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(Editor’s note: As the clock ticks toward the millennium, physician practices should make sure their information systems and medical equipment will be working in the year 2000. In this issue, we examine the steps you should take to ensure your computer software and hardware will work in the year 2000. Next month, we’ll take a look at medical equipment and supplies, and what other practices are doing to prepare for the millennium.)
If your practice hasn’t started a year 2000 (Y2K) review of all its computer hardware and software applications, you should begin immediately. Otherwise, when Jan. 1, 2000, rolls around, your information systems may fail, leaving your practice unable to check patient records, schedule appointments, pay staff, or submit bills to third-party payers.
Donald J. Palmisano, MD, JD, a member of the American Medical Association Board of Trustees, addressed a U.S. Senate committee on the Y2K problem last year. "The year 2000 will affect virtually all aspects of physicians’ practices," Palmisano said. "The medical profession and health care industry in general rely on information technology for a broad spectrum of services and products, from electronic data interchange for patient records, medical research, and billing, to medical devices in the surgical theater."
The Y2K problem arose because most computer hardware and software use a six-digit field for dates, with the "19" in the year being assumed, such as 12/25/99. When the year 2000 rolls around, it is possible 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 on Sept. 9, 1999 (9/9/99).
"No one should believe that they are immune from dealing with Y2K issues, or that there is a quick fix. It is taking a significant risk to try to correct the problems in the last six months of the year," advises Malcolm Morrison, PhD, president of Morrison Informatics, a health care information systems consulting firm in Mechanicsburg, PA.
Morrison advises looking at the Y2K problem as an opportunity to review all of your computer systems and products. You should 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 may need to update your computer systems in the future to deal with electronic data transmission to payers, now is the time to do it, he adds.
"In the future, virtually all reimbursement is going to be done electronically. Managed care will still accept pieces of paper today, but HCFA [the federal Health Care Financing Administration] has stated its intention to get away from paper entirely," Morrison says.
Most IBM-compatible PCs with 286, 386, and 486 microprocessors will have operating problems in the year 2000, Morrison says. Information technology personnel may be able to correct the problem on computers with 486 processors, but it may not be advisable to do so, he adds.
"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.
Most Pentium-type systems are Y2K-compliant, but you should still check on them, advises Ed Cox of Networked Financial Systems, a Houston-based financial accounting systems consulting firm.
If your office uses just one or two PCs, Cox suggests checking them out yourself with an off-the-shelf software product. (For details on how to check your own computers, see p. 34). If you have a network of personal computers connected together, it would be wise to consult a network engineer or whoever installed your network and have that person or firm check it out, Cox adds.
An information technology specialist should thoroughly correct any computers used as servers or servers that are part of a network system, Morrison adds.
"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 software for clinical, financial, scheduling, and other functions is not Y2K-compliant, Morrison says, adding that most Windows-based software designed in the mid-1990s should be compliant.
Most of the time, your software vendors will be able to tell you if your software is compliant, he notes. Many already have taken steps to notify purchasers of compliance.
In one of the first Y2K class action suits, Tampa, FL-based Medical Manager Corp. has agreed to provide a software patch to make its popular practice management software Y2K-compliant. (See details in next story.)