Nonprofit institute offers Rx for health care’s year 2000 computer woes
Jan. 1, 1999, could pose problems as well
Fast forward: You’re back at work on the first work day of a new century, rested from a day off and raring to go. With the holidays over, there’s lots of work piled up. So you turn on your computer, key in a patient identification number to check the patient record, and the record’s gone. Purged. Deleted.
The computer system, programmed to recognize two-digit dates (which have been used routinely for decades in order to save space), was unable to recognize 00 as a valid date and purged the patient information. Meanwhile, in the patient accounts department down the hall, the same date recognition problem is interpreting 00 as the year 1900 and wreaking havoc on the automated billing system.
This could be common on Jan. 1, 2000 especially among smaller, budget-hungry hospitals, experts say if more isn’t done now to tackle computer system date-recognition issues. Welcome to the dreaded year 2000 problem.
"A very large percentage of these [smaller hospitals] are just starting to think about the year 2000 situation," says Ron Bernier, president and chief operating officer of Compucare, a Reston, VA, health information systems company. "Most of their systems are not year 2000 compliant. You can’t admit patients, you can’t discharge patients, you can’t cut bills, unless the dates are accurate," he adds.
But it doesn’t have to happen that way. Your computer systems don’t have to fall victim to the so-called millennium bug, or more properly (since technically the new millennium doesn’t start until Jan. 1, 2001), the year 2000 problem. There is help out there geared specifically to the health care industry in the form of Rx2000 Solutions Institute, a nonprofit organization created to help the health care industry prepare for and avert year 2000 computer problems.
Based in Minneapolis, Rx2000 targets its efforts at the entire health care community, including hospitals and hospital systems, managed care organizations, integrated delivery systems, provider clinic systems, individual provider clinics, long-term care facilities, pharmaceutical manufacturers, and medical device and diagnostic equipment manufacturers.
Founded early last year by Joel Ackerman, who serves as executive director, and a group of colleagues in the health care industry, the institute’s goal is to educate members of the health care industry about what the potential year 2000 problems are and how they can be solved.
Through focus groups and discussions with colleagues, Ackerman says, the list of potential computer disasters continues to grow as the problem is examined more closely. "On a daily basis, we’re learning more about the problems and what the issues are. At the same time, the clock is ticking. The time to solve it is dwindling," he says.
In fact, problems could occur even sooner than 2000. "We’re expecting a mini-year 2000 problem on Jan. 1, 1999," says Ackerman, a former programmer. That’s because in programming, the number 99 is often used to indicate something special. "If we didn’t know a date but had to put one in, we’d use all nines to indicate forever. In some cases, it would indicate the end of the file." An electronic patient record could "stop processing when it hits the record with nines in the date, so it might drop a lot of records."
Such date-related problems could affect not only medical records, but medical devices such as infusion pumps, heart monitors, and MRIs, Ackerman says, as well as billing and accounting software, which obviously are "date-oriented."
A second institute goal is to serve as a clearinghouse for sharing information. As anyone knows who has browsed on the Internet for year 2000 information, there is a dizzying array of Web sites the federal government has several but very few devoted specifically to health care.
"There is a need to learn more about [the year 2000 problem] as well as communicate with others dealing with the same issues," Ackerman says.
Hospital information systems could face serious glitches, Bernier says. "Because there are so many older legacy systems, hospitals are going to have to really question vendors as to what they will have to do to bring them into compliance.
"There have been so many acquisitions of [computer] companies that companies end up with multiple product lines. There are quite a large number of products that are [no longer being manufactured]. And [hospitals] face a total purchase and installation of a new system."
Rx2000 offers a variety of services to help health care organizations prepare their computer systems for the third millennium, including:
• Supplier reporting service. "The key initial thing is supplier information," says Ackerman. Health care organizations need to know if suppliers of basic services have taken into account the potential problems associated with a century change and have solved or are working on correcting the problem.
"We found that organizations that go to suppliers and ask them what the [year 2000 compliance] status is get little or no response back. When they did get a response, it’s typically something glib like, We’re working on it; don’t worry about it.’" (See a sample year 2000 compliance agreement for vendors, p. 60.)
The institute is working with health care organizations that submit a list of suppliers and products that have sparked their concern. The institute contacts suppliers on the list, acting as a representative of a broad coalition of those suppliers’ customers.
Rx2000 is creating surveys for suppliers to complete. The surveys ask whether the suppliers:
• are aware of the year 2000 problem;
• have educated their staff about it;
• have allocated appropriate resources to addressing the problem. Ackerman says the coalition wants to send this message: "If you want to be a supplier to the industry, you need to answer these questions."
The institute plans to charge an annual participation fee for the service.
• Vendor matching service. Rx2000 will match health care organizations that have specific product or service needs with vendors who say they can fill those needs. Health care organizations need to know, "Who’s out there that can help me? What kinds of consultants are out there? Who can work with our software?" Ackerman says.
Like the supplier service, the vendor matching service will ask vendors to fill out profiles describing their business and any preparations they are making for year 2000 problems. The service is free to health care organizations, but vendors will be charged to participate, Ackerman says.
• Web site. The institute’s Web site offers a wealth of information about the potential problems the health care industry faces when calendars turn to the new century. This includes self-help documents contributed by health care organizations from around the country, such as "The Risk Management Matrix," the "Y2k Project Plan & Checklist," and presentations to convince administrators of the potential seriousness of the problem.
• Listserv. The Web site explains how to subscribe to the Rx2000 Solutions Institute listserv, a daily dialogue among health care professionals. Recent discussions have focused on vendor compliance language and hospital liability if patient care is compromised as a result of computer error.
Hospitals that haven’t tackled the problem yet better hurry, Ackerman says. Programmers are being snapped up at a fast clip, and some consultants aren’t taking on any new year 2000 clients.
When it comes to information systems, "If you make a decision in July 1999 to buy something, there is no way you’ll have it up and running in time," Bernier warns.
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