Administrators upgrade computers; plan for worst-case scenarios
Administrators and business managers of orthopaedic practices are immunizing their computer systems against the millennium bug. But just in case the computers to go haywire at the dawn of year 2000, they've got a megabyte of fallback plans.
Many are lining up financial credit with banks, planning to conserve cash by holding back physicians' year-end bonuses and stockpiling supplies. They're planning to print out in advance the appointment schedules for future months and back up accounts payable and receivable files.
The readiness seems to belie a Government Accounting Office report issued in February that said more than 90 percent of doctors have not addressed the Y2K problem. The Department of Health and Human Services in March said its survey showed half of health care providers have billing and medical records systems that are Y2K complaint.
J. Pat McAnally, a member of the board of directors of the BONES Society, is skeptical about the reports. "We think most practices are ready or close to it," he said.
A survey by the BONES Society in late March found that 100 of 129 orthopaedic practices believe their computer systems are Y2K compliant. They told BONES, the national organization of orthopaedic practice administrators, that their equipment passed tests by computer vendors or they either bought new computers and software or upgraded their existing computer systems.
Colleen Harlow, administrator and business manager of Lake Forest Orthopaedics, Lake Forest, Ill., said her practice made sure their computers were ready for Y2K. "We're also checking the compliance of anything with chips-copiers, fax machines, telephones," Harlow said.
At Orthopaedics Associates of Bangor, Maine, Paul McLaughlin bought a new computer package of 12 PCs to replace a batch of dummy terminals. The cost was about $20,000. As this was written, Dover Orthopaedics Center, Dover, Ohio, a four-physician practice, is waiting for delivery of a CD-ROM so a new version of Unix could be installed.
Leasing seemed to be a better route than buying for Linda Higgins, administrator at the Texas Center for Joint Replacement, Plano, Texas. She has 48-month leases on computers to replace nine seven-year-old computers. Six other computers were purchased in the last six months.
Many practices reported that they were asking vendors and suppliers-sometimes at the request of their banks-to provide letters, assuring that their equipment is Y2K compliant.
To avoid computer problems, 72 practices surveyed by BONES had prepared and implemented a written plan of action to become Y2K compliant, but 57 were not as methodical. Eighty-seven practices do not have contingency plans in case their computer systems can't leave the 1900s, but that doesn't mean the administrators aren't thinking about surviving worst-case scenarios.
While computer glitches caused by the Y2K problem may not revive the Stone Age, some administrators said they would resort to using typewriters, pens and pencils.
Sherry Dublin of Central Pennsylvania Orthopaedic Specialists doesn't want to trade her keyboard for a pegboard. She remembers, not too fondly, using the pegboard system of posting charges and codes in a ledger when she started 16 years ago.
Dublin has new PCs for accounts payables and upgrades for account receivables. She's confident the local electric utility company is ready, but if the "juice" doesn't flow, there will be a need for backup systems like the pegboard.
While 100 practices are confident about their computer systems, 73 did not contact their insurance payers, hospitals and suppliers to determine if they were ready for the millennium bug.
Girding for a possible problem in getting reimbursements from insurers that have balky computers, many administrators say they have lines of credit at banks. One practice of 11 orthopaedists said it had a $500,000 line of credit and another of equal size said it had a $1 milllion backup.
Administrators also said that they might have to defer payment of year-end bonuses to their orthopaedic surgeons until their payers are able to reimburse them. Others call it as "taking back the bonus money as a loan."
Higgins of the Texas Center for Joint Replacement, a two-physician practice, said, "if Medicare is OK, we'll be OK. If Medicare is not OK, we're hosed."
It's the smaller payers that worry Orr of Dover Orthopaedic Center. "They tend to drag their feet and this would be just another excuse," she explained.
Supplies won't be a problem for a lot of practices, because the administrators plan to start stockpiling "injectables and soft goods" in the last quarter of this year. One administrator said she would "triple-order" her supplies. On the other hand McAnnally of Ozark Orthopaedics and Sports Medicine, Fayettville, Ark., is confident his usual one-month supply will be enough.