Most health facilities' info systems predicted to fail in the next 2 years
September 1, 1998 6 minutes read
Most health facilities' info systems predicted to fail in the next 2 years
Year 2000 problem may affect SDS items, from PCs to infusion pumps
(Editor's note: This is the first of a two-part series on ensuring your equipment and information system are year 2000 compliant. In this issue, we cover four critical areas you shouldn't miss and give you a list of upcoming seminars. Next month, we'll give you tips from one health care provider on what to ask vendors, as well as other key information. We'll tell you about a nonprofit organization created to help the health care industry prepare for - and avert - year 2000 computer problems. You can't afford not to know about this group. We'll also provide a list of World Wide Web sites with critical information.)
If you haven't started, you're already behind. Those ominous words from health care information specialists serve as a warning to same-day surgery managers about the year 2000 (Y2K) compliance problem. Many information systems and much medical equipment won't be able to handle the date change from 1999, or "99" in computer language, to 2000, or "00," because many computers confuse 00 with the year 1900.
Most medical devices and equipment are embedded with microprocessors or chips that use date-sensitive logic. Microchips that cannot recognize dates in the 21st century may be difficult or impossible to access, and the code written on the chips may be difficult or impossible to rewrite. In some cases, a chip may be upgraded, but in most cases, replacing equipment is the only alternative.
"You may think you have equipment that has nothing to do with computer technology, but there's indeed imbedded chips within equipment that could be affected by year 2000 problems," says Philip Strauss, director of surgical services at Martha Jefferson Hospital in Charlottesville, VA. Infusion pumps are one example, he says.
The potential impact could be disastrous, particularly where patient care is concerned. In same-day surgery, date errors in computers can result in patient age or treatment miscalculations, pharmaceutical errors, miscategorized inventory, billing or reimbursement mishaps, regulatory violations, and ultimately, patient injury.
"In our business, there is no room for that," says Mike Cronan, director of facilities management at Palms West Hospital in Loxahatchee, FL. "A nurse using a piece of my equipment has to be confident it's going to work 100% of the time and give accurate reading and data."
GartnerGroup, an information technology firm based in Stamford, CT, reports health care organizations are behind in preparing for Y2K problems. In fact, it reports that 87% of health care organizations are in danger of system failures within the next two years. "Prioritize your work," Strauss suggests. "You have 14 months left to go."
Ellen Mauldin, manager of implementation, information services, and technology at Egleston-Scottish Rite Health Care System in Atlanta, urges immediate action. "Get in there and do it. It's not too late to get started, but no one should be dragging their feet right now." (For information on Y2K seminars, see p.116.)
Consider these suggestions:
o Inventory your equipment and determine whether it is year 2000 complaint.
"What we go on is if it has a battery, power card, or it's hard wired, you inventory it and check it," Cronan says.
Egleston-Scottish Rite is systematically testing every computer, system, and device for compliance with the date change in a process estimated to cost between $4 million and $5 million. Roughly 70% of the Y2K project involves testing systems and devices for compliance.
As staff in the biomedical engineering department are performing routine preventive maintenance, they test each piece of equipment to determine whether it is compliant. Each piece of equipment is labeled to indicate that it was tested, the dates it was tested, and whether it's compliant. In addition, the health system is contacting every vendor and supplier to obtain as much information about year 2000 compliance as possible.
ECRI, a nonprofit health research agency based in Plymouth Meeting, PA, suggests you perform a risk assessment on the devices in your inventory to prioritize devices that have a critical impact on patient care. ECRI charges about $25,000 to review a hospital's medical devices, provide risk assessment and compliance information, and act as a resource.
Monitoring devices are one example of high priority equipment in same-day surgery areas, says Tony Montagnolo, vice president for technology planning. "Those are critical, and those are devices that have bumped into compliance issues in reviews that we've done," he says. Anesthesia machines also should be a high priority, he adds.
At Martha Jefferson Hospital, one of the first items checked was implantable equipment, such as pacemakers, Strauss says. The hospital also listed the equipment and information systems inventory by manufacturer to simplify the process of finding out whether equipment and devices are compliant.
If the equipment or device isn't Y2K complaint, find out why it isn't, Montagnolo advises. "Ask what alternatives are available to correct potential problems." If you have older equipment, you may be out of luck, he warns. "For devices that are going to be considered obsolete by the manufacturer, there will not be any software or upgrade available for that particular device. It will have to be replaced."
Testing equipment may not be the final step, however, Mauldin suggests. "If anything is done to that equipment once the sticker is put on, then you have to test it again to make sure those changes didn't affect year 2000 compliancy."
Include your computer systems when checking equipment, Strauss emphasizes. "[Preventing] networks from failing and having the ability to get information through your facility is very important," he explains. "Most hospitals are highly dependent on electronic information and networks."
Some facilities, such as Martha Jefferson, are outsourcing the compliance testing to consultants. However, some consultants are booked up already and aren't taking any more clients who need year 2000 assistance. World Wide Web sites can be helpful in determining whether your equipment is compliant.
o Don't buy any new equipment that isn't Y2K compliant.
"We don't release a purchase order anymore without the purchase order stating that equipment being purchased is year 2000 compliant. It's no guarantee, but it's one step in the right direction," Strauss says. Martha Jefferson began this policy eight months ago for any new technology.
At Palms West Hospital, each purchase order includes language that requires vendors to make the equipment Y2K compliant, Cronan says.
Some smaller vendors may try to dump equipment on the market that's not compliant, Cronan warns. "We've included the language on there to cover it," he says.
o Consider adjusting your schedule at the beginning of the century.
At Egleston-Scottish Rite, the Y2K steering committee has suggested that - as a safeguard - the New Year's Day holiday in the year 2000 be extended an additional three to five days. During that time, no surgeries would be scheduled. "We want to make sure no one is in the OR, and a piece of equipment doesn't work that we expected to work," Mauldin says.
The holiday schedule also would give the health system time to ensure no problems exist with important items such as security systems and elevators, she says. "If there is a problem, we want to address it immediately, so we don't have to worry about patients."
At the recent Same-Day Surgery Conference in Palm Beach, FL, some surgery center administrators said they plan to put 24 hours shifts in place over New Year's Eve 1999 to ensure staff are available to address any problems that arise.
"Vendors can say, 'We're year 2000 compliant,' but you won't know until you flip to that date," Strauss says.
o Stockpile supplies.
"One area that's very hard to get a handle on is which suppliers are going to be ready," Mauldin warns. "We need to make sure we can get supplies that we need, not just for the OR but all departments - the OR being a critical one."
If your suppliers' computers crash, and their shipping and distribution break down, how will you get the supplies you need? Egleston-Scottish Rite has decided to stockpile some supplies. "But the question is, how long?" Mauldin says. "A few weeks? Months? We're still trying to work through that issue." Think about it now because others are, she warns. "If everyone decides to stockpile, there could be a shortage."
Take Montagnolo's advice: There's no way to avoid the Y2K problem. "The sky is not falling, but it is an issue that requires high level of attention right now and a fair amount of logistical work," he says.
Conan adds, "We're health care. We've got to be running."
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