The reliability of life-saving medical equipment in the light of Y2K is high on the list of worries for hospital administrators. Like any other area dependent on computers, there is no certainty, but the Department of Health has said it is "actively" co-ordinating a nationwide effort to minimise disruption.
The Department would not clarify the nature of its programme, but says in a statement its primary concern is that "health service clients should be protected from potential dangers arising from the millennium changover and that there should be minimal disruption to normal health services".
A number of areas need to be addressed including "information technology, medical equipment and devices, including labs, estates and supply-chain". Each health board and hospital has been told to draw up a checklist. The South Eastern Health Board area, for example, has approximately 6,000 pieces of equipment, apart from computer systems, that need to be examined.
Recently, senior doctors in the Midland Health Board expressed concern that local health board hospitals may be seriously lagging behind in their Y2K preparations, as a full inventory of equipment in local hospitals had not yet been completed.
Individual working doctors have also been advised to be prepared. The Medical Defence Union, the doctors' insurers, has advised members that on January 1st, 2000, "it is best to presume that anything could fail", that doctors should ensure electronic records will be accessible in the event of equipment failure, and that data should be backed up.
In Beaumont Hospital in Dublin they have "looked at everything that can be plugged in", according to Y2000 project manager Meabh Smith. They sent a questionnaire to the manufacturers and suppliers to see if these items were compliant. "Then we looked at how long it could be done without if it failed. Things like ventilators would be top priority, the computer system for paying staff would be lower but important nonetheless." They got a 60 per cent response-rate and subsequently cross-checked the information against what was available on the internet. "I never found the internet much use but it has been great for this," Smith says.
Some hospitals have simply written to manufacturers asking whether there will be a problem with a certain machine, but not asking specific questions. Smith found that assurances from a manufacturer must be checked. "We found some inconsistencies. One company told us the piece of equipment was compliant but when we checked on the internet it was not."
The hospital is prioritising equipment which is non-compliant and replacing and upgrading it. An upgrade has already been carried out on the hospital's computer system.
The number of medical devices affected is fewer than expected, Smith says. "Of course you cannot have high risk, high priority equipment going down but that is only about 1 per cent of what we have to worry about." The main area of worry involves equipment which monitors patients who are very ill in intensive and coronary care units. X-ray rooms will also need upgrades - the problem lies not with the imaging equipment but with the archiving of the X-ray film. Monitoringequipment in operating theatres can also be a problem. None of the equipment has been replaced yet, but Beaumont has informed the Department of Health and begun ordering the equipment. Beaumont Hospital is 11 years old and that time frame is critical, Smith says. "Microprocessors came into being at that time and they are a vulnerable category of equipment now. And since they are old, manufacturers are not killing themselves checking it out." The hospital is currently purchasing a new blood machine and Smith says staff were "very surprised" to discover it was not Y2K compliant. "Some of the inconsistencies are very surprising. That company now says it will come back with new software."
The Department of Health has been holding special-interest groups around the country and facilitating information-sharing between healthcare institutions. However, there are concerns it is not taking the lead in setting up contingency plans. "They need to drive rather than facilitate that, taking the bull by the horns. It is very important," Smith says. The bill for dealing with the Y2K problem in the Midland Health Board area could come to £2 million, according to Chris Kelly, its Y2000 project manager. A committee has been examining the problem there for the past year, he says. Among the first areas to be examined were electricity supply (stand-by generators have been organised), water, heating and medical gases. Following from there was telecommunications.
His lists critical medical areas including laboratory equipment such as blood analysers - much of the lab equipment, he says, was not date-dependent, while some needed software upgrades. "We wrote to companies asking them and had to make judgments. Suppliers have been very helpful."
The issue of home-based medical devices such as heart and blood pressure monitors, and nerve stimulators for chronic pain, was more difficult to address, Smith says - it is uncertain who is responsible for them.
