February 1999 41

Doom! Panic! Withdraw all your money! The en-tire economy will collapse in a matter of months!

The news is full of stories about “experts” who areabandoning jobs for the safety of remote retreatsstocked with necessities to carry them through an ex-pected Armageddon. The problem? January 1, 2000.Not that this date is unexpected; it has just been ig-nored for many years. Until recently, this date for themost part has been the subject of debate amongpurists who insist that the new millennium does notbegin until January 1, 2001. Others believe that thedate 1 year earlier will have most impact around theworld. So what is the truth? Are we headed for disas-ter, or is the situation another overblown media fren-zy fueled by dire predictions of a poorly understoodtechnology glitch? The simple answer is that no onereally knows.

“Y2K,” “The Millennium Bug,” and “The Year 2000Glitch” are all names for the same problem. In the1950s and 1960s, programmers worked with very lim-ited and expensive computer storage and memory. Tosave space, they chose to limit the year date in theirprograms to 2 numbers. The first 2 digits were pre-sumed, because many forms that ask for a year al-ready have “19” printed on them, with space left for aperson to fill in the last 2 digits. For programmers, lim-iting the year date to 2 digits saved literally millions ofdollars and made more complex programs possible.The programmers were not unaware that this tacticwould create a problem when the century changed;they simply did not expect that their code would stillbe in use 30 years later. However, the investment inmillions of lines of code that was working well was notwasted, and the code has been used over and overagain in all types of computers.

What happens when the date actually changes to“00” is not really known. A newborn may be listed as100 years old and receive a Social Security check fromthe government, a tax bill from the IRS, and a 100thyear congratulation card from American Associationof Retired Persons. Your electricity may be cut forhaving a 100-year-old delinquency, or the bill may behundreds of thousands of dollars with interest calcu-lated for all that time it went unpaid. But that is not aproblem, because your bank just credited your smallsavings account with interest accrued over a century.Not that you can get this money, because the bankclosed January 3, 2000 (the first business day of thatfateful year), when people mobbed the bank to with-draw their funds. Fortunately, many persons couldnot reach the bank because their power and waterquit working at midnight 3 days previously and gasstations ran out of fuel 2 days later when the nation-wide fuel distribution system went down. Fantasy?Not entirely. The insidious code is so well imbeddedin the machinery that keeps society moving that pre-dicting what will happen with any degree of certain-ty is truly impossible.

Stay out of troubleThe first thing a nurse may think is that other than afew personal inconveniences, the Y2K bug will not af-fect the medical workplace. For some hospitals, thatbelief may be true. However, even facilities that havebeen working on the solution for 2 or more years willnot be guaranteed that all issues will be resolved by

Brian Duggan is Clinical Operations Manager, Information Ser-vices, Carolinas Health Care System, Charlotte, NC.For reprints, write: Brian Duggan, RN, MSN, 6708 Pleasant Dr,Charlotte, NC 28211.J Emerg Nurs 1999;25:41-2.Copyright © 1999 by the Emergency Nurses Association.0099-1767/99 $8.00 + 0 18/9/96092

InformaticsY2K: What you don’t know CAN hurt youAuthor: Brian Duggan, RN, MSN, Charlotte, NC

Section Editors: Vicky Bradley, RN, MS, and Marsha Zimmerman, RN, MA

Most of the hospital computerprograms can be fixed. Thereal hidden issue is yourelevator, defibrillator, IVpump, and EKG machine.

42 Volume 25, Number 1

the inflexible deadline. Most of the hospital computerprograms can be fixed. The real hidden issue is yourelevator, defibrillator, IV pump, and EKG machine.

These machines, along with many other devicesthroughout the hospital, have chips embedded inthem that manage dates in one way or another. Thedates on these chips are not reprogrammable and arenot easily tested. Some chips that track maintenanceschedules will not operate if the maintenance extendsbeyond a set parameter (100 years would definitelyset off some alarms). Some dates are calculations andthe machine may simply print fictitious dates whenthe year turns into the new century. The biggest dif-ficulty is in preparing for the unknown.

Systems in your facility that may be affectedcould include defibrillators and monitors, telephones,pagers, EMS radios, telemetry, diagnostic equipment,and laboratory systems. Many hospitals are now as-sessing their potential trouble areas. Your hospitalshould be performing such an assessment, or moreprecisely, it should have been doing so for quite sometime. The assessment is laborious, but the remedia-tion will take even more time. In addition, a goodprobability exists that money has not been budgetedfor this type of expense.

Your hospital should be well on its way to man-aging the problem. If work on the problem is not un-derway, ask your Information Services group howthey plan to manage the Y2K bug and offer to helpthem assess the equipment in your emergency de-partment. The hospital Information Services groupshould be contacting computer and software vendorsand asking for written verification that their softwarewill handle the millennium change. The Internet hasmany sites that discuss Y2K issues, as well as the sta-tus of a variety of medical devices; see Table 1 to findout how to access some of these sites.

The assessment must extend beyond the prima-ry areas of your facility’s responsibility. Vendors ofsupplies and services that are timed to arrive just be-

JOURNAL OF EMERGENCY NURSING/Duggan

fore stock runs out may not be able to fulfill deliveriesfor some unknown period of time following the datechange. Every emergency department should prepareto operate without restocking for a month or more.Water and backup electrical sources are critical to theongoing operations of an emergency department.Hospitals should prepare to feed a large number ofpeople (patients, families, and staff) and provide alter-nate means of transportation. Disaster plans shouldbe reviewed and revised to accommodate weakenedwater, electricity, and supply infrastructure. Althoughthe preparations will be expensive, the potential fordisaster is too great not to undertake them.

Will the bug bring down the United States? Prob-ably not; many companies are working feverishly tobe prepared. Unfortunately, even the US governmentmay not make the deadline, and it is preparing plansto continue payments to hospitals if Medicare andMedicaid reimbursement systems do not cross thedate barrier. On a personal note, a cautious personwould stock up on food and water at home—enoughto survive a few weeks if necessary. Disaster, shouldit strike, is unlikely to last beyond that period.

No matter how many preparations a hospitalplans to make, the most dangerous choice is to ignorethe problem. In the past many problems have loomedbut then faded with time. This problem is unique inthat there is no extra time; deadlines cannot be ex-tended. Do not be caught unprepared.

Table 1Y2K Web sites

• www.yahoo.com or www.excite.com (potentialsearch words: Y2K, medical, hospital, emergencydepartment)

• www.mccs.uky.edu/y2k or www.uky.edu/y2k(University of Kentucky Chandler Medical CenterWeb site on Y2K that includes their current list ofaffected equipment)

• www.hp.com/year2000/index.html (a variety ofvendors have pages devoted to Y2K and theirproducts; this is one example)

Contributions to this column are welcomed andencouraged. Submissions may be sent to VickyBradley, RN, MS, 4017 Palomar Blvd, Lexington,KY 40513; phone (606) 257-2350 (E-mail:bradley@pop.uky.edu) or Marsha Zimmerman,RN, MA, 1414 Ashland Ave, St Paul, MN 55104;(612) 347-8796 (E-mail: marsha.zimmerman@co.hennepin.mn.us).

The hospital InformationServices group should becontacting computer andsoftware vendors and askingfor written verification thattheir software will handle themillennium change.