ALEXANDRIA, VaOf all major American industries, health care appears to be among the least prepared for the complex, interrelated problems known as Y2K. As computers programmed with two-digit year dates move toward the year 2000, many will close down or function improperly because they will erroneously interpret dates beginning with zero as falling in the first year of the 20th, rather than the 21st, century.
This has a potential to result in patient care failures, said Joel M. Ackerman, a former computer programmer who is executive director of the Rx2000 Solutions Institute, Edina, Minn. Mr. Ackerman described the Institute as an independent, nonprofit, member-supported organization dedicated exclusively to assisting the health care community in addressing and resolving the Year 2000 crisis.
Speaking at the Association of Community Cancer Centers annual meeting, Mr. Ackerman warned that many health care payers will be unable to make timely payments as their computers fall victim to Y2K problems. Theres a lot of stuff that just wont work right. There are problems designed into the things that we count on, he said.
Despite the widespread view that problems wont begin until January 1, 2000, Mr. Ackerman pointed out that only about 8% of the failures will occur in the 4 weeks surrounding New Years Day. Fifteen percent will happen in the last months of 1999; some have already begun to occur in various organizations. In one case Mr. Ackerman cited, a providers infusion pumps failed, and 24 hours passed before they could be returned to service.
Potential Legal Problems of Y2K
Because this unprecedented problem makes everyone Y2K virgins, Joel Ackerman said at the ACCC meeting, due diligence and best practices will be defined in retrospect by angry judges and juries.
Many hospitals and other health care providers will be sued, but no legal definitions of appropriate behavior are available now, which will complicate the task of defending oneself later, he said. In the tangle of lawsuits that will follow any care failure, providers will want to shift cost by suing, in turn, suppliers or equipment vendors whose services or equipment failed or failed to arrive.
In terms of the amount of litigation it will generate, Y2K will be asbestos cigarettes, Mr. Ackerman joked, adding that, for the nation at large, legal costs will outnumber the repair costs of fixing computers.
Another 55% of Y2K problems will crop up at various times during the year 2000 itself, and 15% in later years. Less time, therefore, remains to prepare than many people think, he warned, and organizations that are not sure their systems are Y2K compliant need to be working on contingency plans now.
Check With Suppliers
Making sure that an organizations own computers and equipment are fixed does not guarantee that it will avoid problems. If your suppliers are not ready, you are not ready, Mr. Ackerman said. Linen services, food services, pharmaceutical and equipment suppliers, home health care agencies, and many other enterprises can affect health care providers ability to maintain their standards of patient care. Mr. Ackerman advised checking with all major suppliers and vendors to see what they are doing to prepare.
Many providers appear deceptively ready, he continued. In a March 1999 survey of 763 providers, 93% of hospitals reported having a written plan, compared with only 63% of home health care agencies. While 82% of hospitals reported having contingency plans in case of failures, only 2% of skilled nursing agencies reported having such plans.
Lots of people have a plan but no money to execute it, he added. Reprogramming and testing computers and checking all the many pieces of equipment that contain computer chips cost a great deal of money and add an unexpected strain to already stretched budgets. At most, one budget cycle remains until the problem hits in earnest, he warned.
Patients are beginning to express concern as media coverage of the threat intensifies. News organizations will be looking for failures in health care and have already begun investigating the preparations that hospitals and others are making. Many patients will seek to stockpile critical medications, and some will either speed up or delay needed care, in order to avoid the perceived period of maximum vulnerability to failures of all kinds. Hospitals, nursing homes, and other providers may try to shift vulnerable patients to other, supposedly better prepared, institutions.
A Domino Effect?
Even if a providers own preparations are thorough, it is still possible that widespread failures in the community can seriously affect its ability to function.
If public utilities fail, for example, schools will close, making it difficult for staff members with children to come to work. Some hospitals are already planning to have extra staff on site on New Years Eve and, in case of need, to provide emergency lodging for staff members children and even their pets, so that staff members can stay at work and the hospital can continue functioning.
If you are not really scared . . . you dont understand the problem, Mr. Ackerman said. Most health care professionals do not understand the breadth and depth of the threat, he insisted. There are relatively few sources of accurate, unbiased information for the health care field, he said, adding that his organizations website (www.rx2000.org) provides information and links.
No Silver Bullet, No Magic Fix
There is no silver bullet or magic fix to solve an institutions Y2K problems, Mr. Ackerman said. Neither Bill Gates nor the government will offer solutions or protection. Do not expect any other organization to rescue you, he warned. But, he continued, there is still some time to take action to minimize problems and avoid failures; he urged his listeners not to waste it and to make intelligent choices.