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The health care industry lags significantly in its Y2K preparations compared to other key economic sectors, with rural and inner-city hospitals and physician offices among the most vulnerable areas, a U.S. Senate committee has concluded.1
Looking at all sectors of the economy, the Senate committee judged that the United States "will not experience any nationwide social or economic collapse as the result of Y2K computer problems, but some disruptions will occur, and that in some cases Y2K disruptions may be significant. The international situation may be even more tumultuous."
The report says the health care industry lags behind other industries in dealing with the Y2K problem in managerial attention, technical resources available, financial resources committed, and remediation monitoring. Of prime concern are embedded microprocessors in bio medical devices. The devices are used in a wide variety of diagnostic test equipment (e.g., blood chemistry analyzers, MRI, X-ray) and inpatient and outpatient therapies (e.g., radiation).
"These devices are the Trojan horses in the health care industry’s compliance," the report states. "Users are often unaware or unknowledgeable about the impact of the microprocessors inside these sophisticated machines. For example, surgical suite machines such as a $40,000 blood gas analyzer could close down operating rooms if they cannot function on Jan. 1, 2000."
The health care industry currently relies on manufacturers’ Y2K compliance data reports to determine whether the device will function appropriately when the date changes. In many cases, manufacturers have been unable or unwil ling to comment on their product’s ability to function after the millennium change, the report states. As a result of the committee hearings, device manufacturers began providing compliance data to the Food and Drug Admini stration for publication on its Internet Web site at http://www.fda.gov/.
"Perhaps the most disturbing Y2K revelation to the Committee was the disclosure of the domino effect of Y2K failure," the Senate report states. "It can occur in both the use of biomedical devices and in Medicare payments. If one biomedical device malfunctions, it can potentially shut down an operating room. Or even worse, one device can pass erroneous data onto other devices creating adverse patient conditions. In other words, Y2K mistakes can reverberate throughout the health care system."
Other key excepts from the report are summarized as follows:
Rural and inner-city hospitals: Rural and inner-city hospitals have unique Y2K problems. First, because these types of hospitals tend to have limited financing, the expensive discovery, renovation, and testing process is beyond their means. Second, these institutions do not have access to the highly skilled personnel needed to achieve Y2K compliance. Third, these hospitals are more likely to have older medical equipment, which may be disproportionately subject to Y2K problems. On the plus side, some low-tech equipment may not have any Y2K exposure. On the other hand, older versions of bill payment software are more likely to be noncompliant.
Large hospitals: Large hospitals are dedicating considerable resources towards correcting the Y2K problem. They have all the usual Y2K problems of health care plus building management concerns. They have to provide water and power, heating, ventilating and air conditioning, plus maintain elevators and security systems. Large hospitals also must address Y2K problems in biomedical devices and patient data systems. All of the above must function in harmony for patients to be protected adequately. Hospital management is playing a catch-up game.
Doctors’ offices: Because the nation’s nearly 800,000 doctors work out of thousands of separate offices, detailed data on the extent of the Y2K problem in this area are unavailable. Medical offices are expected to have all the Y2K problems similar to hospitals on a smaller scale but without comparable access to technical and financial resources. Because diagnostic testing depends upon biomedical devices, potential problems may exist. Patient data systems are not widely used in doctors’ offices today, but electronic health claims billing systems are nearly universal for Medicare. If doctors have to return to paper billing because of Y2K failures, insurance companies and Medicare would be hard-pressed to accommodate the resulting volume of health claims.
1. United States Senate Special Committee on the Year 2000 Technology Problem. "Investigating the Impact of the Year 2000 Problem." March 2, 1999. Web site: http://www.senate.gov/~y2k/