson. Less than a year after his Texas license was revoked, Ricketson in 2001 implanted the sawed-off shaft of a screwdriver into the back of an elderly Big Island patient. The patient fell at least once after the surgery, shattering the shaft into his spine, and within a week Ricketson performed a second operation to implant the correct titanium rods. The man died two years later and a jury later awarded $5 million to his family.

It wasn’t until 2007 that Ricketson’s Hawaii license was revoked. The case underscores why immediate action is needed once another state revokes or suspends a physician’s license.

Contributing to the slow case-handling is an overtaxed RICO, the enforcement branch that handles complaints against any of the 143,062 licensees — from barbers to dentists, including the state’s 9,763 licensed physicians. Lawmakers should consider creating a dedicated enforcement staff for medical complaint cases to expedite the oversight process.

Enforcement officers are further constrained by 30-year-old technology. Consumers also are shortchanged by the DCCA website’s porous physician profiles, which lack more than two-thirds of the nearly 20 information categories recommended by the Federation of State Medical Boards. Among the missing info — a doctor’s malpractice payment history, hospital sanctions or criminal convictions.

Lawmakers and the DCCA say they hope to streamline oversight practices and upgrade technology — all sorely needed.

But improvements will be of marginal value if more information on physicians isn’t made available to the public. Without it, Hawaii patients cannot make fully informed decisions about their care.

An agency charged with protecting consumers needs to do better.