Only 30% of the nation's hospitals have devised a strategy to make information systems fit to handle dates in the year 2000 and beyond, according to a new survey.
Computer experts warn healthcare executives they will be facing the fallout of millennium-related glitches well before the year 2000 as longer-range clinical and business regimens cross the calendar line.
But according to the survey, more than 40% of respondents are projecting they won't finish their fixes until 1999 or later. What's more, nearly 20% have no plans to address the problem.
The state of preparedness for date-related computations into the next century was a focus of the third annual healthcare technology survey conducted by Gordon & Glickson, a Chicago-based law firm specializing in information and communications technologies.
The survey, conducted from Oct. 16 to Dec. 1, 1996, netted 146 responses, or a 9% response rate from a mailing list of 1,700 hospital executives nationwide. Results were released late last month.
Computer systems and computer-assisted devices at hospitals affix dates on a wide range of electronic data, from patient diagnostic tests to inventories of drugs. A significant percentage of dates are computed by subtracting an original calendar date from the current date.
But in those dates, the years are represented only by their last two digits in much of the computerization upon which hospitals depend. That computation will go haywire when the calendar is reset to 00, the way computers will see 2000.
Healthcare information systems companies and consultants are warning that it could take hospitals two years or more to investigate the maze of computer technology for faulty formulas, acquire the products and expertise to fix them, and fully test the results (Feb. 17, p. 98).
But only 10% of respondents had started on a plan to solve the problem before 1996. Another 16% had joined them by the end of that year. So as of the beginning of 1997, three of every four hospitals surveyed were yet to start.
A burst of action is projected this year (See chart, p. 50), but 25% don't plan to launch a corrective action until 1998 or later, and nearly 20% don't plan to launch one at all.
Hospitals that fritter away the time and start experiencing date-related complications are risking legal consequences, both from the mishandling of their fiduciary responsibilities and from exposure to malpractice, said Diana McKenzie, a partner at Gordon & Glickson.
At the least, caregivers can order the wrong drug or the wrong treatment for a patient based on a mistaken age. Crucial medication may be withheld even though it's available because a computer incorrectly declared the supply too old to use.
A computer crisis that results from date confusion could make patient histories inaccessible in an emergency involving, for example, a longtime diabetes patient with a separate acute problem, McKenzie said.
A decision could be made that harms rather than helps a diabetic patient, even though the hospital treated the patient for years and has a lengthy record on file.
If a lawyer can show that the patient's history was kept from physicians because of computer problems that could have been resolved well in advance, "it's not a good day in the courtroom for something like that," she said.
Well before it begins to affect acute care, the century-date glitch could put a hospital in a revenue bind by complicating efforts to schedule long-term cancer treatment or other chronic-care tests and therapy, she added. And obstetrics operations will start running into trouble sometime in March 1999.
The price of waiting to correct the problem already is climbing. With every new contract signed by firms in the business of solving century-date problems, "the price is going up astronomically," McKenzie said.
Increases of 15% to 20% for the same services are not uncommon every six months, and contractors aren't guaranteeing fees for any longer than that. Demand-fed prices "are going up so fast that even they can't predict what it will cost," McKenzie said.
Gordon & Glickson currently represents "about a half-dozen" such firms, she said.
The cost is becoming so significant in other industries that accounting standards are treating it as a material fact on a balance sheet that has to be noted to protect against a shareholder suit, McKenzie said.
Some industries are forcing companies to build a cushion into their timetable for making computer systems century-ready. For example, the Federal Financial Institutions Examination Counsel has mandated that all corrections be in place by Dec. 31, 1998, allowing a full year for testing and tinkering.