Here’s why your Y2K plan probably won’t work
Develop Plan B’ to avoid millennium meltdown
By Stephen Frew
Frew Consulting Group, Ltd.
Rockford, IL
(Editor’s note: The following is excerpted from a Y2K contingency manual for emergency department managers written by attorney and risk management consultant Stephen Frew. For more information, see Frew’s Web site at www.medlaw.com.)
On Jan. 1, 2000, computers worldwide will transition from the year 1999 to the new millennium represented on many computers and programs as "00" using a two-digit year identifier. This "00" will affect computers in several potential ways.
The first is that the computers will simply and effectively roll over to the new millennial date without incident. Based on testing to date, it appears that fewer than 20% of desktop and laptop PCs will make the transition correctly. Figures for mainframe and mini-computers are estimated to be lower than those for PCs for uneventful transition, but reliable figures are not available.
The second mode is complete failure, where the computer locks up and ceases functioning either temporarily or irretrievably. In "mission-critical" applications, this means the computer will cause a shutdown in the vital functions that it regulates, impair the ability of the institution or business to continue operation, or both.
In recreational or secondary (support) functions, this means that inconveniences will occur that should not seriously impact the ability of a hospital or business to perform its main functions.
The third mode of failure is that the computer will continue to operate but unpredictably provide incorrect data. If the erroneous data are in "mission-critical" positions — such as misstating available inventory so supplies are exhausted unexpectedly or where patient test results are improperly reported and misdiagnosis or mistreatment occur — significant damage can be done to institutional or business functions without warning.
In a sense, the incorrect data may be more damaging than a total cessation of function because the computer users believe that the data are reliable. In a shutdown mode failure, they know there is a problem.
The failure modes that I have just described are certainly bad enough, but many people do not realize that even if we do not use laptops or desktop computers, the year 2000 problem can still have very far-ranging effects, due to what are called "imbedded systems."
These systems are tiny microchips that are imbedded in hardware of all types — applications that you and I are totally unaware of in many cases. We don’t think about it, but everything from thermostats, automotive ignition systems, elevator controls, digital watches, and many handheld medical devices — all the way up to navigational satellites, nuclear reactors, cruise missiles, MRIs, and ATMs — is run using computer chips. Heart pacemakers, monitors, dialysis machines, defibrilators, and other medical devices are packed full of the little chips.
No one knows
Not all of these gizmos and gadgets that we have come to base our whole society on are "date sensitive" — not all of them use dates internally. But the problem is that no one — including the manufacturers, sales companies, government, and users — knows which ones are prone to failure and which ones aren’t. Even when we do identify ones that might fail, no one can accurately predict exactly how they will fail.
No guarantees on corrections
If year 2000 compliance is not systemwide, you cannot be certain that even corrected elements of the system will function correctly — and even if these systems are fully corrected, there are always the 500 billion or so chips imbedded in hardware that cannot be reprogrammed.
It’s too late to fix all of the problems, so we must plan on an unknown level of internal and external failure. And that brings us to why you have to have Plan B developed and implemented prior to Jan. 1, 2000.
We cannot accurately predict the exact level of the failure, the duration of the failure, or the exact impact of the failure on multiple systems in society. For that reason, we have to have a realistic assessment and plan to meet each of the levels of failure that can be anticipated. Whatever level actually occurs, we will be ready to give it our best effort at delivering emergency services to a confused and potentially disrupted community.
Now, you may be tempted to think that you already have an internal and external disaster plan, and that it has been tested per the Joint Commission on Accreditation of Healthcare Organizations’ requirements and has worked OK. Some of you may actually have had to implement your disaster plan in a real emergency.
Those of you who have used a disaster plan probably learned how unrealistic some of them are. Some may have worked well. But none of them — or at least very few of them — are capable of working in anything more than a nominal year 2000 disruption.
Your current disaster plan is not enough. The reason for this is that all of the disaster plans I have reviewed have several fatal flaws:
1. Plans are outdated.
They all are old. They are mostly 1960s-era Cold War nuclear attack plans mixed with snow-storm, tornado, and hurricane elements. They don’t address today’s technology-related issues, and some presume the use of manual systems that do not even exist anymore. God knows we may well wish they did.
2. Hospitals don’t keep inventories anymore.
These plans were written when hospitals kept large inventories of drugs and supplies. Today, drug companies make two deliveries per day in many areas, and daily deliveries in the remainder of instances. "Just-in-time" inventory means that there is never more than three days’ supply of drugs, disposables, and food in any hospital on the average Friday. (Jan. 1, 2000, falls on a Saturday.) This means that the ability to provide care begins to deteriorate immediately if there is any interruption in inventory flow. Keep that in mind.
3. They depend on outside assistance.
They all assume that the disaster is local and that they may rely on neighboring communities, state resources, and federal support in a matter of hours, or in a day or two in the worst of circumstances. That may be an unwarranted assumption in the case of the year 2000 crisis. The Y2K crisis could be widespread and could impair all of your neighboring hospitals, immobilize government support, and truly leave you on your own for days, weeks, months, or, in the worst-case scenario, years.
Your Plan B has to be prepared with contingency plans for circumstances from the least to the most disruption and be predicated on the assumption that everyone is having the same problem you are. You have to strive to operate as self-sufficiently as you can for as long as you can. That means a cautious approach to how you expend your available resources.
If you are prepared at this level, and the new millennium comes in with a whimpering hangover and not a major meltdown — great. If, however, it comes in with serious problems, you are prepared to protect the lives and safety of your community in general and your employees in particular.
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