Will your computers and software work in the year 2000?

Act now to make sure you can still track outcomes, schedule staff

If your facility hasn’t started a year 2000 (Y2K) review of all its computer hardware and software applications, start immediately. Otherwise, you may find yourself in a disastrous situation when the year 2000 rolls around. You should take the millennium bug problem very seriously. If you don’t, you may not be able to bill, schedule your patients, pay your staff, collect outcomes data, or do any of the tasks that involve using a computer.

"No one should believe that they are immune from dealing with Y2K issues or that they can wait until halfway through 1999 and do a quick fix," asserts Malcolm Morrison, PhD, president of Morrison Informatics, a Mechanicsburg, PA, health care information systems consulting firm.

The Y2K problem arose because computer hardware and software use a six-digit field for dates, with the "19" in the year being assumed. When the year 2000 rolls around, it is anticipated that the computers will read "00" as "1900." A less common but also potentially distressing problem may arise because some programmers have used a string of nines to indicate a variety of conditions, such as "infinity" or "delete this record." Therefore, some computers may start having problems in September, specifically on 9/9/99.

That’s why you’re advised to start making changes now and not wait until the last minute.

"It is taking a significant risk if, by the end of June 1999, every aspect of Y2K has not been tested and presumably corrected. In the last six months, other problems may arise, and it’s inadvisable to be in the position of correcting them on December 31," he adds. (For steps you should take to find out if your computers and software are compliant, see box, below left.)

Morrison advises his clients to look on the Y2K problem as an opportunity to review all their computer systems and products. Make sure they are on the cutting edge and will be able to deal with the amounts of information health care providers will need to generate in the future, he suggests.

"If you have to upgrade your system because of Y2K, it’s probably worth it to develop a strategic plan for what your information system will need to do in the future," Morrison adds.

Many providers will have to upgrade their computer systems to handle the software necessary for the Medicare prospective payment system for inpatient rehabilitation providers, which is scheduled to go into effect Oct. 1, 2000.

In addition, Medicare and Medicare are going to require electronic data transmission for payments in the future. "In the future, virtually all reimbursement is going to be done electronically. Managed care will still accept pieces of paper today, but HCFA [Health Care Financing Admin istration] has stated its intentions to get away from paper entirely," Morrison says.

Accreditation organizations are moving toward electronic transmission of data. For example, through its ORYX initiative, the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, has begun to move to electronic data transmission and reporting.

"You may be able to make your 486 computer Y2K compliant and continue to use it. But the fact is that applications are now being developed that require more power to run than that computer can provide," Morrison adds.

The Rehabilitation Institute of Chicago (RIC) began tackling the Y2K problem in February 1998, nearly two years before the problem is expected to occur. "We are looking at anything with a computer system or anything with a date-embedded microprocessor," says Larry Klein, an RIC information systems employee who is working on the facility’s Y2K task force.

The RIC task force has been working since Feb ruary to compile an inventory of all equip ment that might have problems. The initial group is made up of information technology (IT) and business office staff. They are evaluating the equipment and contacting the vendors to get statements of compliance. "You can’t just clear it with your vendor. You have to evaluate each individual piece of equipment," Klein says.

Examine 286, 386, and 486

Most IBM-compatible PCs with 286, 386, and 486 microprocessors will not operate in the year 2000. Information technology personnel may be able to correct the problem on computers with 486 processors, Morrison says.

Most Pentium-type computers are Y2K compliant, but you still should run a check on them, he advises. "There are noncompliant ones. This has occurred when the internal software has been changed for one reason or another, and that made them noncompliant. It’s important to check under any circumstance."

There is software on the market that will check and correct Y2K problems on personal computers. Morrison recommends the compliance-checking software as a minimum measure for the Pentium-type computers.

For older PCs, the compliance-checking software might not solve the problem, Morrison warns. "This is not something an untrained person can determine. Just because a program says it can be corrected doesn’t mean it will."

In those cases, and in the case of any computers that are on a network, you need to get your hospital’s information technology experts involved. An IT specialist should thoroughly check any computers used as servers, or servers that are part of a network system. If you don’t have IT experts on your staff, hire a consultant to check out your equipment, Morrison advises.

"If the servers aren’t correct, nothing will be correct. You can replace all your PCs, but if a server isn’t compliant, it won’t solve your problem," he says.

A significant amount of clinical, financial, scheduling, and other software is not Y2K compliant. Most of the time, your software vendors will be able to tell you if your software is compliant, and most Windows-based software designed in the mid-1990s should be, he says. "But that’s not guaranteed. All of them have to be evaluated."