up for Y2K
Isle facilities have been
working to prevent any harmful
Most susceptibleBy Christine Donnelly
medical areas for Y2K
An ailing man, unable to eat, lies in a hospital bed.
A doctor wants him fed intravenously, punching the order into the hospital's computer system. A microchip linked to the same computer system controls the feeding pump, while recording the patient's identity and when and how much he should be nourished.
Any computer glitch along the way, and the patient could be at risk.
That example, from a recent U.S. Senate committee report, illustrates both the American health-care system's reliance on technology and the massive task it faces in the race to beat the so-called "millennium bug."
The report -- from the Special Committee on the Year 2000 Technology Problem -- cites everything from patient billing systems to life-support systems as being at risk, concluding that nationwide "health-care lags in its progress towards Y2K preparedness."
But Year 2000 coordinators of several local hospitals, as well as a representative of the industry statewide, say the most serious criticism is off base, at least in Hawaii.
"I think it was a good wake-up call to redouble our efforts, to re-examine what we're doing ... but with improvements literally being made every week, it's not asaccurate a snapshot now," said Rich Meiers, president and chief executive officer of the Healthcare Association of Hawaii, which has every Hawaii hospital as a member. Although the report was released this month, the data was gathered during several months prior, he said.
Safety called top priorityMeiers said Hawaii hospitals have spent millions of dollars and been at work more than a year on the problem, which stems from the inability of some computers to comprehend the date 2000. Left uncorrected, systems could crash or spew incorrect data.
Most Hawaii hospitals plan to have all "mission critical" computer systems Y2K-compliant by June 1999, with the rest of the year devoted to follow-up testing.
Patient safety is the paramount concern, and all Y2K coordinators interviewed were confident it would not be compromised. Inconvenience was another matter, however, as several said hospitals or doctors' offices may decide to limit non-urgent visits at the beginning of the year.
"We'll probably modify appointment schedules in the month of January, just to keep our schedules more open in case of any problems," said Bonnie Reilly, Kaiser Permanente's Year 2000 Project coordinator.
Hospitals respondIn addition, several hospitals are limiting staff vacations at the end of 1999 and beginning of 2000.
Although Y2K alarmists urge people to get hard copies of their medical records in case computers crash, Reilly said that is unnecessary because Kaiser already has back-up records.
Hawaii hospitals have a Y2K "users group" where key staff share problems and solutions, reducing the amount of time it takes to solve common problems.
Having been immersed in Y2K-preparedness for over a year as a group member, Reilly said, "I've certainly exposed myself to all the various scenarios, from the worst-case to the best-case, and I think we're going to be OK ... There may be some inconveniences and minor disruptions, but it will not compromise patient care."
Medical technology is involved in virtually every aspect of patient care. Here are a few of the most susceptible areas cited by the report, followed by responses from Hawaii experts.
medical areas for Y2K
BIOMEDICAL DEVICESThey are used in everything from X-rays and magnetic resonance imaging machines to radiation therapy to life-support equipment.
The Senate committee report describes them as "Trojan horses" because many rely on unseen embedded microchips.
Some manufacturers have failed to issue compliance information about their units, the report said, and the health-care industry in general has relied too heavily on makers for information when individuals should be testing the devices themselves.
"If one biomedical device malfunctions, it can potentially shut down an operating room," the report said.
Local response: Y2K coordinators say their institutions are testing, and not just relying on assurances from manufacturers.
For example, Ken Leon, assistant vice president for information services at Kapiolani Health, said 3,000 pieces of critical equipment were identified as having embedded microprocessors "and we are testing every one of them."
Testing is 90 percent complete and less than 1 percent of the devices have failed, he said. Bad chips are replaced before equipment is returned to use.
ELECTRONIC INTERFACESThe sharing of information electronically is "the most prolific and potentially the most likely cause of Y2K failures," the report said.
That's because virtually every step of patient care is computerized -- from admission, to treatment, to billing -- and every link must be Y2K-compliant or the whole system could be at risk.
Local response: Several hospitals are using Y2K as the catalyst for major computer upgrades that will assure accurate communication between systems.
For example, Kuakini Medical Center is replacing two major systems, including one controlling patients' treatment and billing records, said Donda Spiker, director of marketing and public relations.
PRESCRIPTION DRUG SUPPLYAlthough the report said the pharmaceuticals segment is better prepared for Y2K than the rest of the health-care industry, it noted that drug makers rely heavily on foreign suppliers and subsidiaries.
For example, the report said, Denmark produces 70 percent of the world's insulin, critical to the survival of many diabetics.
Local response: Civil Defense guidelines for any disaster planning -- not just Y2K -- include having a four-week supply of prescription medicine.
But Rich Meiers, president and chief executive officer of the Healthcare Association of Hawaii, said if that kind of hoarding occurs nationwide it would create more problems than it averts.
Likewise, he hopes hospitals don't hoard drugs either.
He said there would soon be a national summit of pharmaceutical companies to come up with a plan to ensure a steady prescription drug supply.
People should wait until after that to decide whether to stock up, and by how much, he said.