Y2k This year, most of the world is preparing to celebrate the year 2000 and the coming of a new millennium. However, many businesses, manufacturers, banks and hospitals are quietly hoping for an uneventful new years transition. At midnight on December 31, many businesses will be anticipating what effects the millennium rollover will have on computer software and other equipment that contain a time sensitive chip called an embedded chip. Early computer programmers, in an effort to conserve limited memory space, programmed computers to read the year in only two digits. So computers read 15 as 1915, and 02 as 1902, and so on.

Thus, when the year 2000 arrives, many computer programs might go from December 31, 1999 to January 1, 1900. Some computers will cease to function, or crash. Needless to say, if these programs control functions such as electricity, airline travel, or communications, the results could be disastrous. Many companies and governments have spent countless hours and untold dollars making software Y2K (year 2 thousand) compatible. The consequences of not preparing for the Y2K problem could spell disaster for the company involved.

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For example, a small Midwestern manufacturer encountered a similar date-related problem in 1996 (a leap year) when the company did not realize that their entire computer network would be affected by the extra day in the year. When the year 1997 turned over, all systems shut down. This malfunction caused the liquid solutions being produced to freeze, causing them to destroy the pipelines they ran through. This disaster cost the company over $1 million in new equipment. The catastrophe caused massive delivery delays to their customers, and the company believes numerous customer accounts were lost as a result. This is just a small example of what could happen when computer software and related equipment is not tested for Y2K compatibility.

Now, imagine the confusion and disaster that could result from a similar incident occurring in a hospital–where lives, not inventory, are at stake. Code Blue 2000 is the term used to describe the possible breakdown of the worlds hospital software and related medical devices. Most hospital organizations have prepared themselves for any problems that might occur with their software and medical equipment. It is the organizations that ignore the potential problem that will most likely loose valuable patient information, and in extreme cases, have their ability to furnish adequate health care reduced. Major Hospital in Shelbyville, Indiana, has a team of computer scientists currently testing the hospitals computer systems software for Y2K compatibility. First, mock systems are tested to determine what will actually happen when the year changes.

Then, obsolete software and equipment is replaced with Y2K compliant equipment. Major Hospital has spent over a half-million dollars on research of the Y2K problem. This research is extremely costly to an organization, but the alternative–ignoring the problem–could be catastrophic. This report will cover the numerous ways the Y2K problem could affect hospitals. The first and most important area that will be reviewed is the manner in which the Y2K problem could affect patients.

The Y2K problem could adversely affect the biomedical devices some patients rely on for life-sustaining purposes. Then, the potential problems on the clerical side of hospital administration will be explored; focusing on patients medical records and accounts. Finally, the possible adverse effects on utilities such as electricity, gas, and water will be discussed. A hospital is a place that a person should feel safe and secure. This report will describe the steps being taken by hospitals to ensure that their patients peace of mind and sense of security is unaltered.

The Y2K problem is a concern for hospitals worldwide for a variety of reasons. Perhaps the most pressing concern are the biomedical devices, which contain computer software, that many patients rely on. Some critical biomedical devices are pacemakers, fetal monitors, Magnetic Resonance Imaging machines (MRIs), and heart defibrillators. One of the most important biomedical devices that could be affected by the Y2K problem is the pacemaker. A pacemaker is a biomedical, electronic device implanted in the wall of the heart designed to detect irregular heartbeats and provide regular, mild, electric shocks that restore normalcy to the heartbeat.

The pacemaker then records the time an electric shock was administered; this information can then be downloaded to a computer system and analyzed by medical personnel. Cardiologists use this information to detect patterns and irregularities in the patients heart rhythms. If the software were to record faulty times for the shock deliveries, the cardiologist could misinterpret the results and administer improper medical care. The results could be deadly for some patients. The Veterans Administration interviewed the top five pacemaker manufacturers to gauge their awareness of the potentially hazardous Y2K problem.

One company said the problem would be corrected by mid-year; two companies stated the problem was already under control; and the final two companies were behind schedule in eradicate the problem. In addition to the pacemaker, there are several other biomedical devices that may contain faulty software. One such type of device is an anesthesia monitor. An anesthesia monitor regulates the anesthesias effect on the patient during surgery. Another critical biomedical device is a fetal monitor.

A fetal monitor helps examine the condition of the baby while it is still being carried by the mother. Incubators, critical to a newborn babys survival, could also be adversely affected by the Y2K problem. Other biomedical devices (and their functions) include MRIs (produce computer-generated views of arteries, nerves, tendons, and tumors), infusion pumps (used in intravenous drips), and heart defibrillators (emergency method of establishing a heartbeat). All of the aforementioned devices contain embedded microchips critical to their functions. There are also intensive care monitors that may not be Y2K compliant; these include heart monitors, blood pressure monitors, and machines that provide additional oxygen and physical support. Finally, dialysis machines (help remove waste from a patients blood) and radiation equipment (x-rays, chemotherapy, etc.) are other critical pieces of medical equipment that could fail if the software controlling their functions is not Y2K compliant. Major Hospital is currently working with all of their medical equipment vendors to ensure that all biomedical devices are Y2K compliant.

We are confident that outstanding patient care will not be interrupted, says Carol Hussman, information systems manager at Major Hospital, and we are about 95 percent finished with all testing. One may think that in this day and age, with all of our technological advancements, that the Y2K problem would not be of concern to even the average computer user with a fairly new system; much less a vital institution such as a hospital where thousands of our loved ones lives hang in the balance. However, this is not the case. There are still hospitals in the United States that are not equipped to deal with the Y2K problem. Moreover, the U.S. is not the only place where the Y2K problem is causing difficulties.

In fact, almost a third of computer-related equipment in Australian hospitals, including cardiac monitors and drug distribution systems, have failed the millennium test. The final aspect of patient care that may be affected is the mental health of the patients. In a crisis situation, patients might panic; hospital staffs will have to be aware of this potential crisis. Major Hospital personnel are aware of this aspect of the Y2K problem and are focused on preventing any software problems that may lead to patient confusion or panic. However, there are no specific strategies in place to handle possible patient disorder, other than by answering patient questions on an individual basis. The Y2K problem is not limited to biomedical devices, however.

This dilemma effects non-medical devices such as the personal computers used in record-keeping and accounting. If the programs that are used are not corrected, many problems could arise. Even though some patient records are kept in paper form as a backup, most patient information, such as test results, medical histories, registration, and insurance information are kept in computer databases. These databases, if left unchecked for the Y2K problem, could malfunction. Patient information is important to physicians and other hospital personnel using the databases.

It is readily available to them at the touch of a keypad. If patient information is inaccurate, it could result in detrimental care or incorrect medication being administered to patients. This dilemma could be solved in one of two ways. One option hospitals have is to put all information on paper, which would be very time consuming and prone to cause errors, or the database systems can be programmed to be Y2K compatible. In order to address the Y2K problem, President Bill Clinton signed into law the Year 2000 Information and Readiness Disclosure Act.

In a statement by the president released by the Office of the Press Secretary of the White House, this law requires the shared necessary information tools needed to overcome the Y2K problem. This will help hospital information systems departments acquire the knowledge necessary to reprogram noncompliant systems. The personal computer problem not only affects the hospital records department, but also the purchasing, billing, and payroll aspects of the accounting department. The purchase of essential medical equipment and supplies could be delayed if clerical software is not brought into Y2K compliance. In addition to President Clinton signing into law requirements that hospitals and other businesses share information to help solve the Y2K problem, The Washington State Health Association (WSHA) also recommends steps for compatibility for insurance billing.

According to Tom Byron, chief information officer of the WSHA, The Washington State Uniform Billing Committee (WSUBC) has adopted multiple resolutions concerning electronic submission of Uniform Billing (UB-92) claims such as, (1) use of the Medical Flat File, Version 5.0, (2) all plans should be ready to accept the recommended format by October 1, 1998, (3) providers should submit claims in the recommended format by January 1, 1999, (4) all plans should allow for a period of October 1, 1998 to March 31, 1999 for providers to submit claims in either the recommended format or the current form …