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Before you see Smoke

October 1, 1998
by Alan Joch
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Every day that Marie Palladino works to prepare Deaconess Hospital for the year 2000, the problem appears to keep growing. One of her first steps after becoming Y2K coordinator last year was to conduct an equipment audit to identify all the electronic systems that potentially could greet the millennium with the equivalent of a cyber hangover. She passed out questionnaires to the Evansville, Ind., hospital staff but received only a headcount of PCs. "We made an assumption that end users knew more than they did," Palladino recalls. "They never looked at the biomed equipment or the network infrastructure, or anything else ’invisible.’" So Palladino walked through each department and noted each defibrillator, telephone, fax machine, network server, lighting system and security alarm. "The more I looked, the bigger the problem became," she says.

Then Palladino, an information services nurse analyst, tested an IV pump by setting its internal clock ahead to a date in 2000. Not only wasn’t it programmed to identify the millennium, the fact that 2000 is also a leap year totally jangled the pump’s silicon nerves. "It wouldn’t even let us go back to the present date, so we had to send it to the vendor to be fixed," Palladino sighs.

Deaconess is not alone in tripping over digital "gotchas." Y2K experts say pitfalls are the norm in any millennium preparedness effort. In fact, Deaconess is way ahead in the Y2K game compared with most healthcare organizations. Hospitals rank at the bottom of the list, along with cash-strapped educational institutions, as the least mobilized industry sector for addressing year 2000 problems, according to Lou Marcoccio, the Y2K research director for consultant GartnerGroup. He spends his days checking how well 15,000 companies in a variety of industries are faring with millennium projects. The prognosis for healthcare, he says, is grim. Few hospitals have created a detailed plan to attack the threat or actually fix code, he says. "Healthcare has been too slow, too late and too optimistic about Y2K," adds Jim Woodward, senior vice president of IS consultant CAP Gemini America, Iselin, N.J.

With slightly more than 15 months to go, that means ground zero for millennium crashes will likely be in healthcare’s biomedical equipment and computerized business systems. Experts agree that if you’re still working on millennium fixes, or worse, haven’t begun, IS triage may be mandatory: Focus on fixing critical systems because you may not have time to fix everything else in time.

Digital ’oops’
The millennium problem began, of course, decades ago when computer programmers started using two-digit shorthand to represent years. Thus, 1960 became "60" and 1998 became "98" so precious computer memory wasn’t wasted on extraneous information like the assumed "19."

Sometime around 1970, banks that sold 30-year mortgages became the first to say "Oops." Computers spit back mortgage applications that terminated in 2000 because the little cyber neurons assumed "00" was ancient history. From there, a succession of industries, ranging from insurers with multi-year policies, to brokerages selling long-term bonds, replaced or updated their computer systems to bring them into the 21st century.

Healthcare’s reach didn’t stretch so far into the future, so rewriting business and clinical applications wasn’t a priority until recently. That let the industry focus its IS efforts on modernization rather than reconfiguration. It also helped hospitals ignore the problem until the last minute.

Inaction may have even seemed prudent. After all, if other industries and hired-gun programmers learned time-saving tricks for fixing Y2K, the ramp-up time for latecomers like healthcare should be shorter. Unfortunately, hospital electronics are uniquely complex and the consequences of a missed med or a faulty pacemaker are far more dire than a checking account that doesn’t balance. Secondly, finding available Y2K experts to help your makeover efforts now may be like trying to find a competent accountant on April 14.

The result: Because IS departments face a "hard" deadline that can’t be rolled back, many healthcare companies are already close to being too late, says Woodward. Some hospitals have lulled themselves with rationalizations like "Technology is changing so rapidly, our stuff is probably Y2K compliant." Or, "Hardware and software vendors will help us fix the problem before it’s too late."

"These are blind views," Palladino asserts, after spending the last seven months uncovering plenty of systems that aren’t Y2K compliant and speaking with vendors who have yet to test their computer and software products--let alone figure out how to bring them up to date.

Other hospitals fully understand Y2K consequences, but find themselves strapped for resources. Most IS funds go to new systems that can deliver financial efficiencies necessary in a hotly competitive marketplace. Even with that, IS’s slice of the pie is tiny. The average IS expenditures across all industries is 6-8 percent of net operating revenue, according to Marcoccio. However, U.S. healthcare only spends about 2-3 percent for information technologies. So because millions of dollars and programming hours devoted to millennium problems won’t result in new system features or efficiencies, many IS departments face pressure from the top to devote only a minimal level of resources, Woodward observes.