Health system almost ready for year 2000
Health system almost ready for year 2000
`6,000 devices that are suspect for compliance'
Jan. 1, 2000, is not a moving target. Either your computer systems, medical devices, and suppliers can handle the date change and maintain business as usual - providing quality patient care - or they can't, in which case the entire enterprise will face serious problems.
But unless all systems and devices have been tested, how will you know for sure?
Those concerns have kept administrators at Egleston Children's Health Care System in Decatur, GA, on an extremely focused mission for several years as they prepare for the new century.
In a process estimated to cost between $4 million and $5 million, a year 2000 task force is systematically testing every computer, system, and device for compliance with the date change. In addition, they are contacting every vendor and supplier to obtain as much information about year 2000 compliance as possible.
Egleston is a 235-bed not-for-profit hospital that treats more than 300,000 children each year. A satellite network of 21 neighborhood health centers and five speciality care centers provide urgent care, subspecialty care, primary care, and rehabilitation services.
All these diverse health care sites are part of Egleston's year 2000 project, Tom Cole, director of information services, told those in attendance at the Healthcare Information and Management Systems Society annual conference in February in Orlando, FL.
Egleston began preparing in the late 1980s for the biggest date change in a thousand years, Cole said, by developing an overall information technology (IT) strategy. With more than 1,000 computer system interfaces to support health data transfer, more than 3,000 suppliers, and more than 6,000 medical devices to check for year 2000 (Y2K) compliance, the head start has proven to be a wise decision.
There are various ways to approach the problem, Cole said. One is the "silver bullet approach, which is what we all want." But such a "quick fix" doesn't exist, unfortunately. There is no easy way to ensure that all systems and devices are ready for 2000.
Hiring consultants to fix the problem is another approach. But the time is rapidly approaching when consultants can't take on any more work, Cole said.
Then there is the in-house approach, which means organizing, gaining the attention of top management, and getting started.
Egleston decided to tackle the Y2K compliance problem in-house - a "very labor-intensive" approach - Cole said. Consultants will be hired to fill in any manpower gaps.
Roughly 70% of the Y2K project at Egleston involves testing systems and devices for compliance, said Marion M. Powell, RN, senior analyst and Y2K project manager, who also spoke at the HIMSS conference.
Based on first-hand experience, here are some tips for hitting the Jan. 1, 2000, target dead on:
1. Get the project out of IS (information systems).
A primary concern early on was whether management would consider this "just another IS issue," Powell said. "It is not an IS issue; it's a business issue," she said. It is important to make top management understand that this isn't an ordinary systems problem but one that affects the entire enterprise with enormous ramifications.
2. Assign a project manager.
The manager doesn't have to be from the IS department, though that is helpful. An important point to remember: He or she should be assigned to the 2000 project only and should report directly to top management not through a chain of command that could allow critical issues to slip through the cracks. Before a direct reporting line to management was implemented at Egleston, Powell said, "Initially, it was very difficult to get questions answered."
3. Develop a year 2000 project team.
At Egleston, there are four full-time employees working on the project: two systems analysts, a biomedical engineer, and the project manager. In addition, a part-time executive assistant handles data base input. The expertise of the biomedical engineer has been used to identify and test medical devices for compliance.
4. Set up a year 2000 task force.
At Egleston, this diverse group includes representatives from every aspect of the health care system. At first, it met monthly but now meets twice a month and may meet more often as 2000 approaches. (See story, p. 60, for more information on task force roles.) The group consists of representatives from the following areas:
- Senior administration. The approval and understanding of senior management is critical for obtaining the funding necessary for testing systems and devices and then upgrading or replacing those that don't pass muster.
- Purchasing. This group handles the purchase of supplies, many of which need to be tested for compliance.
- Finance.
- Clinical. This includes representatives from labs and radiology who are familiar with the equipment and can handle the testing for compliance.
- Facilities. This includes staff familiar with the hospital's heating and air and security systems, for example.
- Legal. Egleston's hospital attorney records the minutes at task force meetings. This ensures that everything said at the meetings is protected by attorney-client privilege.
- Physicians.
- Information services.
- Network (clinics).
- Affiliates (HMOs).
5. Network to obtain information.
Powell is a member of the Atlanta Year 2000 Users Group, the Georgia Hospital Association, and the Atlanta Hospital Group, and she regularly logs onto year 2000 Web sites. (See editor's note, p. 61, for Web sites Powell recommends.) Typical meetings of many of these groups include presentations or updates by vendors and suppliers, Powell said, which offer a constant stream of new information.
6. Involve the board of directors early on in the project, Powell advised.
At Egleston, the board of directors is integrally involved in the systemwide Y2K project. The key reason for this is liability. "When it comes to legal liability, it's going to be the board that gets sued, not the project managers. They need to be involved," she said,
7. Break down the Y2K compliance project into several broad categories.
- PCs. "You can't just test one model," Powell said. Two identical PC models can have different versions of the same chip inside. One may be Y2K compliant while another is not.
- Software applications. Egleston's task force has sent letters to software vendors asking for the following information:
a. date data format descriptions;
b. date data in the applications data files;
c. date data within user exits;
d. date data on screens;
e. date data on reports;
f. archive, purge programs or records based on date data;
g. current releases in use at the Egleston health care system;
h. required upgrades, if applicable;
i. costs for upgrades;
j. rollout dates for upgrades;
k. interfaces affected by date change.
Letters were sent on company letterhead via certified mail. Vendors were asked to respond on company letterhead and were given 30 days to respond to the survey - a deadline of June 30, 1997. By that date, 20 of 52 surveys had been received. Responses varied from detailed letters answering all questions to a standard one-paragraph statement. Some even downloaded standard disclaimer information from the Internet and sent that in, Powell said. Follow-up concentrated on the vendors who did not respond. All responses - and non-replies - are being documented and kept on file.
But even with letters certifying compliance on file, Egleston is testing all software. "The letters don't mean much until I've [finished testing]," Powell said. "I'm still testing everything."
- Embedded chip devices. Representatives from each department are responsible for identifying all digital devices in their department and formulating a list of the name of the equipment, when it was purchased, the number of units in the department, the vendor name and a contact name, and vendor phone number and address. All information is kept on file.
- Suppliers. "These are the hardest ones to get our arms around. The only thing you can do is send out letters and rely on documentation," Powell said.
Egleston has budgeted roughly $2 million for upgrades and replacement of equipment that is not year 2000 compliant, Cole said. "It is key to get the cash set aside for the project. Budget for the known parts of the project, but plan for the unknown parts of the project," he said.
To keep up the momentum, Egleston plans no new system installations between now and Jan. 1, 2000. That is because staff are already stretched thin while they are trying to implement 12 systems upgrades between now and October, Powell said.
As the countdown to 2000 moves closer, Egleston plans to spend the fourth quarter of 1999 in an "education blitz" to train staff on all manual procedures just in case computer systems fail when the new century arrives.
Finally, the New Year's Day holiday will be extended an additional three to five days. During that time, no surgeries will be scheduled, and staff will be "ramped up," Powell said, to be in full-battle regalia for the arrival of the new century.
"The fantasy is that all PCs, equipment, and suppliers are going to be Y2K compliant," Powell said. The key thing to do is to practice `reasonable diligence.' It means you did everything feasible to get everything Y2K compliant."
[Editor's note: The following are Web sites recommended by Powell: http://www.mitre.com. http://www.Rx2000.org.
See Hospital Payment & Information Management, February 1998 , p. 17, for a story on Rx2000 Solutions Institute.]
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