Barach P. THE IMPACT OF THE YEAR 2000 ON PHYSICIANS. JAMA. 1999;281(9):862C. doi:10.1001/jama.281.9.862
Prepared by Ashish Bajaj, Department of Resident and
Fellow Services, American Medical Association.
Modern medicine would not have been possible without the 20th-century
technological revolution. It is ironic, therefore, that this technology
may pose significant problems to patients by the end of this year. The
year 2000 problem (Y2K, as it is called) exists because mainframe
computer programs were originally created to read only the last 2
digits of the year field in data, the first 2 digits being an implicit
"19." So, when the year 2000 is entered on older software or
systems, it will be read as 1900. This flaw may potentially wipe out
data, prevent computers from starting up, and lead software programs to
make faulty calculations.
Virtually every aspect of the medical profession depends on computer
systems hardware, software, and microchip-embedded medical devices.
Health care professionals rely on these systems to treat patients,
handle data, monitor vital functions, select medications, document
patient care, and handle administrative functions. In medicine, this
problem could have devastating results since it could affect patient
Respirator-dependent patients without adequate respiratory support,
malfunctioning cardiac support balloons in cardiac-crippled patients,
and vital drug pumps going awry are just a few of the examples of the
problems we could face. Other less life-threatening but potentially
serious administrative aspects of Y2K include Medicare coding and
billing. The Health Care Financing Administration just announced that
it will delay implementation of its Medicare voluntary residency
reduction program until it has addressed the Y2K problem.
Medical device manufacturers must immediately disclose whether or not
their products are Y2K compliant. The Food and Drug
Administration has received Y2K compliance information from only 11%
of the 16,000 medical device manufactures worldwide. Assessing
the status of the year 2000 problem is difficult not only because the
inventory of the information systems and equipment that will be
affected is far from complete, but also because the consequences of
noncompliance for each system remain unclear. Most of the organizations
that have thousands of these devices do not have the expertise and
resources to test these devices properly and will have to rely on the
manufacturers for assistance.
In an effort to address this problem, the American Medical
Association has developed a national campaign entitled "Moving
Medicine Into the New Millennium: Meeting the Year 2000 Challenge."
The campaign, which will launch in July, will include educational
seminars and a dedicated Web site. This site will serve as a
communications clearinghouse, providing up-to-date information about
the Y2K bug, as well as recommendations to solve specific problems. In
addition, the National Patient Safety Foundation has made a concerted
effort to increase public awareness of the year 2000 hazards.
What can you as a resident do to raise awareness and prevent patients'
being harmed? Every resident should ask the chief of service and
hospital administration if the medical equipment has been checked for
Y2K failure and, if it has not, seek assurance that there is a
correction plan that will be implemented in the near future. Ensuring
compliance is vital to the health care needs of our patients.