Hospitals take preventive medicine for the Y2K bug By Eric Hubler Denver Post Business Writer

August 16 - If you must fall ill on New Year's Eve, try to do it in Denver. "I would not mind getting sick in Denver the last week in December,'' said Gary Setterberg of the Minneapolis-based Rx2000 Institute after Wednesday's Y2K preparedness seminar for hospitals, nursing homes and other health-care providers. It was the 21st of 23 such meetings Setterberg is conducting nationwide. Setterberg based his positive view of the local health-care industry's Y2K readiness on the quality of the questions participants in the seminar, held at an area hotel, submitted to presenters. "You don't want to be in some of the major metropolitan markets in this country,'' Setterberg said. "We've had some really conspicuously simple questions that have been scary.'' The bad news is that the several dozen participants from Denver and throughout the West amounted to a kind of health-care intellectual elite that's far too small. "We actually would have liked to have seen several hundred here,'' said Joseph Broseker, Medicare's Baltimore-based Y2K coordinator. While most big hospitals are doing everything they can to cope with the disruptions likely to be caused by the failure of some computers and software to distinguish between 1900 and 2000, many smaller institutions are doing absolutely nothing, he said. "There is a percentage that is saying, "I'm not going to worry about it, I'll just fix what breaks,'- '' Broseker said. "They may be proven right. I don't think so, but I hope so.'' Presenters from the federal government's major healthcare bureaucracies - the Health Care Financing Administration, which is sponsoring the seminars with Setterberg, the Veterans Administration and the Food and Drug Administration - as well as insurance companies that act as intermediaries between the government and providers, rose to describe the thorough and successful systems assessment and testing programs they'd undertaken, and to urge their listeners to do likewise. The theme that emerged was, essentially: "I'm OK. You, I'm a little worried about.'' HCFA, for example, has spent $200 million testing 99 "mission-critical'' systems - 24 of them inhouse and 75 at contractors, providers and intermediaries, Broseker said. "It's a project management nightmare'' involving more than 200 federal employees and 200,000 "data exchange partners,'' he said. But, he declared, it has worked. Early government reports said HCFA, which administers Medicare and coordinates with the states on Medicaid, was failing to prepare for Y2K, but it's ready now, he said. "If providers get claims to us, they will get paid,'' he said. HCFA's goal is "business as usual,'' Broseker said. "I realize there are some who might not be satisfied with that if you have problems with every reimbursement,'' he conceded, but dealing with HCFA just after Jan. 1 "should be no worse than what you have normally experienced over the years.'' Tests thus far reveal that some providers still have computers that have to be replaced, he said. Some test claims have come in with eight-digit dates, as required, but the two crucial digits have been wrong: 19 instead of 20. "That's been hard-coded into some of these systems,'' he said. Perhaps the most nightmarish health care-related Y2K scenario - a pacemaker or other piece of equipment suddenly failing - is unlikely, said Ronald Parr, an FDA official who is helping monitor Y2K problems in medical devices. There are between 1,500 and 2,000 types of medical devices that are computerized in some way, Parr said, but in only 83 of them does the computer's calendar have any direct impact on how the device functions. The makers of those devices are being audited especially closely, he said. "Trust me, the majority of problems we receive have to do with very low-risk situations,'' mainly display errors that are harmless if the people operating the machine know about them, Parr said. Still, a few tragedies related to wrong dates in computerized medical equipment already have occurred, Parr said: A ventilator failed, killing the patient, and a patient who had recently had syphilis was allowed to donate blood, which got into the public blood supply. To help device manufacturers fix date-related problems, the FDA is letting them make Y2K upgrades without going through the normal year-and-a-half approval process, Parr said. Shawn Martin, a Booz, Allen & Hamilton consultant heading the Veterans Administration's Y2K preparations, addressed another big fear of consumers: that the supply of pharmaceuticals will dry up. Don't wait until you're down to your last pill and think you'll be fine, he said; instead, order a refill with five to seven days' supply remaining - something that should be done at all times. The nationwide supply chain has about 90 days' worth of drugs in it, he said, so spot shortages "will be easily correctable within five to seven days.'' As for the VA itself, its systems are "100 percent compliant,'' Martin said. But a series of eight-hour tests at VA hospitals showed the reality on the ground isn't always reflected by the virtual reality inside a computer. In one case, the doors to the emergency room wouldn't open. Sometimes the bathroom lights didn't work. The one elevator on the backup generator worked fine, but it got too crowded. Nobody could find a flashlight. Kelly Collins of Mutual of Omaha, which acts as an intermediary between Medicare and providers, talked of the importance of redundancy - having a backup linen supplier, for example, in case the washing machines at your regular supplier don't work. "This is something you don't want to start on Jan. 1,'' he said. "They're going to be booked.'' Even if an organization conscientiously seeks out Y2K-compliant software, he said, "Don't trust them. You've got to test it.'' And document the test results, because more and more software vendors are certifying their products Y2Kcompliant, only to discover errors and release new versions. There may be electricity outages, Collins said, so getting a gen erator is a good idea - just don't wait until the last minute to try it out. "Do you have the coffee machine and the soda machine plugged into the generator and the ventilator plugged into the wall?'' he said. "Coffee is important, yes, but so is the ventilator.'' Other things to consider: Has the night staff been informed about emergency preparations? Do they have cell phones - preferably on several different systems - in case the phone network goes down? Have payroll records been backed up? There is, in short, a lot to do - and a lot of it isn't getting done. The session "prompted a lot of questions and concerns,'' said Terry Filloon, the billing supervisor at Children's Hospital. Children's uses several third-party claims processors, each with its own software, and "we're relying upon these vendors to be Y2K-compliant,'' she said. Even after the hospital's information services department sent the vendors a questionnaire - a common way of trying to determine whether a supplier is going to cause a Y2K problem - "we haven't gotten any information from them at all.'' It was hard to judge whether optimism or pessimism ruled the day, so perhaps the best attitude was the dark humor of John Wagner, the information systems manager for Colorado's Medicaid program, who opened his talk by asking: "Anyone remember what happened after Y1K? The Dark Ages came. Let's hope it doesn't happen again.'' Copyright 1999 The Denver Post. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Return to top Return to tech@dpost

For educational use only.

Does anybody else want to be sick in Denver - or anywhere else - the last week in December?

I hope this formats as legible as it looks - it's my first attempt & I'm "paste" challenged.

-- Scat (sgcatique@webtv.net), August 16, 1999

Answers

Bet what they take will be a placebo.

www.y2ksafeminnesota.com

-- MinnesotaSmith (y2ksafeminnesota@hotmail.com), August 16, 1999.

"Still, a few tragedies related to wrong dates in computerized medical equipment already have occurred, Parr said: A ventilator failed, killing the patient, and a patient who had recently had syphilis was allowed to donate blood, which got into the public blood supply"

Hmmm...

-- Mike Lang (webflier@erols.com), August 16, 1999.

Thanks, Scat.

Link a Dink a Do:

http://www.denverpost.com/news/y2k/y2k0816.htm

-- (from@rt.LinkLetter), August 17, 1999.

from the article: ""Do you have the coffee machine and the soda machine plugged into the generator and the ventilator plugged into the wall?'' he said. "Coffee is important, yes, but so is the ventilator.""

Oh boy oh boy. And another big surprise here:

"Even after the hospital's information services department sent the vendors a questionnaire - a common way of trying to determine whether a supplier is going to cause a Y2K problem - "we haven't gotten any information from them at all." "

Thanks for the post.

-- winter wondering (winterwondering@yahoo.com), August 17, 1999.

I'm confused 8<)...

Were these meetings (and this press report from the government) supposed to scare the hospital out of us, or re-assure us that everything will be fine?

___

Damn - bad news throughout, if these are typical of the problems being found.....and discussed. "Brief your night staff" is a revelation to hospitals!!!! these guys need to be told to "Check your generator" or "get flashlights..."

-- Robert A. Cook, PE (Kennesaw, GA) (cook.r@csaatl.com), August 17, 1999.