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How will Y2K hit hospitals?

The Senate committee on the Year 2000 problem holds a hearing to address the bug's impact on the medical industry.

    The Senate subcommittee responsible for addressing the year 2000's impact on computer systems today said the health care industry is not yet ready for the end of the century.

    Industry and government experts demonstrated and discussed medical device failures as a result of the millennium bug, as well as economic hits to hospitals when Y2K failures prevent Medicare and Medicaid payments.

    "If tonight when the clock struck midnight the calendar flipped to December 31, 1999, large portions of the health care system would fail," said Sen. Bob Bennett (R-Utah), chairman of the Senate Committee on the Year 2000 Technology Problem. "There are some six thousand American hospitals, 800,000 doctors, and 50,000 nursing homes, as well as hundreds of biomedical equipment manufacturers and suppliers of blood, pharmaceuticals, linens, bandages, insurance payers, and others that are not yet prepared."

    The hearing is also addressing the health industry's status in preparing its systems for the Year 2000 bug, which experts warn has the potential to destroy systems holding private medical records and payment systems and could impair medical devices used for diagnostic tests, patient monitoring, and life support systems.

    The bug was created by antiquated hardware and software formats that denote years in two-digit formats, such as 98 for 1998 and 99 for 1999. The glitch will occur in 2000, when computers are either fooled into thinking the year is 1900 or interpret the 2000 as a meaningless "00" . The glitch could throw out of whack everything from bank balances to elevator maintenance to building security procedures.

    Senate committee members explained the complexity of health care computer systems and their roles in the industry.

    Virtually every diagnostic and therapy machine is powered by one or more microprocessors. If a patient requires hospitalization, his physician electronically schedules a time-specific hospital admission date, as well as medical orders. The hospital computer then will generate a letter that tells the patient which medically necessary tests will be needed. Every test uses one or more date sensitive microprocessors, which automatically feed biological results into the hospital's computer-based clinical data system.

    This same computer schedules the time, surgical suite location, and staffing for an operation as well as a list of essential medical needs for the surgery, Bennett said. Throughout the operation the patient will be connected to life saving machines--monitors, ventilators, anesthesia control, and infusion pumps--that are microprocessor operated. High technology also follows the patient into the intensive care unit, and even into regular wards, where a computer generates a menu for each patient's meals.

    Bennett warned that the health care industry is lagging behind other industries in making critical Year 2000 fixes, citing the Gartner group, which says more than 90 percent of individual physician practices are not yet aware of their Y2K problems.

    Experts and government officials outlined, for the committee, the extent of the troubles facing the medical insurance industry. If the insurance and Medicare eligibility process cannot function, doctors' offices and hospital admission processes would default to paper. Their daily output is nearly 4 million Medicare claims and approximately 27 million pages of medical records. Thus, defaulting to paper, could create a health care paperwork traffic jam.

    "This could immediately affect a patient's access to quality health care. Concurrently, the nation's 1.6 million providers would have monumental cash flow problems without electronic payment from insurers and Medicare, which accounts for nearly 50 percent of health care payments--almost $1 billion per day," Bennett said.

    Since its inception in April, the Senate committee has built a reputation for not holding back on dark forecasts for should industries and government agencies not cleanse their systems of the Y2K bug. It has also openly criticized those who fall behind in their efforts to deal with the problem. Today was no different.

    "I find it hard to understand why the manufacturers of biomedical devices, represented by the Health Industry Manufacturers Association, have not provided a central clearinghouse for the data that only they possess. The complexity of biomedical products causes me to take the unusual step of publicly requesting the industry to help solve the Y2K problem, which they helped create, and we will hear from them today," Bennett said.

    Speakers at the hearing included senior officials from the Health and Human Services Department, the and Food and Drug Administration, the Health Care Financing Administration, and representatives from the American Hospital Association, the American Medical Association, and the Health Industry Manufacturing Association.

    Health and Human Services has been criticized in the past for its slow efforts to prepare its computer systems for the Year 2000.

    After a detailed survey of its public-owned health service, the British National Health service estimated that it will cost $530 million to fix the Year 2000 bug, a junior health minister told Reuters.