Over the main Y2K hurdle!

Questions on Y2K spending make providers bristle

The bug afflicting hospitals across the country Jan. 1 wasn’t from Y2K problems. The flu took that honor instead.

As emergency departments filled with flu-ravaged patients, providers breathed a collective sigh of relief as 2000 arrived with only a few computer glitches.

"Our transition from the 20th to 21st century was, with just a few minor disruptions, smooth and seamless," says Sen. Christopher Dodd, (D-CT). Dodd is the vice chairman of the Senate’s Special Committee on the Year 2000 Technology Problem.

"We saw that it was business as usual — a nonevent event," says Dionne Dougall, assistant director of media relations for the American Hospital Association’s (AHA) Washington, DC, office. "The successful outcome was a tribute to the number of hours that people all the way from the CEO down to each and every hospital employee put in toward that goal."

The reports of problems received by the U.S. Food and Drug Administration (FDA) in Rockville, MD, have been minimal. As of close of business on Thursday, Jan. 6, the FDA had received 24 reports regarding possible Y2K problems with medical devices, only five of which were direct reports to the FDA. Two reports were determined to be false. Four reports were determined to be not Y2K-related.

The remaining 18 reports on medical device problems related to Y2K were followed up by the FDA’s Center for Devices and Radiological Health. Five of these devices were known to be noncompliant by the FDA. None of the problems discovered in the 18 devices were safety issues either because the problem did not affect the functionality of the device (it was a date display or printed date issue only) or a manual reset or date reset option was available.

Problems with Medicare payments occurred, too, but not because of problems with the Health Care Financing Administration’s (HCFA) computer systems. A Y2K-related problem at a Chicago area bank temporarily interrupted Medicare payments to providers in at least eight states, including Oregon, Washington, and California. The problem only affected electronic funds payments.

Medicare contractors worked around the problem by sending diskettes containing processed claims to the bank by courier or Federal Express so that the payments could be made. The glitch was reported to be fixed by Jan. 6, according to HCFA.

Other widely reported problems in sectors other than health care included multiple charges of credit card purchases from retailers using noncompliant payment software. The Pentagon also shut down one of its key intelligence-processing computers while testing for a Y2K correction. The shutdown interrupted the flow of spy satellite data for several hours.

Both the U.S. Office of Management and Budget and American Hospital Association estimate that the costs of Y2K preparation will reach the $8 billion range. Providers have done such a good job preparing for the Y2K transition, though, that the media and some members of the public question the urgency of the situation.

If, critics contend, computer systems were so vulnerable, why weren’t more problems reported? Could the entire situation have been a lot of hype or even a hoax? Was the money spent wasted?

These questions anger many involved in the Y2K preparation process. First of all, they say, the problem still isn’t resolved. "The fact that there continue to be date-change glitches reminds us that the Y2K challenge was very real," says John Koskinen, chair of the President’s Council on Year 2000 Conversion. "The hard work of thousands of dedicated employees in the public and private sectors is the reason why what we have seen thus far are minor difficulties and not serious national problems."

Did hard work make transition look easy?

Maybe providers did too good a job, says Dwain Shaw, director of information services at the Medical College of Georgia in Augusta. "Most of us who worked so diligently understand what would have happened had we not tackled the problem. I think the real question is — Would we have been greater heroes if there had been more catastrophic failures?

"My personal take is that the media wanted to see failures at the stroke of midnight and when they didn’t happen, the obvious [reaction] was for the whole episode to be labeled as a hype and a hoax. The fact that it was overhyped was actually a blessing in disguise because it kept people at home, giving us [in health care] the time to devote to any failures that did arise."

The media and hoax theorists are looking at the current results with negative thoughts, he adds. "Did we spend too much? I don’t know because if we had spent less, even one dollar less, how will we ever know if that dollar would mean the difference between success or failure, life or death? In retrospect, I would do the same things I did, as I believe would my peers, to prepare," explains Shaw.

The money and resources spent on Y2K preparation were definitely not wasted, Dougall says. "Y2K was an issue that was identified early on as a challenge. Hospitals would have been remiss if they had not looked at the possible implications [Y2K problems] might have on patient care."

A largely seamless transition was not the only benefit of the Y2K preparation. Providers are much more in control of their computer systems now.

Providers did a technical "cleansing," replacing old technology with new. "In the process, we corrected those things we found wrong," Shaw says. "We will never have a better handle on our inventory than we do right now. We will never again review our business processes with such diligence."

"Assessments of information technology systems and inventories have resulted in streamlined processes, leading to increased efficiency and productivity," Dodd says.

Hospitals also were able to develop and fine-tune their contingency plans and make sure they had disaster drills in place, Dougall says. "We like to pride ourselves on being prepared for the unexpected." In reviewing the plans, hospitals were able to establish and possibly maintain tighter relationships with some of their community partners.

Y2K also helped increase public awareness and opinion of health care providers. "From my perspective, the consortium of our area hospitals led the charge to dispel the doomsayers and help educate the community with the truth about Y2K," Shaw says. "In so doing, we instilled a level of confidence in our community probably higher than it has ever been before.

"At the national level, the health care industry had to rely on trust and good faith that everyone was going to do their part of the job to see to it that Y2K was a yawner," he continues. "In the process we found out who was dependable and who was not. At the international level, we led the charge to help the rest of the world prepare their systems so no harm would come to the patient for what we did or did not do in preparation for Y2K.

"I am unaware of even one patient suffering because of Y2K, and that is one heck of a report card for us."