American College of Physicians: Internal Medicine — Doctors for Adults ®


Will the Y2K bug force you to replace your computer?

Tips to determine how the year 2000 problem will affect your practice's ability to conduct business

From the March 1999 ACP-ASIM Observer, copyright 1999 by the American College of Physicians-American Society of Internal Medicine.

By Carl Cunningham, MBA

If you haven't prepared your practice to handle the year 2000 computer problem, you now have two things to worry about: not only is there a chance that you have to replace, rather than fix, your computer system, but time to do so is running out.

While the problem, frequently referred to as the Y2K or millennium bug, is expected to affect computing devices throughout health care, it will hit physicians the hardest by crippling practice management software. If you think that the worst thing the Y2K bug can do is cause your bills to go out misprinted "Jan. 1, 1900" instead of "Jan. 1, 2000," think again. Experts say that when a computer reads "1/1/00" as "Jan. 1, 1900," it could get confused, shut down and possibly even refuse to reboot.

At that point, with no access to your accounts receivable, how will you bill your patients and third- party payers, or even know which payers owe you? Without access to patient schedules, how will you know which patients are coming to see you the next day and what slots are available for future scheduling? Obviously, your cash flow and office operations could be seriously disrupted.

If you don't already know whether your existing practice management system can be made Y2K compliant, call your vendor. If you have minimized your practice's expenses by retaining an older computer system and/or by deferring the purchase of software upgrades, your system may not be Y2K compliant. Recognize that as late as 1997, a number of vendors were still selling expensive software that was not Y2K compliant. Physicians have taken at least two of these vendors to court to address the problem.

If your vendor can supply you with a "patch" to fix the Y2K problem, order one right away. Backlogs for these retrofits could develop by midyear as practices rush to get them. Some vendors are exploiting this situation by charging thousands of dollars for Y2K compliance packages. Worse yet, there may not be Y2K compliance retrofits available for many older systems, whose original developers have gone out of business or been acquired by large national firms that don't want to support older products.

If you own one of these phased-out "legacy" systems, you may have to replace your hardware as well as your practice management software. Even if you can fix your existing system, it may be more cost effective to buy a modern system that gives you greater functionality.

Unfortunately, time is quickly running out to make such a complex purchase. With literally hundreds of systems to choose from and a flood of end-of-the-millennium orders, it will probably take longer than the usual six to nine months to select and install a new computer system. As a result, the longer you wait to start the selection process, the greater the risk that the vendor you pick will be too busy to install your system before Jan. 1, 2000. Some analysts predict that backlogs for new systems will start to develop this spring, so you should start your search immediately.

Smaller practices may be able to opt for "off-the-shelf" products that you can use to replace your existing system. These low-end products typically sell for less than $2,000, but they offer only bare-bones features and very basic billing and scheduling functions. That may be enough for small practices, however. These products may also prove to be the best—or only—option if vendors of high-end products can't deliver before Jan. 1, 2000.

The College can also help. Over the last year, articles about how to cope with the Y2K problem have appeared in both the ACP-ASIM Observer and Today's Internist, and another comprehensive article is planned for the next issue of ACP-ASIM Observer. (Go to ACP-ASIM Online at for back articles from either publication.) In addition, the College's Center for a Competitive Advantage has developed an information packet, "Selecting a Software System," which is available on the College's Web site and through ACP-ASIM Customer Service (800-523-1546, ext. 2600, or 215-351-2600, 9 a.m. to 5 p.m., EST).

The College is also developing new guides, checklists and scorecards to help members evaluate, compare and select Y2K-compliant practice management and electronic medical records software. Look for these and other tools on ACP-ASIM Online in the "Computers in Medicine" section. Finally, members can call the College's Medical Informatics Department (800-523-1546, ext. 2572) for more information about Y2K compliance issues and the Center for a Competitive Advantage (800-338-2746, ext. 4553) for information about purchasing a computer system.

Carl Cunningham, MBA, is Director of the College's Center for a Competitive Advantage.

Government to doctors: time to get office systems Y2K compliant

The federal government is turning up the heat to encourage physicians to make their office systems Y2K compliant.

As part of its Y2K efforts, HCFA has instructed its Medicare carriers to reject electronic claims that do not use a four-digit number to indicate the year beginning April 5, 1999. In a Jan. 13 letter, HCFA directed its carriers to return to provide claims that use the older two-digit format. Computer systems can misunderstand two-digit dates on claims that describe years beyond 1999; that confusion is the heart of the Y2K problem.

Based on its current experience, HCFA believes that the restriction will immediately affect only a small percentage of Part B claims. Many physicians submit their claims through clearinghouses or other electronic intermediaries, which already correct date formats. College officials are concerned, however, that physicians getting help from these services may mistakenly believe that their systems are Y2K compliant because HCFA and other payers are able to process their claims. The problem is that these services will be unable to work with physicians using non-Y2K compliant systems starting Jan. 1, 2000.

HCFA had previously said that it would require claims to be Y2K compliant by Jan. 1 of this year but then extended its deadline to give providers more time to prepare. For more information about the change, contact your Medicare carrier.

In another year 2000 development, the government will hold its second "Y2K Action Week" March 28 through April 3. The goal of the event is to raise public awareness about Y2K issues and to alert community organizations to prepare their systems for the new millennium.

The week will focus attention on institutions and organizations in 25 different business sectors ranging from banking to food service to health care. During the week, members of the press in local communities are expected to talk to members of these industries, including physicians, about their plans for dealing with Y2K issues.

HCFA officials are encouraging physicians to prepare to answer questions that reporters and patients may ask. Officials say that physicians should be able to answer detailed questions about how they have prepared their office systems—including computerized records systems, billing systems and appointment scheduling systems—to handle year 2000 problems.

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