The year 2000 could bring unexpected trouble to unprepared practices

Start the countdown to chaos; or follow these tips

You’ve heard the term before: millennium bug. But you don’t know what it is or how it can affect you. Even if you have read enough to know that it concerns many computers’ and software programs’ inability to deal with digital date codes that include "00," you may have thought the glitch would affect only banks and government agencies like the Internal Revenue Service. But medical practices have to consider the effects of the bug, too, and should make sure that their computer systems are prepared for the problem.

"The predicament for practices won’t be as bad as for banks or even hospitals," says Cheryl Berthelsen, PhD, RRA, associate professor of health information management at the University of Mississippi in Jackson. "It’s one time where the fact that practices have lagged behind in purchasing information technology will help. Hospitals with proprietary software who got into this early are going to be in real trouble."

Berthelsen says there are three areas where you should check for potential problems.

1. Hardware.

Practices with PCs that are more than 10 years old or older minicomputers that have dates programmed into the read only memory (ROM) should test their systems. "This is fairly easy," she explains. "Most PCs will let you set the clock, so set it for 15 minutes before the millennium change."

If, when you turn on your computer again after 15 or 20 minutes, it does not boot up, she says, then you have a problem. "Make sure that you do this after everyone on your network has signed off," Berthelsen adds.

Such a problem can be solved by purchasing new hardware. "It’s an expense, but you have to do it," she says.

2. Operating systems.

Older systems, such as UNIX, old IBM systems, and VAX VMS cause the most concern, Berthelsen says. "Don’t worry about Windows or Macs."

If you have one of the older systems, contact the vendor. "Many of the older operating systems are proprietary," she explains. "DEC, for instance, has a proprietary VMS system. Your vendor would know about this and should be able to provide you with guidance on how to fix the problem or where to go to get it fixed."

3. Software.

Any program you run which does calculations, such as a billing system, has a risk of being unable to deal with the millennium change, Berthelsen says. "If you have a software program with a copyright year prior to 1995 or 1996, you should check it out."

Don’t forget to check your database

Of particular concern are database programs. "Look in your database systems under the index to data fields or the data dictionary." That should show you the format for dates. If it says it uses a Julian date, then the system uses a number to describe how many days have elapsed since a certain date, and there is no problem.

If your data field index indicates the system uses a four character date field, you are also safe, she says, because the year will read 2000, not 00. Only if it says you have a two space date field should you worry.

"Be sure you look at every field that has a date — patients’ birth dates, the last date a patient was seen," says Berthelsen. "If the date doesn’t include a calculation, it isn’t a major problem. The worst that could happen is it will say you have a patient who is minus 1 year old, not 101."

Errors in software are most easily addressed by purchasing new programs, she says. While the effect of doing nothing is not as dire as for a bank, failure to solve the problem can lead to billing errors and delays, which can have an adverse affect on cash flow.

There are a couple other areas where medical practices should look for problems, advises Berthelsen. Those machines which have computer-based hardware with a date component — such as an EKG machine with a date stamp or an ultrasound machine that notes the date — may be at risk for the millennium bug.

"You can’t check these as easily," she says. "But you should know what machinery you have that has date stamps and then contact the manufacturer."

She advises against contacting the vendor. "They just won’t know. Instead, write a letter to the manufacturer’s technical service department providing the equipment model, year, and serial number. Tell them that you are concerned about the millennium bug. They should respond to you."

Berthelsen adds that it is probably a waste of time to phone the customer service number. "The people who answer those calls don’t usually have all the information you need."

Practices that receive digital lab reports may also face problems when the year 2000 rolls around, says Berthelsen. "Check to see how the dates come across. If they are sending you two digit date codes and the information goes straight into your computer, then you have to make sure that is changed to four digits."

Berthelsen says there is help out there for practices who are concerned. Along with your vendors and manufacturers, there are several Web sites that can provide assistance. (For a list of Web sites, see box, p. 114.)

Cheryl Berthelsen, PhD, RRA, Associate Professor of Health Information Management, University of Mississippi, Jackson. Telephone: (601) 984-6315. E-mail: cherylb@fiona.