Gov. Lou Leon Guerrero has called the 38th Guam Legislature into special session to direct nearly $20 million in excess Section 30 funds to the Guam Memorial Hospital Authority and the University of Guam's Fadian Hatchery.
The proposed legislation directs $15,885,394 to the Guam Memorial Hospital Authority in response to a letter from Interim Hospital Administrator and CEO Dr. Joleen Aguon on Sept. 14, which requested emergency funding for a new modern electronic health record and revenue cycle management system.
In the letter to the governor, Aguon said the hospital is in "immediate operational and financial crisis" due to "obsolete hardware, sunset software and broken interoperability."
"GMHA's primary clinical and financial engines, specifically, our Admission, Discharge, and Transfer (ADT) and Revenue Cycle Management (RCM) systems are operating under severe technical conditions that create catastrophic institutional risks," Aguon said.
According to Aguon the RCM and ADT databases are a critical high risk, because they run on "end-of-life" physical server hardware at the hospital.
"There is no vendor hardware maintenance, no replacement parts availability, and zero on-island technical support. A single server motherboard or disk array failure would instantly halt hospital admissions, billing operations and patient record access with no path to immediate recovery," Aguon said.
Meanwhile, software for the RCM and ADT workflows is no longer supported by vendors and receive no security patches or billing compliance updates, creating another critical high risk for the hospital.
"Operating on sunset software exposes GMHA to severe cybersecurity vulnerabilities, HIPAA regulatory compliance violations and unfixable system crashes," Aguon said.
Aguon said GMHA relies on "fragmented, standalone systems across emergency, inpatient, laboratory, radiology, pharmacy and billing departments."
Without the interoperability, she said, clinical staff must manually re-enter patient data across the isolated databases.
"This fragmentation creates severe clinical blind spots, leads to massive billing drop-offs and claim denials and paralyzes external interoperability with key partner institutions including the Guam Behavioral Health and Wellness Center, Department of Public Health and Social Services, local primary care clinics and off-island referral facilities," Aguon said.
Aguon emphasized the need for action, telling the governor that the existing software contract expires in 2028.
She said delaying action would guarantee a future "severe institutional crisis."
"Securing Guam's hospital digital infrastructure is an urgent matter of public safety, risk mitigation and fiscal responsibility," Aguon said.
The Office of the Governor acknowledged the technology upgrade has been needed for a long time and said it "will give healthcare professionals real-time access to patient records, improve the coordination of care and maximize billing and revenue cycle management to strengthen GMHA's financial operations."
The governor also proposes directing $4 million to the University of Guam to support the development of the Blue Economy Innovation Center at the Fadian Hatchery.
The governor's office said the funds would go toward rehabilitating and modernizing the hatchery to expand sustainable local aquaculture production and research. According to the governor's office the project supports Guam's food security, reduces reliance on food imports and creates local jobs.
"Together, these initiatives address immediate needs while building long-term capacity. A modern EHR system will strengthen the infrastructure necessary to deliver quality healthcare to our people. The Blue Economy Innovation Center will advance food security and create new economic opportunities through greater local production. Both are investments in a more resilient, self-reliant Guam," Leon Guerrero said.
Special session begins at 10 a.m. on Tuesday.