The century-date dilemma is an irresistible force, but in healthcare it's meeting some immovable objectives.
Software vendors already are making product consolidation a prime objective, which results in upheaval and complicates the task of fixing century-date problems.
Another objective is to continually update software already installed. The routine created for those updates can leave customers unable to install important revisions, such as those for century-date problems, if they don't buy every new software release.
The consolidation of smaller or niche information systems companies into larger enterprises strengthens the merged firm's finances and product breadth. In the process, the company may cut loose a number of older or duplicative systems with scores of provider clients.
But that gives the company extra resources to commit to the remaining product lines. And the users of the old products become a prospective base of clients for the new ones the merged company is concentrating on.
Continual innovations in those product lines take shape as regular software updates for existing customers. That keeps the product cutting-edge for clients, as long as they plan-and pay-for a regular schedule of new releases.
The process is similar to what you'd find buying programs for a personal computer: At some point, new releases won't work with a previous version that's too out of date.
For many healthcare organizations, the necessary updates for century-date complications will be dispatched as part of a normal routine of working new releases into the installed systems, say the two largest healthcare software companies: Shared Medical Systems of Malvern, Pa., and HBO & Co. of Atlanta.
But consultants say it's time to check that version number and keep track of the renewal date for software maintenance contracts.
Both SMS and HBO & Co. are readying product-by-product summaries of their progress in making their software "century-ready."
Besides target dates for making the changes in each product, the summaries will designate the version that customers must be operating or must plan to install to incorporate the century-date revisions.
For example, customers of HBO & Co.'s mainframe-based HealthQuest 2000 system will have to be on version 3.0 and stay current with periodic releases, says Michael Kappel, senior vice president for strategic product planning and marketing.
About 45 HealthQuest customers have converted from version 2.0 since the latest version became available in February 1995, says Joseph Ryan, vice president for HBO & Co.'s mainframe-based product lines.
Of the 75 customers remaining, nearly 60 either are using their own staff to make the upgrade or are committed to having HBO & Co. install the upgrade and are being scheduled for it, Ryan says.
HBO & Co. is offering the upgrade at no charge with two stipulations: Customers must purchase a contract for maintenance and future enhancements, and the upgrades only cover conversion of features that customers already have running on their existing system, Kappel says.
Customers that don't have sufficient in-house technical staff likely will purchase a service agreement covering the implementation, data conversion and training costs of upgrading the system and educating both computer pros and the healthcare personnel using the system.
The price of the implementation package ranges from $150,000 to $250,000. It varies according to how equipped providers are to handle some of the work themselves, Ryan says.
Conversions take six months on average, but some can be done in as few as four months and others take much longer. Some systems span only part of the available software range, while others have the full range.
Kappel estimates HBO & Co. can do 40 conversions of full-range systems a year, with an imple-mentation group starting a new job every month and working on as many as four jobs concurrently.
The HealthQuest system is one of HBO & Co.'s original products, dating to before the company went on a buying spree and added many systems that it must now work into its lineup. Decisions on those systems involve upgrades, consolidation of multiple products into a single survivor, or phase-out.
Patient accounting and financial systems acquired from Ibax Healthcare Systems-Series 3000 for smaller hospitals and Series 4000 for mid-size hospitals-are undergoing a combination of all three options.
The company is tying future development to an IBM computer called the AS/400 and consolidating both lines into a successor system for that computer, to be called Series 2000.
For the Series 4000, which already runs on the AS/400, customers need only stay current on software releases, Kappel says. HBO & Co. counts 201 customers for the patient accounting system.
But for the Series 3000, which was written for an older generation of IBM hardware, customers will have to spend up to $150,000 to upgrade hardware and implement new software.
Most of the roughly 150 customers of Series 3000 have changed over to the AS/400, and HBO & Co. says it's not charging existing customers to acquire the Series 2000 as long as they sign up for the maintenance and enhancements. But existing computers may need upgrading to add storage and other capacity, which will cost them about $50,000, Kappel says.
In addition, a fee of $70,000 to $100,000 will be charged for a service package that includes training and software tools to convert databases, he says.
For hospitals without an AS/400 computer handy, add another $100,000 to $250,000 of hardware investment depending on how much processing capacity is required for a particular size of institution, he adds.
Even for customers paying the high-end expense, Kappel says it's "probably cheaper than hiring someone to evaluate where they stand on the year 2000 problem. And then they've turned the risk completely over to us."