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| Y2K EMERGENCY | |
 August 5, 1999  | |
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ELIZABETH FARNSWORTH: The latest white House report on the year 2000 technology problem was released today. It said there would definitely not be a national catastrophe on January 1, but there are potential trouble spots in the healthcare industry. Tom Bearden reports. TOM BEARDEN: This is the neonatal intensive care unit at the medical college of Georgia in Augusta. Nowhere is it more evident than here how dependent the healthcare industry has become on computer technology. BARBARA MEEKS, Medical College of Georgia: Did he just get the ventilator off yesterday, or today? SPOKESPERSON: Yesterday. TOM BEARDEN: Barbara Meeks is director of inpatient care. She's concerned about Y2K, the popular acronym for the inability of some computer software and hardware to recognize dates beyond the year 1999. Most of the devices in this ICU have embedded microchips that could potentially stop working properly when the century turns. BARBARA MEEKS: In all of our intensive care units, we're very concerned about the patients that will be here prior to New Year's Eve, because they have the majority of the technological needs that -- and equipment on, that we're utilizing with them for their patient care that have the microchip in there that could be impacted by Y2K -- particularly our ventilator, that help the -- in this unit, the little babies breathe, and these babies are very sensitive to their respiratory status. We've been contacting all our vendors for all of our different equipment to make sure that everything is Y2K compliant. TOM BEARDEN: But even after three years and $20 million, there are still non-complaint devices in the hospital, like this $24,000 bedside monitor. Jim Young is director of the college's biomedical engineering department. JIM YOUNG, Medical College of Georgia: Because when you advance the date from 1999 to year 2000 it defaults back to 1980. I can show you that. There's the July 21, 1999, and when you increase the date, it goes to 1980. TOM BEARDEN: If it isn't fixed, the monitor will record false data. The hospital will install a free, upgraded microchip before the end of the year, but other biomedical devices couldn't be fixed and had to be replaced. For example, modern intravenous pumps use microchips to meter dosages, and some models would simply stop working when the date rolls over to 2000. JIM YOUNG: This particular device -- which delivers IV fluids -- has a program in it for calculating drug dose. In that calculation you have to enter the patient's age. And certainly when you want to enter age, it includes a month, date and a year. And with the millennium bug, if you don't have a four-digit number, if it rolls over to 00, you have no way of knowing whether it's the year 2000 or 1900. TOM BEARDEN: So it would throw the device haywire in terms of trying to calculate what the correct dosage would be? JIM YOUNG: It would not calculate it. TOM BEARDEN: As a result, the hospital had to replace all 525 of the $1,200 devices with new leased units. DWAIN SHAW, Medical College of Georgia: What this represents - TOM BEARDEN: Dwain Shaw heads the hospital's Y2K task force. He says there were literally thousands of such devices to be considered. DWAIN SHAW: I guess everybody seems to think that Y2K is a computer problem. And if that's all it was, if that's all I had to worry about, we could have solved this problem in six months time. But it's not. It involves everything that has a computer chip embedded in it, everything that is date-dependent from a computer or an automated standpoint. So the magnitude of it becomes one that is so overwhelming that even today, I mean, five months away from the actual event itself, I still don't think people fully recognize how big the problem is, and what the impact left unattended could potentially be. TOM BEARDEN: Hospitals all over the country are facing a similar challenge, and few of them are as far along as the Medical College of Georgia. The reason it's taken so long and so much money to deal with Y2K is the fact that computers control critical functions all through a modern hospital -- from patient records and billing, to running the elevators and heating systems. They even deliver medicine. Dr. Rusty May runs the hospital's highly automated pharmacy. DR. RUSTY MAY, Medical College of Georgia: This is our picsus machine. It's kind of the brains of --and it's connected to all the nursing units where they have similar cabinets to these. What happens is the physician writes an order, we enter that in our computer system, check for allergies, drug interactions, appropriateness of dose, and once it's in the system, that computer talks to this computer and tells it that it's okay for the nurse to receive the drug. So the nurse will walk up into her unit, type in the patient's name, decide on the drug she wants and a drawer pops open and gives her access to that particular medication. It keeps a perpetual inventory, it bills at that time, and all that's an automated system which -- which we have to think through manual systems to handle all those, all those operations. TOM BEARDEN: What that means is staffers will have to fill out reams of paper for prescriptions, claim forms by the thousands, procedures that will take many more people and take far longer to complete. Not every healthcare provider has the resources available to institutions like the Medical College of Georgia. Rural clinics are believed to be the least prepared for Y2K. Janet Lasick is C.E.O. of Northeastern Rural Health Clinics in Lassen County, California. She says the clinics can't fall back on manual record and billing systems. JANET LASICK, Northeastern Rural Health Clinics: With the volume of patient visits that we do, it's really not possible any longer to type all of these claims and send them out. And then when we did get paid, we wouldn't have a system to enter them into, so - TOM BEARDEN: What consequences would there be? JANET LASICK: In my mind, the consequences would be that the clinic would have to close. We don't have enough in reserves to keep operating. If you can't bill for your services, then there isn't any way to stay in business. That's where the revenue comes from. CHILD: That tickles. HEALTH CARE PROVIDER: That tickles? CHILD: Mm-hmm. TOM BEARDEN: Lasick says if the clinics close, people here would be forced to go to far more expensive hospital emergency rooms, or travel up to 100 miles for alternative care. She says the State of California has been pressuring clinics to upgrade their computer systems, but has offered little financial assistance. Lasick believes that puts the more than 2 million Californians served by 515 community clinics at serious risk. JANET LASICK: This isn't just a couple of clinics that have this problem. This is an industry-wide problem, and they're just now getting to it. But this is now the second half of 1999, and if you haven't really made arrangements so far to take care of this and at least gotten a date to have your upgrade done, you're really behind the eight ball, and it may be likely that you will not have it done this year. TOM BEARDEN: The Lassen County Clinic has scheduled an upgrade for its computer system, but has to raise $80,000 to pay for it first. Big city hospitals that serve the medically indigent are also worried about getting paid for their services. 90 percent of all billing for federal programs such as Medicare and Medicaid claims is done electronically. Washington says the government's computer systems are fine. But the Medicaid program for the poor is administered by states and sometimes even by counties. A General Accounting Office study indicates that serious Y2K problems at that level may prevent providers from being compensated for Medicaid patients. For most hospitals, the single biggest Y2K fear is something they can't control-- a utility failure. Most hospitals have backup generators, but can't cope for more than a few days if the water supply fails. MARY ELLIMAN: Just a quick suction, and then we're going to go right back outside, I promise. TOM BEARDEN: Such failures would have even more impact on what some hospital administrators refer to as the hidden vulnerable population, people like Mac Elliman. The 13-year-old has Muscular Dystrophy, and he's dependent on several medical devices installed in his home in the Denver suburb of Englewood, Colorado. Mac's mother, Mary, says the devices are critical to keeping him alive. MARY ELLIMAN: That's the suction machine that stays stationary and that obviously is plugged in. And that's his ventilator that he is on at night. That has something that is called an oxygen concentrator and a compressor, which is in the other room, that both run off electricity. That's his oxygen tank that we use when he's in bed and also that we use to fill the portable that he's got. TOM BEARDEN: No one really knows how many people receive health care at home or in nursing homes that don't have backup generators. So a consortium of Colorado hospitals is taking a census of how many people like Mac Elliman might be forced to show up on their doorsteps because of power or computer chip failures. Other regions have yet to take such extensive precautions. HEALTH CARE WORKER: We would go back to a manual system. We would take the blood pressures, record them every few minutes -- TOM BEARDEN: As the clock ticks down to the new century, medical groups and organizations are preparing as best they can. Georgia Medicals Chief Operating Officer, Richard Bias, says there's nothing to fear if adequate precautions have been taken. TOM BEARDEN: A lot of people are wondering, what's exactly going to happen to hospitals on December 31. Are people going to die because of this? RICHARD BIAS, Medical College of Georgia: I'm very comfortable that there's an extensive level of preparation. I can't speak to the work that's been done elsewhere, but knowing that this is doable, I see no reason for anybody to expect that kind of problem or to be fearful. TOM BEARDEN: But Georgia Medical's Dwain Shaw is the first to admit that the medical community won't know if they've thought of everything until midnight, December 31st. TOM BEARDEN: How do you know there's something out there you didn't think of? DWAIN SHAW: I would never even take that bet, because I know there's something out there that we didn't think of, and it's not going to be because we didn't try our dead level best, the thousands, hundreds of thousands, of millions of people. There is something that's going to fail. I don't think it's going to be a catastrophic failure, but something will fail. TOM BEARDEN: And that means that many of the nation's health care workers will be celebrating the dawn of the new millennium on the job, standing by for the unexpected. |
