Year 2000 computer crisis may be biggest single issue facing providers

How your practice can beat the millennium computer bug

Guess what? You can stop worrying about innocent billing mistakes triggering a federal fraud and abuse investigation. And never mind about managed care upheaval and impending changes in the Medicare system.

Because all of this is going to seem like small potatoes if your practice's computer systems - and the systems of the payers, hospitals, and other providers and suppliers you work with - melt down come New Year's Day 2000 when the year 2000 computer bug bites, possibly crashing every information system and piece of equipment containing a computer chip in the country.

With less than 500 days to go, health care in general - and physicians in particular - lag far behind most other groups in the country when it comes to preparing for the year 2000 bug, says a study by the Gartner Group, a Stamford, CT-based information technology consulting firm.

In fact, information systems and various other computer-dependent systems in 87% of all health care organizations in the country are still vulnerable to year 2000 failure, says Dave Garets, director of research at the Gartner Group.

Physician practices are among the worst-prepared members of the health care community, says Garets. For instance, as late as March, 92% of physicians had no realistic concept of how vulnerable their practices were to year 2000 complications, according to the firm's research.

"Physicians think just because their computers are less sophisticated than those used by hospitals and integrated health systems, they don't have as much to be concerned about. Plus, they have until right before year 2000 to fix any potential problems, so why worry now?" says Gartner senior analyst Lynne Dunbrack. "The reality is just about any piece of software, computer, or medical device is subject to a year 2000 shutdown."

"The health care community is in serious trouble due to anticipated problems of the year 2000 changeover," Joel Ackerman, executive director of the Minneapolis-based Rx2000 Solutions Institute told the Senate Special Committee on Year 2000 Technology in July. "Patient care and patient lives are at stake." The Rx2000 Solutions Institute is an independent, nonprofit, member-supported organization created to help health care organizations address the year 2000 issue.

According to Ackerman, health care organizations face the following significant patient care and business risks from year 2000 failures:

· dependence of physicians, hospitals, and other health care providers on computing technology such as medical devices with embedded computer chips, date-sensitive information systems, electronic medical records, outsourced services, and electronic exchange with insurers and claims processors;

· little coordination of year 2000 activities and significant duplication of efforts among provider groups, hospitals, insurers, claims processors, and other related suppliers and vendors;

· concerns over who will ultimately be liable for year 2000 failures, patient injury, and death;

· lack of necessary project management and technical and financial resources for year 2000 preparation among many small or rural health care providers;

· underestimation of the costs and effort needed to detect and correct potential problems;

· shortage of qualified personnel, particularly biomedical engineers, to do the work needed.

Among the actions Ackerman and other parti cipants at the hearing recommended the federal government take to help health care institutions prepare for the year 2000 changeover:

· Place more emphasis on helping medium, small, and rural health care providers make necessary changes in their computer systems.

· Increase national and international health care information sharing.

· Provide low-interest loans or other financial assistance to help health care organizations finance year 2000 programs.

· Support rapid expansion of comprehensive year 2000 education, information sharing, and vendor reporting services provided by both private-sector and government organizations.

· Support federal attempts to help Medicare and Medicaid intermediaries in their year 2000 compliance efforts.

· Create national hotlines to give informed, responsible answers to year 2000 questions from patients and health care providers.