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YOKOTA AIR BASE, Japan – Tripler Army Medical Center in Hawaii is preparing to become the state’s next low-level trauma center, with plans to soon open its emergency room doors to non-military patients.

The first major step comes Jan. 25 when the hospital will begin officially accepting low-level trauma patients from the military community and documenting the cases as part of the state’s designation process for trauma centers, said Lt. Col. Kurt D. Edwards, an Army lieutenant colonel and trauma surgeon at the hospital.

Tripler, on the main island of Oahu, already accepts some walk-in trauma patients from the military community, just not in a “systematic way,” he said.

Up to now, low-level trauma patients – including military personnel and family members – who called for ambulance service were sent to Queen’s Medical Center, a high-level trauma center, even though they feasibly could be treated at Tripler, he said.

The hospital must hire two more surgeons and establish new administrative processes required of a state-certified trauma center before it can be officially designated as a Level 3 facility, according to state health officials. The process could take between three and six months.

Tripler’s ability to accept civilian trauma patients will help alleviate some of the pressure on Queen’s, the only other trauma center on Oahu. Queen’s is a Level II trauma facility, meaning it has more resources and doctors at its disposal to deal with traumatic injuries.

As part of the state’s trauma network, Tripler will receive $350,000 annually to help run the expanded emergency room services.

The move to accept civilian trauma patients in military hospitals is not without precedent: Other Army hospitals around the country, including Madigan Army Medical Center in Tacoma, Wash., and Brooke Army Medical Center in San Antonio, Texas, have already been established as regional trauma centers and accept civilian patients.

Among the biggest concerns with Army hospitals becoming trauma centers that are open to the general public is losing money to uninsured patients, Edwards said.

But a transfer agreement with Hawaii will allow Tripler to move such patients to other public hospitals after they are in stable condition. Couple that with the state’s highly insured population, and the risk is lower than in most other states, he said.

“That’s the big plus,” Edwards said. “It’s not lucrative, but it’s sound.”

The move will help Tripler better serve victims of trauma, the most outsourced cases among the active-duty population, Edwards said.

Hawaii for years has been trying to convince Tripler and other hospitals on Oahu to join the state’s trauma network. The biggest concern with having only one trauma center on Oahu – where three-fourths of the state’s population live – is dealing with a mass casualty event, said Dr. Linda Rosen, from the Hawaii State Department of Health.

“The military just has tremendous assets in terms of experience and talent when it comes to trauma,” Rosen said. “Their participation in our system will keep the bar high.”

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