Hospitals fight millennium bug

Health-care officials shoot for stable condition after Y2K

Last summer, The Cassandra Project hosted a Year 2000 Public Awareness and Preparedness Seminar in Boulder as part of a nationwide effort to promote community awareness and preparedness for Y2K.

At that conference, Joel Ackerman, founder and executive director of the Rx2000 Solutions Institute, a nonprofit organization that consults with the health care community on Y2K issues, spoke about the potential effects of Y2K on patient care.

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He gave alarming predictions that the programming glitch that prevents computers from recognizing the year 2000 will cause equipment failures in hospitals resulting in patient deaths, and he declared that the health care industry as a whole was woefully behind in its preparations for Y2K.

Local health-care professionals, however, disagree vehemently with Ackerman’s assessment and insist that the health care community will be as prepared as it possibly can be for the year 2000.

“I expect we’ll have a few glitches, but I don’t expect any problems with our clinical equipment,´ said Paul Hobson-Panico, director of strategy and information management for Western Plains Health Network.

Hobson-Panico heads up the network’s Y2K task force, which has been working for more than two years to solve the millennium dilemma for Western Plains’ member facilities, which include 11 hospitals, among them North Colorado Medical Center in Greeley and McKee Medical Center in Loveland.

The team approached Y2K compliance using a five-step process widely embraced by businesses and municipalities alike. Using the process, they must inventory all computer systems and equipment to determine which are noncompliant; identify mission-critical systems, prioritize systems in order of criticality; replace, repair or remove those systems/devices; and test them. In addition, contingency plans must be made to mitigate disruptions beyond the system’s control.

Hobson-Panico said that his team is well into step five of this process .

“We have a first-quarter 1999 deadline to complete testing of clinical equipment prioritized as having the greatest impact on patient care,” he said. “We’ve been replacing systems since mid 1998 and will continue through mid 1999.

Western Plains has implemented a total of six new computer systems, he said.

The network also has made significant progress in terms of preparing its physical facilities for Y2K “making sure elevators will go up and down, automatic doors will open and close, etc.” and it has contacted vendors, suppliers and equipment manufacturers to confirm that their services and products are Y2K-compliant,” Hobson-Panico said.

“We have a standard letter that will go out to all agencies that provide services we need,” he said. “We’ll send it certified and use the same process with our biomedical equipment providers.”

Poudre Valley Hospital is also well under way in its efforts to fend off the millennium bug.

“We’ve completed our inventory, identified mission-critical items and prioritized them in categories of patient care, facilities, information systems and supplies,´ said Stephanie Doughty, chief financial officer for Poudre Valley Health System and leader of the hospital’s Y2K task force.

The hospital has replaced its primary information system responsible for processing orders for patient care, patient information, billing, payroll accounts receivable ” everything the hospital needs to conduct business. And noncompliant equipment will be upgraded or replaced by the end of the year, Doughty said.

“We’ve had a multidisciplinary team meeting every week since the middle of last year,” she said. “And we’ve just brought on a Y2K coordinator to oversee the effort.”

Lisa Lundgren, formerly with Larimer County’s Department of Health and Environment, has come on board to oversee internal preparations, work with local public agencies to identify and solve potential Y2K problems and help ensure that the system’s suppliers and vendors are able to meet their obligations in the new year.

Neither PVHS nor Western Plains could put an exact price tag on the cost for Y2K compliance because many systems were scheduled to be replaced anyway, and the century’s end only hastened their replacement. But Doughty said that PVHS has earmarked $2.5 million for equipment expenditures and already has spent more than $1 million.

Both systems have received some help in their Y2K preparations. The Colorado Health and Hospital Association holds monthly meetings at which guest speakers address members on such topics as utilities, i.e., Will they work?, and the Medicare and Medicaid systems, i.e., The federal government has its hands full when it comes to preparing those programs for Y2K.

“We have about 35 people attend these meetings, and the group wants to keep them going until next summer,´ said Peg O’Keefe, executive director of CHHA.

“They’re finding it helpful to interface with other organizations, share good ideas and think about contingency plans,” she said.

Like providers, the region’s insurers have also addressed Y2K. According to the company’s Year 2000 Readiness Disclosure Statement, PacifiCare Health Systems has been working on the problem since 1996.

Initially remediation efforts were focused on the company’s core legacy computer system. However, with the purchase of FHP International in February 1997, the scope was expanded to include the former FHP legacy computer system operating in offices in four states.

PacifiCare’s program addresses “all major computing information systems, including core application systems, networks, desktop systems, infrastructure and critical information supply chains,” and the company expects to complete remediation, testing and certification of all systems by December 1999.

Large companies such as PacifiCare have dedicated millions of dollars and thousands of hours to the Y2K problem. Smaller players with fewer resources, however, have, in some cases been more creative in their Year 2000 plans.

United Physicians of Northern Colorado, for example, a Fort Collins-based independent practice association with 160 doctors, will implement an Internet-based information system available through the IPA’s management firm, PhyCor Inc.

The Independent Practice Association Management Solution, a venture launched by Andersen Consulting and NationsBanc Corp., is designed to cut down on practice-administration costs by running information over the Internet rather than through more “archaic” methods such as phone and fax, and the product is Y2K-compliant.

“This system will allow doctors to interact with our office in real time,´ said United Physicians executive director Dr. Don Wells. “PhyCor is shifting from the physician practice management business to providing support services. This very sophisticated system was designed specifically for IPAs, and it won’t cost (United Physicians) anything because we have a contract with PhyCor.”

United Physicians also worked with the independent-hospital consortium HealthCare Colorado as a pilot office for a Y2K-compliant software program for personal computers.

Wells is confident that both the IPA and Associates in Family Medicine, the five-office general medical practice he directs, will be ready for the millennium, but even if there were major problems and the system went down, AFM could still see patients because patient’s records are still on paper, in folders, filed in large bookcases.

Contingency planning is the one piece of the Y2K picture that’s still fuzzy for providers and managed care companies.

PacifiCare says it will have contingency plans in place by June 1999, and both PVHS and Western Plains are working on theirs, but part of Western Plains’ contingency planning will hinge on responses the network receives from vendors and service providers detailing their level of preparedness, Hobson-Panico said.

“Right now we don’t know how long a disruption we will have to prepare for, but those plans should be complete by the beginning of the third quarter,” he said.

A big piece of Western Plains’ preparedness plans involve staff. Network hospitals will significantly increase number of staff on-duty and on-call, in case there is trouble or more of the work has to be done manually.

PVH will do the same. The hospital’s contingency plans are in the “infancy stage,” Doughty said, but the staff will be prepared to deliver care the “old-fashioned way” ” the way it was done before computers.

The hospital has generators capable of churning out power for 33 hours without refueling and, in accordance with an existing disaster plan, PVH will have 15 days’ worth of diesel fuel on hand, Doughty said.

Hobson-Panico and Doughty are both confident that due diligence on the part of both systems will help minimize any legal trouble stemming from Y2K

“Our task force is now getting into the what-ifs,” Hobson-Panico said. “We’re meeting with people and cooperating with local agencies. We feel we’re being completely upfront with the situation.”

“We’ re doing due diligence, but we won’t say that it will be business as usual,” Doughty added. “We’ll keep patients safe but in terms of sophisticated procedures, we may opt not to perform some unless it’s an emergency.”