Military Health System Treats Y2K Symptoms
By Douglas J. Gillert
American Forces Press Service
WASHINGTON, Apr. 2, 1999 Newspapers nationwide are reporting severe problems in the medical community with preparing computer systems for the Year 2000 date change. Within DoD Health Affairs, however, the prognosis for Y2K compliance is much brighter.
Still cautious, Military Health System chief information officer James Reardon said the overriding concern is for the health and safety of military patients.
"It's a process of constant refinement," Reardon said. "I think we've mitigated the risk substantially in the last four or five months, and we will continue to stay on top of this right through the first of the year."
The Year 2000 problem, nicknamed "Y2K," refers to a past computer industry practice of writing years with just two digits -- 1999 would be "99." Because of this digital shorthand, on Jan. 1, 2000, some computer systems, software, and certain devices with microchips might treat "00" as "1900" and shut down or malfunction. Affected systems, equipment and devices that recognize the year 2000 are called "compliant."
That DoD medics are out front in curing Y2K ills is in large part due to aggressive timelines the department established for all DoD organizations. Those timelines required Y2K compliance of all mission-critical systems by Dec. 31, 1998, and compliance of all other systems by March 31,1999, or timelines and plans to attain compliance shortly thereafter.
To meet these deadlines, Health Affairs sought compliance in four areas: information systems, biomedical equipment, facilities infrastructure and TRICARE contractors' systems. The Military Health System identified 12 systems as mission-critical.
"We determined that a system was mission-critical if it has a direct impact on the delivery of health care," Reardon explained. For example, doctors, nurses and administrators use the Composite Health Care System to admit patients and render care. So the computer system was deemed critical, as were the Defense Blood Standard System and other systems that "we take to war," Reardon said.
This category also includes pharmacies, the most heavily used medical benefit. Reardon said all systems used to process and fill prescriptions are Y2K-compliant, and DoD is working with vendors and contractors to make sure medications are available to patients when they need them.
All 12 mission-critical systems met the DoD deadline for Y2K compliance.
The medics test their systems by turning the dates forward and making sure they work. "We then bring in a contractor to independently validate and verify that the systems are, indeed, Y2K-compliant," Reardon said. Then follows the integrated, end- to-end testing directed for all DoD mission-critical systems.
Beginning in April, Health Affairs will test its mission- critical systems in a laboratory environment. They'll be connected to their interfacing systems, the managed-care-support contractors' systems and the Defense Enrollment and Eligibility Reporting System to ensure they can operate together.
"We will test all those systems together," Reardon said. "Although all the pieces today may be Y2K-compliant, we want to make sure as we look at the actual flow of data between the systems that it doesn't somehow disrupt operations."
With its mission-critical systems individually ready for the Year 2000 changeover and integrated testing of the systems scheduled, the Military Health System is now wrapping up preparation of its noncritical systems. "Our objective and the DoD directive is to ensure that all of those systems are Year 2000-compliant by March 31," Reardon said. He said he was confident 85 percent of the systems would be compliant on time, with only five or six systems still needing work beyond March.
Other Y2K nonmission-critical components include biomedical equipment, items ranging from CAT scan and magnetic resonance imaging equipment to laboratory instruments with imbedded chips. Hospitals and clinics are filled with this type of equipment, and in each facility, a biomedical engineer has to determine if the equipment has a chip and, if so, whether the chip has a date-related function.
The biomedical engineers contacted manufacturers to find out if their equipment was compliant or needed updates. More than 98 percent of biomedical equipment within DoD now is Y2K-compliant, Reardon said. In cases where manufacturers can neither confirm compliance nor provide updates, their equipment will be removed from service and replaced with compliant equipment, he said.
As it did with its mission-critical systems, Health Affairs sought outside verification that biomedical equipment is ready for Jan. 1, 2000. A contract with Emergency Care Research Institute, an independent biomedical equipment underwriter, will cover further testing. ECRI will look at how the manufacturers tested their equipment and verify that it is, indeed, compliant.
At hospital and clinic levels, both Health Affairs inspectors and base engineers are scrutinizing elevators, heating and ventilation, fire suppression and other infrastructure systems. Each service medical department also has a project officer responsible for ensuring Y2K compliance at all facilities. These officers periodically report progress to Reardon.
"We got a report a week and a half ago, and essentially what they told us is that the large portion of infrastructure systems are Y2K-compliant," Reardon said. "These project managers know which ones aren't ready and have dates and a plan for achieving total Y2K compliance."
Most of the managed-care-support contractors who deliver health care off base to DoD beneficiaries have reported their systems are compliant. Health Affairs is validating those claims with end-to-end testing.
Health Affairs is particularly concerned about its ability to process claims. It has met frequently with Palmetto Government Benefit Administration and Wisconsin Physician Services, the two claims contractors, and it plans to include claims processing in the end-to-end testing beginning in April.
"We're going to track patients through the entire process -- enrolling in TRICARE, getting appointments, being treated and discharged and getting prescriptions filled -- and then also on the other end of it to make certain they're able to process claims," Reardon said. "The contractors have been very interested in working with us collaboratively on this project."
Like any other defense agency, the Military Health System relies heavily on local area networks to flow information among its facilities. The health system comprises more than 500 separate facilities, from hospitals and clinics to research institutes and medical headquarters. If the wires and data communication pipes connecting those systems aren't Y2K-compliant, they could create serious problems for the health care deliverers.
"Over the last 12 months, we've been ordering the components we needed to bring all these networks up to Y2K compliance," Reardon said. It's a good thing, because lately a lot of private sector hospitals have begun scrambling to solve their own Y2K problems. "I'm glad we got it done early, because we don't want to be in there with the rest of the nation trying to get these components, now."
Throughout 1999, DoD will exercise every hospital and clinic to be as sure as possible they have achieved Y2K compliance or have backup plans in case of a systemic failure. The results of the exercises will be reported back to Health Affairs. "We'll meet to review what those results are and see if there are some lessons or findings that we can push back to our hospital commanders," Reardon said.
In the fall, Health Affairs will establish a tri-service situational awareness center that will respond rapidly to help resolve any Y2K issues that may surface anywhere throughout the Military Health System.
Related Site of Interest: Military Health System Year 2000 Integrated Product Team. [site no longer available]