Health-Care Providers Brace For Millennium Bug
20:12:48, 26 May 1998
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By Jon Van, Chicago Tribune Knight Ridder/Tribune Business News May 26--On Jan. 1, 2000, a computer glitch called the Millennium Bug kills thousands of people when heart pacemakers, defibrillators and myriad other high-tech medical devices malfunction because they can't read the date.
It's a scary thought, but one that belongs in a Hollywood B movie. Medical experts say it's just not going to happen. For one thing, essential medical devices like pacemakers don't care what time it is: They're designed to function according to cardiac cycles, not calendar dates.
But if it's unlikely that people will die when the millennial odometer turns over, that doesn't mean there won't be foulups to seriously hamper many doctors and hospitals.
Indeed, many health-care providers that have neglected to plan for the Millennium Bug could find themselves faced with chaos in a year and a half, when computer chips unable to read dates in the year 2000 seize up.
"Most medical devices will work just fine," said Anthony Montagnolo, vice president for technology planning for ECRI, a non-profit private agency that evaluates medical devices for health-care providers. "But they may have documentation problems by stamping the wrong date on the patient's medical records."
Because of potential threats to patient care and the certainty of legal liability for any snafus, ECRI has advised hospitals to check every item of equipment on the premises for Millennium Bug problems and to communicate with vendors about having items fixed or replaced.
Hospitals that started looking for bugs a year or more ago are generally in good shape, although technicians say the best they can do is to assure that whatever surprises the year 2000 brings will be relatively minor.
But many hospitals are just now beginning to attack the problem -- which some techies call "Y2K," for "Year 2000" -- and those hospitals probably will come up short, said Judith R. Faulkner, president of Epic Systems Corp., a health-care software firm based in Madison, Wis.
There just aren't enough trained people in the country to accommodate all the businesses and government agencies now trying to find and fix all their potential Y2K problems, Faulkner said, so anyone who doesn't already have a good start on the project is likely to fail. This will lead to some interesting personnel moves in the coming months, she predicts.
"A lot of programmers will be assigned to write programs to fix up Y2K problems," Faulkner said. "Sometime in mid-1999 or so, they will realize that there is no way they'll get finished in time for the new year. As they see failure looming, an organization down the street from where they're working will be desperate to hire more programmers and will be offering premium salaries.
"It's natural to expect that people will move to new employers where they have a chance of being a hero and leaving jobs that they know are doomed to fail. We'll see lots of churn."
Most computer problems likely to plague health-care providers will center on billing and patient scheduling, rather than on direct clinical care issues, predicts Dr. Ian Cummings, head of the Association of Emergency Physicians.
"Hospitals tend to be shielded from serious clinical problems because they're in a technological Stone Age," Cummings said. "Even though physicians use some of the highest technology available, they mostly write out records and orders by hand. Very few places have computerized patient records."
Hospitals at the forefront of computerizing their operations also tend to be the ones who got a head start on addressing the Millennium Bug problem.
An example is MacNeal Health Network based in Berwyn, where the Y2K task force is nearly done with its work. MacNeal has computer connections to some 30 scattered clinics and physician offices, and it relies on information technology to make its just-in-time delivery of supplies work.
MacNeal's heavy reliance on computers makes it more vulnerable to Millennium Bug problems, but also gives the hospital a leg up on diagnosing and fixing problems before they surface.
Getting a head start was very important, said Daniel Howard, MacNeal's manager of information services applications development, because there aren't enough people to solve everyone's Millennium Bug problems. The hospital didn't want to be looking for new software in 1998 or 1999 because its technical people knew that hundreds of other hospitals would also be scrambling around for new systems.
Instead, MacNeal opted to become a test site for new code that a vendor is preparing to handle just-in-time purchasing, accounts payable and other business functions.
"Other hospitals will get this after we've tested it," Howard said. "They'll get it the end of 1998 or sometime in 1999."
By that time, the new system will be old stuff at MacNeal, and during the test period its older systems, riddled with Y2K bugs, will continue to carry the load, making what Howard hopes will be a graceful transition.
Oddly, the biggest problem MacNeal's information systems people encountered in their Y2K odyssey was getting others to take the problem seriously early on.
"It was amazing to me that many vendors weren't concerned," said information applications manager Jean Ostrander. "We had vendors tell us they were going to get to it next year. But most have woken up by now. I guess their lawyers have been active, describing their liability."
Howard estimates that 80 percent of MacNeal's information technology resources are now devoted to the Y2K problem. The hospital has hired an outside consultant to go over its systems, looking for problems the internal staff may have missed or holes in the fixes put in place.
"We're really not concerned that any computer problems will threaten patient care," Howard said. "Even if some software doesn't recognize the year 2000, our nurses and doctors are the ones who actually provide care, and their brains aren't going to stop on New Year's Day. But if our business systems break down, that could have big implications for the institution, and that's why we take this seriously."
One thing about Jan. 1, 2000, that works to a hospital's advantage is that it's a holiday and very few patients schedule elective surgery at that time, so the patient load probably will be very light when computer glitches show up.
"Hospitals typically get by with light staffing and light patient loads over the holidays," Ostrander said. "But all of our information services people will be on the job over the holidays, ready to do whatever we need to do. We'll do our celebrating the week after New Year's."
Part of the staff's job in this endeavor is to reassure patients, and putting bright stickers on equipment that has been tested and found Y2K compliant is part of that effort. Equipment that cannot be made compliant to win a sticker is being replaced.
To Dr. Alan Spacone, MacNeal's emergency medicine information service consultant, it is most irksome to find equipment that cannot read a four-digit year designation and cannot be fixed.
Several defibrillators fall into this category. These devices administer electrical shocks to patients whose hearts aren't pumping to restart regular pumping action.
"I'm surprised at how many defibrillators aren't Y2K compliant and how many manufacturers no longer support them," Spacone said. "We have 11 defibrillators that are perfectly good. They maintain their charge and deliver it as calibrated, but they time stamp the wrong date."
Introducing inaccurate dates into patient records could produce bad medical consequences, said Spacone, and he had little choice but to replace the devices to the tune of $6,000 apiece because the vendors wouldn't supply new software to fix them.
Perhaps the biggest headache for MacNeal's Millennium Bug catchers is the realization of how much is beyond their control.
Tom Bogan, director of network systems, for example, said he is frustrated because MacNeal's information network is completely dependent on Ameritech Corp., and he's been unable to get documentation that Ameritech's systems are Y2K compliant.
An Ameritech spokesman said the Chicago-based telecommunications carrier is taking care of its Y2K problems with business customers one quarter at a time this year so that by 1999, all issues with all customers should be settled.
David Printz, MacNeal's chief information officer, said his hospital considers its investment in information technology a competitive advantage and that Y2K represents a major challenge to its financial health.
"You may continue to provide excellent care to your patients," Printz said, "but if you can't bill for services and don't meet your payroll, you're going to have a lot of ticked off people.
"It's our job to see that doesn't happen." ----- Visit the Chicago Tribune on America Online (keyword: TRIBUNE) or the Internet Tribune on the World Wide Web at chicago.tribune.com
----- (c) 1998, Chicago Tribune. Distributed by Knight Ridder/Tribune Business News.
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