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Year 2000 problem: a medical menace
Hospitals working to make sure life-saving equipment won't go haywire
By Joe Manning
of the Journal Sentinel staff
July 28, 1998
It's one minute to midnight on New Year's Eve 1999, and you're in a hospital, attached to a ventilator. You think you have problems? Brother, you're just getting started.
Next thing you know, your life support shuts down, your spouse gets trapped between floors in a hospital elevator and your credit rating takes a major hit because a computer says you haven't paid your 100-year-old hospital bills.
Farfetched? Maybe not.
Thanks to the year 2000 bug, hospitals everywhere are faced with the possibility that any computerized machinery or any software will be about as useful as a pumpkin at that moment because of its failure to distinguish between the years 2000 and 1900.
And while the bug affects almost all businesses and institutions, the stakes are much higher in hospitals, where glitches could cost someone's life.
"That New Year's Eve will be different than any other. We won't be celebrating until just a little bit past midnight," said John Schwarz, director of the year 2000 project for the Milwaukee-based Aurora Health Care system.
Instead of "kissing our partners" as the new year dawns, Schwarz said, staff members will be holding their breath.
"Hospitals are very concerned that medical devices are still working when the clock strikes midnight," said Bill Bazan, vice president of the Wisconsin Health and Hospital Association.
"This is a major challenge. It's a crisis," Bazan said, adding that all the hospitals in the state have been working feverishly on the problem.
The problem was caused years ago when programmers, in order to save space when writing programs, used only the last two digits to note a year. Thus, 1969 became "69." That doesn't work after the first two digits have to change, and there are fears that computers that haven't been upgraded might read "00" as 1900, not 2000.
Most computers will crash if they do not have what they interpret to be correct dates, said Timothy Longden, who is in charge of the Medical College of Wisconsin's efforts to correct the problem.
The price of this little menace will be in the many millions. Waukesha Memorial Hospital alone is spending $3.5 million, and Froedtert Memorial Lutheran Hospital in Wauwatosa has budgeted $10 million.
The Association of American Medical Colleges has urged hospitals to confront the problem soon because of the "potentially disastrous ramifications for patient care."
One of the problems that can develop involves medical devices with maintenance chips inside. The machines' chips may assume they have not been maintained in 100 years and shut down. The same goes with elevators, parking-lot gates, heating and cooling systems, telecommunications, and thousands of other items.
Embedded computer chips could print out incorrect dates on X-ray and ultrasound scans, confounding patient records, which could also end up hopelessly lost when dates past 1999 mean nothing to a computer.
In addition, hospitals fear their own lifeblood -- money -- may suddenly be in short supply because of the problem.
Health insurance companies and the federal government's Medicare program "may not be making timely payments" on patients' bills because of their own computer glitches, said Rod Dykehouse, in charge of solving year 2000 computer problems for Froedtert.
That can severely cut into a hospital's cash flow, he said, resulting in patients being billed for thousands of dollars.
Efforts by hospitals to find potentially malfunctioning chips will increase dramatically as this year draws to a close, Schwarz said.
"We hope to be done in early 1999 or late 1998. Then we will test and overtest and go over things so we will be very comfortable when that midnight comes," Schwarz said.
Dykehouse, vice president of information systems and chief information officer at Froedtert, said Froedtert is devoting 50 people to the project.
"We are making sure that when the year 2000 comes, our systems will not fail and patients will not suffer because a defibrillator is not functioning properly or a monitor fails. No interruption in patient care is our objective," Dykehouse said. "Anything with a computer chip we need to take a look at."
Dykehouse said Froedtert, a large but not untypical hospital, has 28,000 items to examine and test. There are 7,800 computerized machines used in patient care. Hundreds of devices already have been found to be unready, he said.
Equipment that cannot be reprogrammed will be replaced, he said.
To test the equipment, dates beyond 2000 are plugged in to see whether the devices still function. "We have been working on this for nine months," he said.
Froedtert and other hospitals are putting together plans in case they lose a major system as the double zeros roll in, he said.
"This is a major initiative for us. We have turned over the vast majority of the rocks. There still may be a few minor surprises," Dykehouse said.
"Nobody really knows what the impact will be. We are trying to keep problems away from patients. The last thing they should be concerned about is a technological problem," he said.
Health care device manufacturers are working with hospitals to help correct the problems, Dykehouse said.
Waukesha-based GE Medical Systems, a manufacturer of diagnostic imaging equipment, has been providing software updates at no charge on newer machines. For older machines, the company is offering "a software solution or functional work-around" for free, a company spokeswoman said.
"We are going to make sure things don't shut down," said Carl Budde, vice president of facilities management at Waukesha Memorial Hospital. "We may have to replace more than chips. We may have to replace whole equipment."
"We are going to spend millions," Aurora's Schwarz said. "We are taking this very seriously.
"Patients should be assured they will be fine. We are working our butts off. No one knows for sure what will happen. If there are any failures, they will be at the lower end of mission-critical. We will have our stuff in order. We have to have a contingency plan in case things fail."