Get your pencils ready

It’s time to prepare staff to push paper

If your case management software fails on Jan. 1, 2000, would you know how to complete a client intake, file necessary paperwork, or find the proper diagnosis codes? An important part of your year 2000 (Y2K) contingency planning is to identify the systems and tasks essential to your job and then figure out how to complete the necessary work without the systems you’ve come to rely on, says Elizabeth H. Wheeler, RRA, a management consultant with Superior Consultants, a health care information systems and management consulting firm in Southfield, MI.

Here’s her four-step planning guide for your final countdown to New Year’s Day.

1. Know your organization’s mission. "Your Y2K contingency plan must be geared toward supporting your organization’s mission," Wheeler says. "Without a clear understanding of the mission, you can’t properly identify the systems and products necessary to meet the mission goals."

2. Identify systems necessary to fulfill the mission. "You must identify all the systems used to support the organization’s mission," she notes. "This will be an individualized list specific to each case management department or company."

3. Rank systems in order of importance. "Within any organization, there are not enough dollars available to replace, upgrade, or change every system that may require it for Y2K compliance," Wheeler says. "You have to develop an arbitrary ranking system that somehow matches each business function and the systems needed to perform it with the organization’s mission."

Your ranking system could be based on a scale of one to three with three being very important and one being not important at all, she notes. "Assign a rating from your arbitrary scale so that each product, process, and system holds a value that enables the risk severity to be assessed and documented."

It helps if case managers look at risk assessment in terms of the exposure their organizations would face in the event of a Y2K failure. "Your rating scale should, in effect, be a description of the impact of that system failing," Wheeler explains. "If a piece of medical equipment necessary to properly care for a patient fails, that naturally holds a higher risk exposure than if there is a temporary interruption of revenue due to a system failure."

4. Write contingency plans. "You must develop contingency plans that support the continuation of every function you identified as essential to supporting your organization’s mission goals," she says. "There has to be a plan in place for performing functions in a backup fashion."

For example, if your case management software fails, you still could complete notes by hand. However, are you prepared for the additional time completing patient paperwork by hand requires?

"If your electronic systems fail, you may need additional people to complete the same amount of work in the same amount of time," she says. "This is the time to contact local temporary services to arrange for temporary staff. You may have to offer a retainer to get on their list, and if you need specialists, there may be fierce competition for those services."

Also, if your case management staff are predominately younger than 40, they may not know how to complete tasks manually, Wheeler cautions. "This is the time to do some staff training on how to do things the old-fashioned way. For example, do your case managers know how to use a code book to find diagnosis codes?"

Wheeler stresses coding with all of her health care clients. "We’re finding that people are so used to using electronic systems for coding that they have forgotten how to use coding manuals. And remember that coding manuals really can’t be shared. If you hope to keep your productivity up, each employee needs a coding manual. If you don’t have them, don’t wait until October to order them, they may not be available."

Most organizations will be without their systems only for a few days, possibly weeks, Wheeler notes. "However, be sure to think through your contingency plans thoroughly. Some of the things you may think are going to be your backup systems may or may not be available to you. For example, if you can’t rely on electronic exchange of information, you may plan to use a courier service. However, if you cover a large geographic area, a courier service may not be practical or timely enough for your needs."

And, of course, document all of your Y2K compliance efforts, she urges. "The first thing attorneys will ask you to show them in the event a failure results in a lawsuit is all the documentation that shows you made an effort to obtain compliance information from all of your vendors and trading partners and plan properly for potential failures. Remember, if it isn’t documented, it didn’t happen. You can’t prove you made an effort unless you keep careful notes."