Healthier systems. Stronger communities. Designed together.

Hiraya Strategies partners with health centers, health systems, and community organizations in Hawaiʻi to strengthen the systems behind care and promote community health.

Hiraya community pattern: a sun rising over a community of people and waves

What we do

No two organizations need the same thing, so we shape our work around yours. Some partners need an interim leader for six months. Others need a training series, a redesigned workflow, or simply the right room for a hard conversation.

Fractional and Interim Leadership

Steady, accountable leadership when you need it most.

Health Center and Practice Transformation

Better care, built into the rhythm of the clinic's day.

Prevention, Chronic Disease, and Food is Medicine

Bridging primary care and community to support whole-person health.

Strategy, Sustainability, and Systems Navigation

Clear direction, and a way to keep going.

Facilitation, Convening, and Learning

Bringing people together, and helping them learn as they go.

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How we work

Co-design is at the heart of how we work.

Every engagement starts with listening, so the solutions fit your people, your community, and your reality. Cristina and trusted collaborators bring the right mix of experience to each project. When we step back, your team is ready to carry the work forward.

Our approach

Why we started

Hiraya Strategies grew out of need, and a desire to stay in the work.

Why we started

About Hiraya Strategies

Hiraya Strategies is a purpose-driven business. We choose our work and our partners by asking one question: will this help build a healthier future for Hawaiʻi and the communities we serve?

Founded by Registered Nurse and health system leader Cristina Vocalan, Hiraya Strategies brings more than 25 years of experience, from the clinic to the policy table.

More about Hiraya

The meaning

ᜑᜒᜇᜌ

Hiraya is an old Tagalog word for imagination: the vision you carry before it becomes visible.

Healthier communities start that way, as something people imagine for their keiki, their kūpuna, and the generations to come. Our work is helping that vision take shape.

The story behind the name

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What we do

Whatever moves your mission forward.

Our experience spans clinical care, public health programming and translation, community and network engagement, training and technical assistance, clinical quality improvement, learning collaboratives, and health systems and policy change. That range means we can meet you wherever you are.

Below are the kinds of work we do most often, but they are starting points, not limits.

01

Fractional and Interim Leadership

Steady, accountable leadership when you need it most.

Vacancies, transitions, and growth spurts are hard on any organization. We step in to keep the work moving, support your team, and set up whoever comes next to succeed.

  • Interim leadership roles. Stepping in at the executive or director level during vacancies or big changes, from CEO and Chief Strategy Officer to program and department director, keeping daily operations aligned with your mission and your community commitments.
  • Organizational stabilization. Keeping operations on track during transitions, so team morale, grant requirements, workforce culture, and patient care don't slip.
  • Board insight on care and community. Helping boards understand clinical quality, health equity, and the needs of the communities they serve, including community needs assessments, so their decisions reflect the people they're accountable to.
  • Leadership mentoring. Mentoring clinical supervisors, practice managers, and emerging leaders, the people who will guide your organization next.

02

Health Center and Practice Transformation

Better care, built into the rhythm of the clinic's day.

Good care depends on workflows that make sense to the people doing the work. We help care teams improve quality without adding to their load.

  • Practice facilitation and workflow redesign. Working side by side with care teams to redesign workflows, improve UDS and HEDIS quality measures, and cut unnecessary documentation.
  • Proven improvement methods. Drawing on the IHI Model for Improvement, lessons from HRSA's Health Disparities Collaboratives, and Dartmouth Clinical Microsystems training to help teams test changes, learn quickly, and spread what works, paired with staff listening sessions so changes reduce burden instead of adding to it.
  • Team roles that work together. Optimizing the roles of care managers, care coordinators, community health workers, and health coaches alongside primary care providers, so every member of the team works to their full strengths.
  • Population health management. Using data and dashboards to track quality, find patients who need outreach, and guide improvement over time.
  • Value-based care readiness. Preparing safety-net providers for alternative payment models and Med-QUEST quality benchmarks, so resources follow patient health and equity rather than visit volume.
  • Recognition programs. Hands-on guidance for NCQA Patient-Centered Medical Home (PCMH) recognition and Age-Friendly Health Systems.
  • Getting the most from technology. Making sure EHR tools, care plans, and reports help care teams instead of slowing them down, and choosing new tools that fit your team and budget.

03

Prevention, Chronic Disease, and Food is Medicine

Bridging primary care and community to support whole-person health.

Health is shaped by far more than what happens in the exam room. We help organizations connect care to the food, resources, and relationships that keep people well.

  • Chronic disease programs, from design to daily practice. Implementing the Medicare Diabetes Prevention Program (MDPP), hypertension control, and chronic disease management programs, including redesigning care team roles and workflows so programs fit how clinics actually run.
  • Food is medicine programs. Designing and launching produce prescriptions, clinic-to-farm partnerships, and medically tailored nutrition programs, with financing that can last.
  • Social needs screening and referrals. Choosing and implementing SDOH screening tools in the EHR, with closed-loop referrals and warm handoffs that respect patient dignity.
  • Culturally grounded prevention. Adapting evidence-based programs, like diabetes prevention and cancer screening, to fit the cultures and languages of the communities they serve.
  • Community health workers and health coaches. Designing, training, and sustaining CHW, patient navigator, and health coaching programs that bridge clinic and home.
  • Health education that connects. Materials written in plain language, for the communities they're meant to reach.

04

Strategy, Sustainability, and Systems Navigation

Clear direction, and a way to keep going.

Good programs struggle when the grant ends or policy shifts. We help you plan for the long run, so the work lasts.

  • Strategic planning and theory of change. Practical three- to five-year plans tied to your real capacity and your community.
  • Human-centered program design. Using design thinking to build new programs and services with the people who will use them, from first idea to pilot.
  • Sustainability and financing. Building programs that outlast the grant by aligning them with insurance and payment, coverage and benefit options, and value-based arrangements.
  • Policy navigation. Translating HRSA requirements, state Medicaid policy, and federal opportunities into practical strategy.
  • Start-ups and network approaches. Launching new programs, organizations, and subsidiaries, and designing shared or network models so organizations can do together what's hard to do alone.
  • Evaluation and learning. Building logic models and evaluation plans from the start, then using data analytics and qualitative analysis, from dashboards to interviews and focus groups, to show what's working, why, and what to adjust.

05

Facilitation, Convening, and Learning

Bringing people together, and helping them learn as they go.

  • Coalition facilitation. A trusted, neutral facilitator who brings providers, agencies, payers, and community organizations together around shared goals.
  • Listening sessions and community engagement. Town halls, listening sessions, and stakeholder input that shape real decisions.
  • Training and learning collaboratives. Training series, health coaching training, and peer learning networks for every member of the health care team.
  • Convenings and events. Designing conferences, summits, and retreats around what you want them to accomplish, with careful thought about how to engage your audience so people leave connected and ready to act.

Who we work with

Rooted in Hawaiʻi and open to work beyond it.

  • Health centers
  • Health systems and providers
  • Provider networks
  • Health plans
  • Public agencies
  • Community organizations
  • Funders and coalitions

The values that guide our work

Don't see it here?

If it helps your organization serve its community better, chances are we've done it, or we know someone who has. Tell us what you're working on.

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Values & how we work

What guides us, and how we work.

The people living with a challenge usually understand it best. Consultants often arrive with answers, leave a report, and move on. We work differently. We co-design every engagement with the people who will live with the results: staff, leaders, patients, and community members.

Our values

Everything we do comes back to one hope: helping you, and the communities you serve, flourish.

Leading with empathy.

We start with the person in front of us. Understanding what people carry, and what they need, comes before any plan.

Kapwa.

Kapwa is the Filipino value of shared identity: the self that is found in others. It's why relationships sit at the center of our work. We build trust over time, show up beyond the scope of a contract, and see the people we work with, and the communities they serve, as part of us. Our wellbeing is tied together, and so is our responsibility to each other.

Everyone has a role to play.

Every person brings something to the table, shaped by their background and experience, from front desk staff to executives, from community members to policymakers. Our job is to recognize those gifts and make room for them. That humility is what makes kapwa real.

Curiosity, grounded in evidence.

We ask questions before we offer answers, and we never stop learning. We hold ourselves to an honest, rigorous process grounded in data, evidence, and science, and we bring creativity and a sense of play, because the best solutions often come from trying something new. Hiraya means imagination, after all. Evidence keeps it real.

From the roots up.

The people closest to a challenge should help shape the solution, and systems should work for everyone, especially the communities that have been left out. We believe change grows the way roots do: through relationships, often quietly, one connection at a time. So we begin with what's already working, build on it, and help the networks around us grow stronger, from families and clinics to communities and policy.

These values guide how Hiraya Strategies works and who we work with. They began with Cristina, rooted in her Filipino heritage, and have been shaped by her years alongside communities in Hawaiʻi, including the Hawaiian values of pilina (relationship and connection) and kuleana (responsibility, and the privilege that comes with it), which we strive to honor. Every collaborator who joins us shares them.

Our approach

  1. Listen first.We start by understanding your people, your history, and what you're really trying to achieve.
  2. Design together.Solutions are built with your team, not handed down.
  3. Start where you are.We meet your reality, including your budget, capacity, and timeline, rather than an ideal on paper.
  4. Do the work with you.We roll up our sleeves, from facilitating the meeting to testing the new workflow.
  5. Leave you stronger.The skills, tools, and relationships stay with your team long after the project ends.

The right tools for the job

We draw on proven frameworks and tools from primary care, public health, quality improvement, and evaluation, and we use them where they help, not for their own sake. The right approach depends on your work, your team, and your community.

The right support for each project

Every engagement has one point of contact and one accountable partner: Hiraya Strategies. Cristina leads many projects herself. On others, trusted independent collaborators lead or support the work, with Cristina staying involved to make sure it reflects how we work.

Meet our collaborators

How engagements are structured

We offer project-based work, ongoing retainers, and fractional or interim roles. We'll recommend the structure that fits your needs and resources, and we're upfront about cost from the first conversation.

What success looks like

We measure success two ways.

First, the numbers: did the measures move, and are funding and reporting requirements met? Second, the people: do care teams feel less friction in their day, and do patients and communities feel the difference? Lasting change needs both.

Have something in mind, or just a hunch? Let's connect.

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About

About Hiraya Strategies

Hiraya Strategies brings more than 25 years of experience across clinical care, public health, and health system leadership to the organizations working to keep Hawaiʻi healthy.

Why we started

Hiraya Strategies grew out of need, and a desire to stay in the work.

Organizations and communities are still facing the same problems we faced decades ago: access, justice, and fair distribution of resources for the communities that need them most. We're here to work alongside them.

Hiraya started when people Cristina had worked alongside for years began asking, "What's next? How can we keep working together?" It's part of our commitment to Hawaiʻi and beyond: to cut through complexity and strengthen the relationships and systems that keep people and organizations well.

Hiraya Strategies is a purpose-driven business. We choose our work and our partners by asking one question: will this help build a healthier future for Hawaiʻi and the communities we serve?

Our valuesThe story behind the name

The people behind Hiraya

Cristina Leah Vocalan

Cristina Leah Vocalan, RN

Founder and Principal | Health Systems and Community Health Leader

Core focus: Fractional and Interim Leadership · Health Center and Practice Transformation · Prevention, Chronic Disease, and Food is Medicine · Strategy and Sustainability · Facilitation and Convening

Background: Cristina brings a career spanning clinical nursing, public health, and community health leadership. She began her nursing career caring for families in urban settings, then provided clinical leadership of statewide chronic disease programs at the Hawaiʻi State Department of Health, including diabetes and breast and cervical cancer programs. At the Hawaiʻi Primary Care Association, where she spent more than 15 years, she started as a clinical technical assistance specialist and grew through several roles, eventually serving as Director of Health Systems Improvement and later Chief Strategy Officer, and as Interim CEO of Hana Kīhāpai. A systems thinker, she's energized by sticky challenges and by making change hold. She holds a BS in Nursing from Johns Hopkins University, a BA in Anthropology and International Studies from UNC Chapel Hill, and completed graduate studies in public health at George Washington University.

Roots: Cristina grew up an only child in rural North Carolina, in a family of health care professionals and in a community where hers was one of two Filipino families. She moved to Hawaiʻi nearly 25 years ago and grew up professionally here, alongside the people and organizations she now serves. That early experience of looking for belonging still shapes how she builds community in her work, and Hawaiʻi is home. She lives in Central Oʻahu with her husband, is mom to two adult children, and spends her free time traveling and in her garden. Her recent experience as a caregiver has fueled her drive for systems change.

Off the clock: Currently growing ʻulu · Favorite trip: Peru · Go-to snack: anything I can get my hands on

Connect with Cristina on LinkedIn

What Cristina brings

  • Deep knowledge of Hawaiʻi's health and public health systems
  • Bridge-building
  • Clinically grounded systems thinking
  • Steady leadership through change
  • Building from the ground up
  • Culturally grounded community work

Collaborators

Trusted partners, when the work calls for them.

Some engagements are led by Cristina alone. Others call for more hands or different expertise, and that's where our collaborators come in: independent consultants whose skills complement hers and whose values align with Hiraya's. In some situations, they lead projects, with Cristina's guidance or involvement.

Jermy-Leigh Domingo

Jermy-Leigh Domingo, DrPH, MPH

Collaborating Partner | Public Health and Community Practice Leader

Core focus: Program Incubation and Implementation · Food is Medicine and Chronic Disease Prevention · Social Needs (SDOH) Screening · Health Coaching and Patient Navigation Training · Data Analytics and Qualitative Analysis

Background: Jermy specializes in taking new public health initiatives from idea to everyday practice. Trained in community-based and translational research, she turns clinical evidence and community priorities into practical programs, curricula, and tools that care teams can use. For nearly 20 years, she has worked across Hawaiʻi's community health centers, hospital systems, and nonprofit organizations, leading initiatives in chronic disease prevention, nutrition security, and care for older adults. She holds a Doctor of Public Health (DrPH) and Master of Public Health (MPH) from the University of Hawaiʻi at Mānoa.

Roots: Raised in ʻEwa Beach, Jermy has spent her life helping family members navigate complex clinical and social service systems, an experience reinforced through her role as a parent to an autistic son. This lived perspective anchors her commitment to designing accessible, coordinated health systems that support families without unnecessary barriers.

Off the clock: Currently finding my peace and enjoying moments with my kiddo · Favorite trip: Visiting with family in the Bay Area, always a good time · Go-to snack: Furikake popcorn

Connect with Jermy on LinkedIn

Collaborators are independent consultants with their own practices. They partner with Hiraya Strategies by subcontract on select projects.

What we bring together

Lived experience inside the system.We've worked in clinics, run community programs, led organizations, sat at policy tables, and faced conflict leading community meetings.
Many skills, one team.Clinical quality, prevention, workforce, policy, events, and technology come together on one project, so you don't have to coordinate several firms.
Innovation grounded in reality.We bring new models, from value-based care to patient-centered medical homes, behavioral health integration, and food is medicine, and make them our own to fit island communities and real budgets.

Interested in collaborating?

Are you an independent consultant who shares these values? We'd love to connect.

Connect on LinkedIn

Have something in mind, or just a hunch? Let's connect.

Contact us

What’s Hiraya?

The meaning of Hiraya

ᜑᜒᜇᜌ

Hiraya (also spelled haraya) is an old Tagalog word for imagination: the mind's eye, the vision you carry before it becomes visible.

Over time, it has also come to mean hope and aspiration, the fruit of one's dreams.

Hiraya Strategies logo: a sun mark above the name

The mark

The Hiraya mark represents a sun. It is inspired by the Batok sun symbol, a motif found in indigenous Filipino tattoo traditions that represents new journeys, growth, and the beginning of new possibilities. It carries the same hope as the name: optimism and forward movement.

The patterns

The patterns throughout the site draw on the same Batok tradition and on breeze blocks, the patterned screens found in homes across Hawaiʻi.

Breeze blocks mean home: sturdy, yet open to air and light.

Together, these shapes reflect the founder's ties to the Philippines and Hawaiʻi, and reflect our commitment to community and equity. One pattern shows the sun rising over a community of people and waves, because this work is always shared.

Have something in mind, or just a hunch? Let's connect.

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Contact

Let's talk.

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Other ways to reach us

Email: hello@hirayastrategies.com

Phone: 808.330.1528

LinkedIn: Cristina Vocalan

Based on Oʻahu.

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Last updated: November 2026