Hospitals and doctors offices are believed to be behind in preparing their computers for Y2K. The potential errors could be devastating. Patient records could be lost or corrupted. These have already started.

Computers May Be a Risk at D.C. General By David A. Vise Washington Post Staff Writer Wednesday, March 24, 1999; Page B1

The health of patients at D.C. General Hospital is being endangered by massive problems with old computer systems  some caused by the approaching year 2000  and a financial squeeze that could force new cuts in health care services, according to city officials, consultants and internal memos.

In recent months, computer malfunctions have purged information from some patients' electronic files at the hospital and introduced errors into other patients' records, said Kent Gale, executive director of Legacy Systems Inc., a consulting firm hired by the hospital to keep its antiquated computer systems running.

New doctors at the hospital, meanwhile, were unable to electronically retrieve patient information earlier this year because the computer system would not issue passwords  which are supposed to be good for one year  that would expire after Dec. 31.

The glitch, known generally as a year 2000, or Y2K, problem, stems from a decades-long practice of computers identifying years by using only the last two digits. On Jan. 1, such computers will interpret "00" not as 2000, but as 1900. This will cause computers to shut down or, in some cases, to produce inaccurate information.

Gale, who has written the hospital a series of memos and "Patient Harm Alert" warnings, said that conditions at the city's public hospital are going to get worse in the coming months and that District officials and residents should be aware of the potential risks to patients.

In a Dec. 28, 1998, memo, Gale told hospital officials that problems with D.C. General's computers were increasing.

"The disk drives are too full," he wrote. "This condition is creating an environment that is producing data errors. Such errors are erratic and totally unpredictable. Errors are showing up as missing data and incorrect data. Critical patient results are disappearing."

In an interview, the consultant said that some senior hospital officials  including Chief Executive Officer John Fairman  do not appear to understand the severity of the situation and are moving too slowly to prevent a crisis from occurring later this year.

"I don't think that [Fairman] recognizes that the system is dying," Gale said. "Their system can't survive this year."

D.C. Council member Sandy Allen (D-Ward 8) said yesterday that she will launch an immediate investigation into the situation and that she is concerned about the dangers posed by the computer problems. Allen also expressed confidence in the doctors, nurses and other medical professionals who work for D.C. General and its clinics and said many of her constituents rely upon them daily for medical care.

Fairman and other senior D.C. General officials agreed that their existing computer systems often produce errors, and they said that they recognize the enormous financial and time pressures they face in replacing those computers. However, hospital officials emphasized yesterday that they are on track to address their computer problems over the next six months and that they will do their best to come up with the $4.6 million in additional technology funds they need without slashing health care services.

"We take our mission seriously and are actively committed to putting in place systems that promote and protect patient care," said D.C. General spokeswoman Donna Lewis Johnson. "The installation of a new health information system is a core example of our commitment to provide quality care to our patients. As we make the transition to the new system, we are safeguarding against any harm to our patients."

But Gale said D.C. General cannot install new computer systems on the tight timetable and budget it has outlined for the months ahead. "I think it is going to crunch them," he said.

Allen said a lack of financial support from the city, coupled with severe technology difficulties, has left the hospital fighting for its survival. The city budget proposed by Mayor Anthony A. Williams (D) would reduce the District's subsidy to D.C. General Hospital and its health care clinics by about $24 million next year to $22.6 million, council officials said.

Allen says the cut could force the closing of the 250-bed hospital, which serves thousands of the District's poorest residents, as well as a large number of victims of violent crimes. The mayor has argued that D.C. residents can get quality care at a lower cost through a new insurance program for the poor that defenders of D.C. General say would decimate the hospital by causing patients to go untreated or to get care elsewhere.

"We have been fighting to keep [D.C. General] alive and get good care for the patients," Allen said. "We are in a battle right now."

Fairman said that for months, he has been "begging" D.C. officials for millions more dollars needed to address the hospital's technology problems. Fairman said the lack of funding, along with uncertainty over the hospital's future, forced him until recently to delay decisions about how to address major computer problems.

In December, hospital officials signed an agreement with Shared Medical Systems Inc. to have a new system for patient information installed by Oct. 1. While Gale said that hospital officials are wise to invest in new technology, he added that D.C. General is trying in nine months to install a complex new computer system that normally takes about 18 months to put in place.

Meanwhile, D.C. General officials said they are developing plans to address any Y2K problems that arise. They said hospital personnel and computer experts have been detecting and correcting other computer data errors.

D.C. General serves tens of thousands of city residents annually, including many who visit its emergency room and trauma center. Last year, 51,237 patients went through the emergency room, and 88,208 patients were treated as outpatients, according to hospital figures.

The hospital's long-running computer difficulties stem from its roughly $10 million investment in a new system some years ago that never worked properly, officials said. Ultimately, D.C. General negotiated a $2.5 million settlement with Ameritech Corp., which acquired the computer firm that provided the original system.

D.C. General's Fairman said the hospital may be forced to cut health services to come up with the money to pay for unanticipated Y2K expenses. Mary Ellen Hanley, program manager in the District's technology office, said D.C. General is receiving technical assistance and some financial support for its testing and contingency plans related to Y2K issues. But she said the city is not planning to provide the hospital with the money it needs to purchase its new computer system.

D.C. General has entered into a five-year contract worth about $2.3 million annually with Shared Medical Systems of Pennsylvania to replace its existing computer systems. William Wilds, the hospital's senior vice president of compliance, said that the firm has agreed to phase in new technology systems at D.C. General and that the main computers for the system will be based in Pennsylvania and connected to the hospital via two high-speed telephone lines. Wilds also said there are financial penalties in the contract that give Shared Medical Systems incentives to get the job done on time.

Gale doesn't believe the job can be done on time and says that his firm, which receives about $22,000 a month from D.C. General to keep its current computers operating, may not be able to keep the systems intact much longer.

Greg Holloway, a District accountant hired by D.C. General to monitor the installation of its new computer system, said the hospital is doing a good job of addressing patient care issues as it plans for the future. He also said there are several ways for doctors and nurses to get critical information about patients when computer systems malfunction.

"Nothing unexpected has occurred," Holloway said, "and there is no reason to think things are not going to play out as expected."

) Copyright 1999 The Washington Post Company

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Are similar problems occurring in Wilmington? Are the hospitals and doctor offices even aware of the potential problems that this could cause? I have seen no information about how Wilmington's medical community is addressing this potentially dangerous situtatin.

-- B.K. Myers (B.K.Myers@cwusa.com), March 25, 1999

Answers

Critt, please also ask about pharmaceuticals. My understanding from Senate hearings on Y2K is that 80% of all pharmaceutical ingredients and 70% of all finished pharmaceuticals come from overseas. (Think rain forest, e.g.) From the same hearings, I understand non-industrialized (and some industrialized) countries are far behind the US, UK, Canada, Oz, and NZ on Y2K remediation. Transportation will be a problem. . .

In addition, most medical insurers permit the stockpiling of only 90 days' worth of medicine. Some doctors are circumventing this policy by "over-prescribing" for patients they know.

-- Old Git (anon@spamproblems.com), April 18, 1999.