A last-minute triage plan for Y2K compliance

Internist group offers some solutions

Despite the fact that time is running very short, there are still things procrastinating practices can do to fix potential year 2000 problems, experts say.

According to the Philadelphia-based American College of Physicians-American Society for Internal Medicine (ACP-ASIM), smaller medical practices are the least prepared to cope with potential Y2K problems. In fact, studies show only about half of all internists are verified Y2K-compliant, while as many as 10% have done nothing to prepare for dealing with possible year 2000 computer glitches.

Y2K threatens scheduling, reimbursement

While most practice offices are not as dependent on medical device as hospitals or clinics, there are potential problems with different types of equipment ranging from X-rays to accounting systems to telephones and pagers.

But the biggest potential Y2K threat to most practices is a meltdown in their computer and billing systems, which could send their patient scheduling, medical files, and financial records into the ether of cyberspace, making it difficult or impossible to make appointments, process claims, and get paid.

To minimize the odds of this happening, ACP-ASIM has developed a six-point Y2K "triage" program to help practices that have not yet done their computer homework avoid Y2K shock come the millennium.

Here’s how it works:

1. Inventory and assess. List everything in the office that could be affected because it contains a computer chip, including answering machines, automated lighting systems, smoke alarms, treatment equipment, and computer software and hardware.

2. Prioritize. Determine what absolutely must be checked and fixed and what you can let slide. A fast way to assess the Y2K readiness of your office equipment is to visit the various vendors’ Web sites to see if they list the status of their equipment. Pay special attention to those everyday items you tend not to think about but that can put your business down for the count when they’re not working.

Joel Nobel, MD, president of ECRI, a nonprofit health care research agency in Plymouth Meeting, PA, gives this example of prioritizing your Y2K issues: "If your building access card doesn’t work, you can always break down the door," he says. "But if it’s January in Maine, you are in deep stuff if your heat will not come on."

3. Check your hardware. Much of the concern surrounding Y2K issues has focused on what happens if your software crashes — medical record programs, billing software, etc. But this overlooks the fact all that software has to run on some kind of hardware.

"The typical practice has asked their vendor if its software is compliant, but failed to check out their hardware," says Diana Parish, Y2K project coordinator for Nationwide Medicare in Columbus, OH.

Tip: Most major computer makers have programs on their Web sites to test and update basic computer input/output systems and which can be downloaded free of charge.

4. Update software. When it comes to software, many large vendors have already supplied software upgrades or patches to physicians.

It is possible for a small practice to replace its old practice management software for as little as $300 to $700 if it is willing to settle for simple, off-the-shelf software that does a good basic job of patient scheduling and billing. The price starts to go up once you add data conversion, clinical support, or expanded features.

This off-the-shelf software can usually be bought by mail or on-line and delivered within a couple of business days. Add another day for installation by an already tech-savvy office worker or physician.

Off-the-shelf packages also can be purchased for larger practices with starting prices between $1,000 to $3,000. For a system installed and supported by an outside vendor, the prices begin at about $5,000 to $10,000.

Most larger practices with a networked system should seriously consider hiring an outside consultant to help install any off-the-shelf software and provide staff training.

Tip: If you don’t have enough time to complete a full data conversion, think about leaving your old system running while you’re setting up a new, parallel system. For example, for practices on a typical 90-day billing cycle that install their parallel system in October, most new appointments and active patient information, along with new charges, can be entered into the new system before January. Previous records still must be entered into the new system manually, but that can be done after getting past the Jan. 1 drop-dead date.

5. Test your systems — carefully. While many experts say you should extensively test both hardware and software, others do not like the idea of nonprofessionals mucking around with these systems because they can create more problems than they solve.

Carolyn Albert of ACP-ASIM’s Center for a Competitive Advantage recommends scheduling a thorough on-site testing and system review with your computer maintenance company. "Explain that you will require written confirmation of the results and an accurate survey of all hardware and software components, including model and serial numbers," she recommends.

Tip: Before anyone tests your system, print out and save a copy of critical schedules, accounting information, follow-up reports, and other needed documentation. Also, talk with the tester about what kinds of recovery procedures are available if the system should crash during the test.

Besides your main operating system, make sure the modem, backup software, laboratory interfaces, claims submission software, accounting and payroll programs, report generation software, diagnostic software, and electronic claims-submission data are tested.

Also, test-run all programs in the your office that exchange data, including laboratory interfaces, accounts receivable, payroll, accounting, and report generation software to ensure they are both individually compliant and compatible with each other.

6. Have a back-up plan. Everything in your office may be Y2K-compliant, but there is nothing you can do about what happens elsewhere. In turn, you need a contingency plan for such processes as scheduling, examining patients, billing, record-keeping, telephone service, access to bank accounts, and arrangements with vendors and hospitals.

Tip: Consider not scheduling any patients until Jan. 5 or 6 to give yourself some leeway should you blow a Y2K fuse despite all your efforts.