Y2K
CHAPTER 1
Introduction
The year 2000 computer issue is defined by Zetlin (1998) as “the result of a universal programming standard that records dates as six digits rather than eight, using only two digits for the year. Software that uses two-digit year fields (that is, almost all of it) will understand the year 2000 as “00” if the problem is not corrected in time” (pg. 1).
The medical industry as a whole will approach year 2000 with months of new system implementations and developing contingency plans to deal with problems associated with Y2K. Medical manufacturers must pay close attention to the way medical facilities plan for Y2K. The variances in facilities ordering patterns due to Y2K could affect the medical manufacturer’s forecasts and inventory levels leading to a shortage of supplies. Also computer system compliance issues could result in loss of medical records or critical medical equipment failure. Manufacturers typically use historical usage to forecast for the coming year. However, with potential changes in ordering patterns, some adjustments may be necessary to meet customers’ needs. In addition, computer systems must be Y2K compliant to ensure Electronic Data Interface (EDI) which is used to exchanges computer data will function properly and patients health will not be at risk. For the purpose of this study, I have created a fictitious medical supply manufacturer, Equiptek Industries, which will be located in the eastern part of the United States.
The Business plan on Computer Information Systems
INFORMATION SYSTEM CASE STUDY Great-West Life & Annuity Insurance Company is an indirect wholly-owned subsidiary of The Great-West Life Assurance Company the largest stockholder-owned insurance company in Canada, and a member of the Power Financial group of companies. We are searching for a new enterprise system. We are looking for a structured approach that eliminates the guesswork and makes ...
Background
Medical facilities across the United States are concerned with critical date sensitive medical devices and products availability as January 1, 2000 approaches. Hospital concerns include issues such as the scheduling of elective procedures and supply issues with manufactures. Elective procedures are medical procedures that are non-emergency and can, if necessary, be postponed. Laura Bruce (1999) states “Have extra staff on hand and don’t schedule elective surgeries. That’s what experts are advising hospitals do to get through the Y2K rollover as risk-free as possible” (p. 1).
The main concern is with critical equipment such as monitoring devices that records vital signs and other life sustaining equipment. Some facilities may choose to avoid elective procedures for a week or even a month to ensure the date rolls over and the equipment is still functioning properly. Patients who will be in the hospital attached to critical date sensitive equipment when the date rolls over will be under careful observation. Joel Noble, MD (1999) advises hospitals to cancel leave for staff members and make sure that every patient attached to a critical machine has an individual monitoring them.
Allegiance Healthcare (1999) states “As health-care providers grapple with the complexities of Y2K readiness, there is an emerging concern about the uninterrupted availability of products to deliver care”. Many medical facilities are concerned with the manufacturer and the distribution partner being able to meet current inventory levels, which may cause them to purchase additional inventory to minimize the risk. The manufacturers and distribution partners on the other hand are concerned with the additional inventory levels that some facilities may order. Manufacturers forecast future inventory levels based on historical usage and without having adequate information to build additional inventory a backorder situation is very likely. S. Wayne Kay from the Health Industry Distributor Association (HIDA) reported in Health Care Distributor “Stockpiling or hoarding of medical supplies is very likely to cause artificial shortages of medical supplies”. Based on these concerns hospitals are making decisions that will impact medical supply manufacturers.
The Essay on Dresses appropriate for medical facility
Do you think that Mindy dresses appropriate for medical facility? In working for any medical facility, practice, or clinic there are certain criteria that is required. Having bright color pieces in your hair is a violation of code, especially in ethics. Having multiple piercings, visible tattoos, and visible inappropriate body parts are also prohibited. Proper attire would be medical scrubs, ...
As part of an ongoing effort to stay on the cutting edge of medical supply manufacturing, Equiptek Industries formed a Y2K committee to evaluate the company and make necessary adjustments to become complaint. The group has worked to become 100% compliant by October 15, 1999. The company performed mass computer upgrades and system audits of all critical equipment and notified customer of their efforts. Once the customers learned of the committee, numerous surveys concerning Y2K compliance and ability to provide products flooded into the corporate offices. Sub-committee after sub-committee developed to manage inter-company and external evaluations. Equiptek’s main focus was to ensure that computer compliance and customer supply needs were addressed before January 1, 2000.
Importance of Study
The significance of this study is to determine what the purchasing decisions of medical facilities will have on the medical supply manufacturer, Equiptek. This survey was influenced by the repeated request of medical facilities concerning supply issues and the articles published in medical publications concerning stock piling of products. The objective of Equiptek is to determine where the facility is regarding Y2K, how the facility view the Y2K issue, and what variances in purchasing patterns may occur.
In order for Equiptek to meet the needs of its customers, the company must know what the medical facility is planning regarding operation and purchasing. The results of this study will influence to inventory levels that will be maintained during the last two months of 1999 and the first quarter of 2000. This study will explore not only the variance in purchasing patterns, but will also evaluate the opinions of the facility regarding the impact of Y2K on their organization.
Literature Review
Y2K. The Year 2000 computer problem is sometimes referred to as Y2K or “the bug”. Regardless of the name most sources use similar definitions to define the problem. According to an excerpt of the “Y2K: Mission Critical – An Executive Briefing for CEO’s and Other Health Leaders” (1998) the Year 2000 problem occurred from using a six-digit field for the date in computer programs, with the “19” in the year being a fixed value. These programming practices began in the 1950s and continued through the 1970s. During this time period software, hardware, computer languages, and product capabilities were constantly changing. Information technology developers had no idea that these systems would be the same systems in use at the turn of the century. Erich Luening from CNET News.com (1998) denotes “The bug was created by antiquated hardware and software formats that denote years in two-digit formats, such as 98 for 1998 and 99 for 1999. The glitch will occur in 2000 when computers are either fooled into thinking the year is 1900 or interpret the 2000 as a meaningless “00” (p. 1).
The Essay on Impact Of Computers On Health Care
Introduction People have been using computers for hundreds of years: the abacus used by the ancient Chinese is actually a crude computer. Thus, the concept of using machines to do calculations is an old one. However, when we use the term "computer technology" we are thinking of the innovations of the last 20-30 years, and particularly the development of the microprocessor. It was this that made it ...
Strategic business plans of medical facilities. Modern Healthcares’ February 22 edition (1999) states that the Y2K problem is financially draining and creates risk to the basic systems that ensure the operation of all medical institutions. Healthcare organizations across the country are exploring options to eliminate the computer bug. Some facilities initiated the development of strategic Y2K planning three years in advance while other are just beginning. The efforts are intended to minimize the potential problems associated with Y2K from critical equipment that deals directly with patient care to information systems that store medical records.
The National Center for Policy Analysis (1998) stated that “Experts contend that the nation’s 6,000 hospitals, 50,000 nursing homes and 700,000 doctors all need to locate and repair billions of lines of faulty computer code” (p. 1).
It continued by saying that the “Senate staff researchers had found that 80 percent of hospitals are looking into the problem, but only 30 percent have formal Y2K plans” (p. 1).
Some hospitals are testing and replacing their own equipment for Y2K compliance to alleviate the financial strain of using an outside source. This can be a very time consuming task in which individuals are appointed to guide the project as a temporary full time job. Laura Bruce cites a few hospital administrators’ positions on Y2K in the Human Help is the RX for Y2K Hospital Patients article (1999) on the bankrate.com web page. The first, Ben Lee, who is also the Y2K project director of Jackson Memorial Hospital in Miami, says “there are 70 acres of buildings, 13,000 pieces of medical equipment and 12,000 computers. Each department has two Y2K representatives, who are responsible for making sure everything in their department is Y2K ready” (p. 2).
The Essay on Cincinnati Children's Hospital Medical Center
-What factor(s) trigged the initiation of CCHMC’s continuous improvement program? Cincinnati Children’s Hospital Medical Center” (CCHMC) details how one institution has implemented its own version of health-care reform, taking overall performance levels from well below average to the top 10 percent in the industry. The leadership of CCHMC did a great job of tackling important problems ...
Also, Jim Wagner, Chief Information Officer of the University of Iowa Hospitals and Clinics, stated that the position of its hospitals is to test all pieces of equipment that could possibly be life threatening.
Due to the nature of the medical industry the Food and Drug Administration (1999) is working very carefully to ensure that products, production and distribution channels are completely operational and complaint before January 1, 2000. Many surveys have been performed to assess the readiness of the industry both on an operational and technical front. “The FDA action on medical devices came amid concerns that the health industry may be one of the most vulnerable to problems from computers that read only the last two digits in dates and mistake 2000 for 1900” (p. 1) as found in the USA Today Tech Report (1999).
The Food and Drug Administration (FDA) publication FDA Talk Paper (1999) reports that about 2,000 of the United States 13,500 medical supply manufactures produce devices that could be possibly be affected by Y2K problems through the computer components. The majority of these items are not date dependant for operational purposes. It concludes in the FDA Consumer magazine (1999) that Medical manufacturers producing products dependant upon computer components will fall subject to the normal regulatory processes. These processes include comprehensive manufacturing evaluations that will ensure product safety should minimize the possibly of putting patients at risk.
Modern Health Care Magazine (1999) performed a survey the last quarter of 1998 to assess the readiness of medical facilities for Year 2000. At that time only 19% of the respondents were at the testing stage, just 4% of facilities as a whole had completed the testing and very few facilities were in the verification stage. Based on this information they concluded that two-thirds of respondents were still in preliminary stages of Y2K readiness. A few months later in March, 1999, the American Society for Healthcare Risk Management released survey results (1999) which affirmed that the majority of the hospitals within the US say they will be Y2K compliant by January 1, 2000. One-third stated that they will not be completely compliant but all of the systems that are concerned with patient care will be. They do not expect operational problems to occur in relation to Y2K. Actually, less than 1% of hospitals indicated any concerns about not being completely prepared by year-end.
The Essay on Hospital Supply Inc
Hospital Supply, Inc. needs to sell 1,882 units to break even and make $8,186,700 to break even in sales dollars. Hospital Supply, Inc. should not sell units at lower prices, $3,850 compared to $4,350, even though 500 more units will be sold. Although revenues increase by 425,000 due to the variable costs increasing, there is a smaller contribution margin. Because there is a $610,000 drop in ...
The American Hospital Association Y2K Readiness Report (1999) reaffirms the commitment of association hospitals to be Y2K compliant by January 1, 2000.
Y2K is a critical issue, which they are actively working to address because patient safety is a top priority. The fact that hospitals had the highest survey responses rate shows their willingness to be forthcoming about the work that is still needed to be completely Y2K ready. To reach their goals, hospitals continue to work around the clock and are constantly reviewing the latest guidance from the federal government (p. 1).
Contingency plans of medical facilities. “Although year 2000 projects differ from company to company, there are many aspects of every Y2K fix that remain the same, whether you do the work yourself or hire an outside consultant” (p. 74) states Minda Zetlin (1998) author of The Computer Time Bomb. All companies should develop a contingency plan to fit their individual company. “Companies need to define and document Y2K failure scenarios resulting from errors introduced during remediation or from delays in repairing or testing. These scenarios should include potential infrastructure disruptions, as well as possible breakdowns in the supply chain” as cited in The Lipman Report (1999 p. 4).
Several facilities have put in place contingency plans that deal directly with patient care. In the “Human Help is the RX for Y2K Hospital Patients” (1999) on the bankrate.com web page, Laura Bruce reports that Ben Lee, Y2K project director is certain that Jackson Memorial Hospital in Miami will be ready come year end. If something were to go wrong, Lee’s contingency plan allows for the facility to function for two weeks without help from any outside source. Officials at the University of Iowa Hospitals and Clinics in Iowa City, Iowa have decided their team will also be prepared for Y2K by having individuals in place to manually operate critical equipment if necessary. Chief information officer Jim Wagner (1999) stated “additional staff will be on hand in the intensive care unit and other critical care areas during the rollover. In addition, extra personnel will be on hand to handle any technology or communication problems” (p 3).
The Essay on Survey and question design
Initial design considerations Before you design your survey Clearly articulate the goals of your survey. Why are you running a survey? What, specifically, will you do with the survey results? How will the information help you improve your customer’s experience with your agency? Make sure that each question will give you the right kind of feedback to achieve your survey goals. When in doubt, ...
According to Laurie Roquemore-Austin, Director of Information Services at Dallas/Fort Worth Medical Center statement on the City of Grand Prairie, Texas web page (1999)
Hospitals in the area have been working for several years to prepare for the year 2000. The hospital systems are prepared to work manually in the event of an internal or external system failure…Our contingency plan outlines backup procedures for up to four weeks without power, phones, water and other necessary resources (p. 1).
The American Society for Healthcare Risk Management (1999) states that
“Hospitals are focusing on community-wide back-up plans and have already contacted some of their community partners, such as utilities, other hospitals and emergency services” (p. 2).
Hospitals’ main concern at this point is to ensure the safety of the patient and continue to operate regardless of automated or manual facility operation.
Effect of variances in medical facilities purchasing patterns. Other concerns face the medical industry on the supply chain side of the business with product availability issues due to stockpiling. Allegiance Healthcare Corporation (1999) is one company in the industry that states concerns about hospitals and other medical facilities that may choose to stockpile product to ensure availability. By stockpiling medical products they can at the cause a shortage of supplies for other customers. As January 1, 2000 approaches, The Health Industry Manufacturers Association, HIMA, states in the June edition of Health Care Distributor , (1999) that it is becoming more aware of the discussions throughout the industry that are creating concerns that some health care providers may hoard supplies as part of their contingency planning. HIMA is working very closely with the American Hospital Association and the Health Industry Distributors Association to negotiate stocking issues. The National Wholesale Druggists’ Association also reports “progress in the industry initiative to deal with potential supply-chain problems stemming from Y2K” in the April edition of Health Care Distributor. They determined that “the best philosophy is that everybody ought to have their prescriptions and other medical supplies available…Our job is to protect the current supply chain” (p. 10).
The ability to protect the supply chain will be lost if people hoard medical supplies.
The Health Industry Distributors Association, HIDA, (1999) held a “Y2K Summit” to have open floor discussion concerning the possible impact of stockpiling medical products in association with Y2K. They concluded that “the most responsible course of action is close cooperation and intensive contingency planning between supply chain partners to avoid overstocking and causing unnecessary shortages” (p. 32).
Medical product manufactures and distributors are trying to work with hospitals to determine what product needs each facility will have in relation to Y2K. Allegiance (1999), is national distributor of medical supplies in an effort to alleviate stocking issue states that “Ultimately, a rational response to Y2K comes down to trust: confidence that your suppliers will be there for you when you need them most. That’s when you can count on Allegiance and all of our supply chain partners” (p. 2).
In a press release before the House Commerce Committee’s Subcommittee on Health and the Environment (1999), Kent Smith, chairman for Baxter Healthcare Corporation’s 2000 committee states “We want the patients who we serve as an industry to have confidence in us, and we will continue to do whatever we must to deserve their trust” (p. 1).
According to Minda Zetlin (1998),”The care you have taken to make sure they are year 2000-compliant – especially if you helped them achieve that goal – is an opportunity to deepen those relationships” (p. 87).
Problem Statement The medical industry as a whole will approach Year 2000 with months of new system implementations and developing contingency plans. Each individual facility, distributor, and manufacturer will determine what key elements will impact their organization and build a strategic plan that will protect them from problems associated with Y2K. Medical facilities purchasing patterns guide both the manufacturers and distribution partners in determining the level of inventory to keep on hand. Variances in these ordering patterns and computer compliance will determine whether the manufacturer should address supply forecast issues and possible Electronic Data Interface (EDI) problems that could related to Y2K.
Research Questions:
The following questions will assist the research process.
1. What is Y2K?
2. What effect will Y2K have on the medical industry?
3. What strategic business plans are medical facilities making in association with Y2K?
4. What effect will Y2K have on medical facilities purchasing patterns?
5. What impact will changes in medical facilities purchasing patterns have on medical supply manufacturers?
6. What impact will Y2K have on medical supply manufacturer’s inventory?
7. What contingency plans will medical supply manufacturers consider?
Scope and Limitations
Equiptek Industries, Inc. is a medical manufacturer of orthopedic, acute, and wound care products in addition to data management operating room computer software. The company has been in operation for 36 years with the corporate office located in East Tennessee. Equiptek also maintains 15 other subsidiaries within the US and abroad and employees approximately 2,500 employees worldwide.
To measure the level of readiness, opinions, and needs of Equiptek customers in association with Y2K, surveys were mailed to members of the sales force to distribute to their top accounts within their territory. Approximately 200 surveys were distributed within the continental United States. The survey inquired about the facilities level of readiness and opinions of possible problems that would be encountered concerning Y2K. It also addressed the issues of ordering extra product or stock piling products prior to January 1, 2000 and what concerns the facilities may have.
The majority of the surveys were distributed to larger accounts that purchase a high dollar volume of products and therefore limitations exist involving the amount of information provided by small customers. Only in cases where a relatively smaller population of hospitals within a sales territory is surveyed would the lower dollar volume customers have an opportunity to respond. Larger customers have the storage capacity and finances available to maintain a higher level of inventory where small customers do not. This survey does, however, include a good general sample population of medical facilities within the US but global generalizations cannot be inferred due to the lack of surveying outside the US and their different views of Y2K.
CHAPTER 2
Methods
Research Design
This was a descriptive study to determine the impact of medical facilities’ Y2K plans on the medical supply manufacturer, Equiptek. The survey was distributed to 100 top medical facilities across the United States on October 15, 1999. These customers were asked to complete the survey and fax or mail the responses back to the corporate office in East Tennessee by November 15, 1999. The facilities were advised of the purpose of the survey in the cover letter.
Selection of the Sample
The medical facilities that were selected for this survey consisted of top accounts within different sales territories across the United States, based on two primary sales regions. This target group was selected based on a sales report that calculated the total sales volume by account within a one -year time frame. The top 100 dollar volume accounts within the sales territories were isolated. Due to the structure of these territories, the top accounts consisted of mainly larger sales volume facilities but also included some smaller sales volume facilities. Eighty-four of the 100 medical facilities responded to the survey by fax or mail by the November 15, 1999 deadline.
Source of Data
The data were collected from medical facilities that purchase products from Equiptek. This survey was constructed to determine what impact these medical facilities Y2K plans will have on the medical supply manufacturer, Equiptek.
Development of the Survey
The survey instrument, Appendix A, used a Likert scale and a multiple choice-single response scale. The survey was conducted to answer the research questions by determining medical facilities readiness for Y2K and to evaluate the possible changes in ordering patterns in relation to Y2K.
The 14 question survey was used to collect data from the medical facilities regarding their Y2K plans for computer systems and inventory requirements. This survey was designed to measure the overall Y2K readiness and inventory needs of Equiptek’s top customers across the United States. Sales reports were generated to identify the accounts that would be surveyed and addition surveys were sent to smaller sales regions to ensure adequate representation in the different regions. The survey questions were designed in a clear and concise manner to ensure the validity and reliability of the survey.
Validity. To ensure the validity of the survey, questions were developed that were directly related to the medical facility and the purchasing patterns in relation to Y2K. The development of questions that were directly related to the topic protected content validity. The basic terminology in the medical industry was used to protect face validity. The questions were worded in a clear and concise manner to protect construct validity.
The survey instrument was designed to establish a thorough understanding of the topics and to minimize possible bias. In an effort to achieve this goal, more than one question relating to a specific topic was developed. The evaluation results of the survey led to redesigning questions 1, 2, 3, and 4 to use the Likert scale which allowed for clearer responses. The reordering of questions 5, 6, 7, and 8 allowed for obtaining general information first and then more specific data.
Reliability. The survey was constructed with clear and concise questions that the respondents could answer. Also all of the questions were related to their individual facility and did not require them to make inferences about other facilities.
Survey Questions
Survey Questions 1 through 4 used the Likert scale. These questions were designed to indicate changes in inventory requirement due to Y2K. The questions were broken down by specific product category to evaluate the inventory requirement based on Operating Room System Software, Orthopedic Products, Surgical Products, and Wound Care Products.
Survey Questions 5 and 6 used a multiple choice-single response scale. These questions were designed to determine the facility’s stage of completion for both overall operations and technology.
Survey Questions 7 through 11 also used a multiple choice-single response scale of Yes or No. These questions addressed specific areas of Y2K concerns such as reductions in elective procedures, disruption in workflow, computer installations, and developing contingency plans. The questions also addressed the need for onsite Y2K manufacturing presentations.
Questions 12 and 13 also used a multiple-choice single response scale and helped in the development of individual and corporate demographic profiles. Question 12 indicated the gender of the respondent and Question 13 addressed the size of the facility being surveyed. Question 14 was a simple fill in the blank question that assisted in determining the representation of the different sales territories.
Survey Questions 7, 8 and 9 were developed to determine what operational changes may occur in the day to day operation of the medical facility and if new computer systems were being installed. These questions will provide information that will assist in answering Research Question 2 to determining what effect Y2K will have on the medical industry. Survey Questions 5 and 6 were designed to determine the facility’s stage of completion regarding Y2K. These questions assisted in answering Research Question 3 concerning strategic business plans that medical facilities make regarding Y2K.
Survey Questions 1 through 4 and 11 helped to determine what inventory level variances may occur due to Y2K and what other needs the facility may have from the medical supply manufacturer. These survey questions helped answer Research Questions 4, 5 and 6 concerning effect of Y2K on purchasing patterns, the impact on the medical manufacturer, and on the supply inventory levels. Survey Question 11 was developed to determine if medical facilities are developing contingency plans in relation to Y2K. This question assisted in answering Research Question 7. Survey Questions 12 through 14 were designed to provide demographic information about the respondent and the medical facility surveyed.
Procedures
This survey was distributed on October 15, 1999 to the outside salesforce of Equiptek, five copies to each representative. The sales representative then distributed the survey by hand to the individual medical facilities to be surveyed. If possible, the sales representative conducted the survey in person and mailed or faxed the information back to the corporate office. Otherwise, they left the survey with the purchasing agent to have completed and they returned it by mail or fax it to the corporate office.
Each survey was distributed with the attached cover letter that explained in detail the purpose of the survey. The letter and survey both indicated that they return the completed survey form by November 15, 1999. In order to maintain confidentially, any names, fax numbers, or return addresses that was included with the survey was discarded.
Data Analysis
The survey data was analyzed using a statistical program within the software package, Microsoft Excel. The frequency distributions were calculated for each survey item to determine how the respondents answered the questions with the choices available. The means were then calculated to determine the most repeated response. The Cross-tabulations were generated to show associations between the survey questions and the demographic data. This information was used to show how different demographic groups answered the same question.
CHAPTER 3
Results
Respondents and Response Rates
One hundred medical facilities within the United States were selected as the target group for this survey. The group consisted of only hospitals or health systems that generated the highest sales volumes within the primary sales regions. This sample was chosen based on sales volume to represent the largest accounts that order the highest volumes of medical products. These facilities’ purchasing patterns dictate the necessary inventory levels that the manufacturing company must maintain to provide uninterrupted product supply.
Computer technology is another area of importance that was stressed in the survey. Medical facilities that purchase products can place orders electronically. This process is preformed through Electronic Data Interface (EDI).
These same systems are also used for reporting sales volumes back to the company. It is necessary to determine the number of facilities that have addressed Y2K computer issues and those that have not. Those customers that utilize the EDI ordering and reporting method should be Y2K compliant to avoid potential problems.
Surveys were distributed to all of these accounts on October 15, 1999. Eighty- four of the 100 accounts responded to the survey by mail or fax by the deadline. All of the surveys 82 were complete and two left one question blank. One of the two incomplete surveys left question 6 blank which addresses the technology stage of completion. The other respondent left question 12 blank that asked the gender of the person completing the survey. All 84 surveys are reflected in the resulted as presented in this chapter. The margin of error for these results is ± 1%.
The size of the medical facilities participating in the survey was determined through question 13. Respondents were asked to categorize their facility by small, medium and large. The highest number of responses was from large facilities that represented 71 of the 84 total respondents. The responses from medium size facilities represented 10 of the 84 respondents and the small facilities represented 3 of the 84 total responses. The percentages of the results are shown in figure 1 below.
Figure 1.
The medical facilities were selected based on sales within the Western and Eastern sales regions to ensure the responses exhibited a good cross-section of the United States. Question 14 addressed the state in which the medical facility was located. The total respondents represent 69% of the states within the United States. This 69% was broken down within the two sales regions by 36% within the Western sales region and 64% within the Eastern sales region. These results are shown in Table 1 and Figure 2 on the following page.
Table 1.
Respondent Facility Locations
State Frequency Appendix B State Frequency Appendix B
AR 3 4% MT 2 2%
AZ 2 2% NE 3 4%
CA 5 6% NC 1 1%
CO 1 1% NM 1 1%
CT 1 1% NV 1 1%
DE 1 1% NY 2 2%
FL 5 6% OH 1 1%
GA 5 6% OK 2 2%
ID 2 2% OR 1 1%
IL 4 5% PA 4 5%
KS 3 4% TN 5 6%
LA 2 2% TX 3 4%
MA 2 2% UT 1 1%
ME 1 1% VA 3 4%
MD 2 2% WA 3 4%
MI 2 2% WI 1 1%
MN 1 1% WV 1 1%
MO 2 2%
MS 5 6% Total 84 100%
Figure 2.
Analysis of the Data
The survey instrument, Appendix B, consisted of four survey questions using the Likert scale, nine multiple choice-single response questions, and one fill-in-the-blank question. Demographic data was obtained using questions 12, 13, and 14. The survey questions were designed to answer the seven research questions.
Survey Questions 1, 2, 3 and 4 were developed to determine what changes in ordering patterns might occur in relation to Y2K. Each question represented a specific product category for the respondent to address. The surgical product area held the highest percentage of facilities that plan to increase orders due to Y2K. They represented 23% or 19 of the 84 respondents that purchase surgical products. The next highest percentage of facilities that plan to increase orders was in the orthopedic product area. They represented 19% or 16 of the 84 respondents that purchase orthopedic products. The product area that represented the smallest increase in orders was wound care. They indicated that 17% or 14 of the 84 respondents would increase orders due to Y2K. Five percent or 4 out of the 84 respondents planned to slightly increase their orders in both surgical and orthopedic products. The majority of the facilities plan to keep order levels the same. The highest percentage of facilities that plan to remain consistent with their ordering pattern is 99% of those facilities that purchase operating room system software. The next highest group is at 81% and consists of those facilities that purchase wound care products. Figure 3 on the following page shows a graphical interpretation of the data responses for each possible answer.
Figure 3.
Questions 1-4 were cross-tabulated with question 13 to determine if size had any bearing on the changes in ordering patterns. Thirty percent of the 71 large facilities indicated that they would increase orders for surgical supplies. Twenty-four percent of the 71 would increase orders for orthopedic products due to Y2K. Ten percent of the 10 medium facilities indicated that they would increase orders for surgical supplies with 30% of the 10 increasing order for orthopedic products due to Y2K. None of the small facilities planned to increase orders for Y2K.
Questions 5 addresses the overall facility stage of completion and Question 6 addresses the technology stages of completion due to Y2K. Overall, 70 out of the 84 respondents indicated they were in the testing stage of completion for technology and 65 were in the testing stage for the overall facility stage. Fourteen out of the 84 were in the implementation stage for technology and 16 were in the overall facility implementation stage. Figure 4 below gives a graphical interpretation of the stages of completion.
Figure 4.
Question 7 addresses the respondent’s opinion on reducing the number of elective procedure performed during the first quarter of 2000. Five percent out of the total respondents indicated yes, that they might reduce the number of elective procedures performed during the first quarter. The other 95% answered no to the question.
Question 8 addresses the opinions of those respondents concerning disruptions in workflow due to Y2K. The majority of the respondents answered yes, expecting some type of disruption in workflow while 6% expected no disruptions. Question 10 requests that respondents indicate if the facility was developing contingency plans. Ninety–eight percent of the facilities were in the process of developing contingency plans for Y2K while 2% were not planning for contingencies. Table 2 below shows both the frequency and percentages for both questions 8 and 10.
Table 2.
Disruption in Workflow and Contingency Planning
Disruption in Workflow Contingency Plan
Response Frequency Percentage Frequency Percentage
No 5 6% 2 2%
Yes 79 94% 82 98%
Total 84 100% 84 100%
Cross-tabulations were used to compare how the different size of a facility effected the answers to Survey Questions 6 regarding the technology stage of completion and 9 regarding new computer equipment or software installations. The small facilities, consisting of three of the 84 total respondents or 4%, indicated that they were not installing new computer equipment or software. Out of those three, one was in the planning stage and the other two were in the implementation stage of completion. None of the small facilities were in the testing stage. The medium facilities represented 12% or 10 of the 84 respondents. These facilities indicated that three were not installing, while seven were installing new computer equipment or software. None of the medium size facilities were in the assessment or planning stage, two were in the implementation stage, and eight were in the testing stage of technology completion. The large facilities represented 71 out of the 84 respondents. Sixty-four were installing new equipment or software, while the remaining seven were not. Within those 64 facilities 21 were in the implementation stage and 50 were in the testing stage of technology completion. Table 3 indicates the percentages of technology stage of completion for the different size facilities.
Table 3.
Technology Upgrades Based on Size
Small Medium Large
Total Assessment 0% 0% 0%
Total Planning 33% 0% 0%
Total Implementation 67% 20% 30%
Total Testing 0% 80% 70%
100% 100% 100%
CHAPTER 4
Discussion
Introduction
Y2K planning is a management initiative that many industries are taking to prepare for the new millennium. The medical industry has established a network of individuals that encompass all aspects of the medical field from those that manufacture medical products to actual physicians that utilize them. These individuals are attempting to minimize the potential problems that could occur due to Y2K. This group is communicating the need to work together to solve both product supply and technical issues that Y2K is rapidly bring to surface. In an attempt to determine what effect Y2K will have on the medical supply manufacturer, Equiptek, a survey instrument was distributed to the top 100 medical facilities that represent a cross section of the customer base.
This research analysis evaluates the level of Y2K readiness and changes in ordering patterns associated with Y2K within a sample group of Equiptek customers. The survey questions included in the questionnaire were developed to aid in answering the seven research questions. The literature review contains information regarding Y2K and the strategic planning taking place throughout the medical industry. This evaluation conveys the intentions and opinions of medical facility staff across the United States.
Summary of Major Findings
The 84 respondents that contributed to the survey represent 69% of the states within the United States. These respondents were classified by size: small, medium, or large using Survey Question 13. The highest response rate was within the large facilities. This group large represented 71 of the 84 total respondents. The medium size facilities represented 10 and the small facilities 3 of the 84 total responses. The difference in size of the responding facilities is due to the limited number of small sales territories; therefore, more large facilities were surveyed.
Survey Questions 1-4 addressed changes in ordering patterns associated with Y2K within Equiptek’s four primary product categories. The results show that only 23% of the facilities surveyed plan to increase orders for surgical products, 19% for orthopedic products and 17% for wound care products. Therefore, 77% of the surveyed medical facility do not find it necessary to stock additional inventory for even the most critical product area which is surgical supplies. Overall, the majority of the surveyed facilities planned to keep order levels the same.
The cross-tabulation of questions 1-4 with Question 13 showed that the size of the facility could affect the decision to increase orders. Thirty percent of the large facilities indicated that they would increase orders for surgical supplies and 24% would increase orders for orthopedic products. None of the small facilities that responded to the survey indicated any changes in ordering patterns.
The cross-tabulation between Question 6 and Question 9 with Question 13 shows that the size of the facilities could affect their progress in the technology stage of completion and in the decision to install new computer equipment and software. None of the small facilities plan to install or new computers or software. Out of the small facilities, one was in the planning stage and the other two were in the implementation stage of technology completion. None of the small facilities were in the testing stage. Within the group of large facilities, 64 out of 71 respondents planned to install or had already installed new computers or software. Within those 64 facilities, 21 were in the implementation stage and 50 were in the testing stage of technology completion. Based on these results, the smaller the facility the less likely they are planning to install new computers or software. The technology stage of completion is much lower within the smaller facilities than in the larger ones. Overall the results show that the larger the facility, the more involved they are in technology improvements.
Discussion
The medical industry is actively planning and taking initiatives concerning Y2K. Research Question 3 addresses the strategic business plans that medical facilities are making in association with Y2K. Modern Healthcare magazine (1999) states that some facilities initiated plans up to three years ago and other are just beginning to address the Y2K issues. Survey Question 5 addresses the medical facilities overall stage of completion in regards to Y2K. Sixty-five of the total 84 respondents indicated that they were in the testing stage and 16 of the total indicated that they were in the implementation stage of Y2K completion. These results supports the American Hospital Association (1999) statement that hospitals are actively working to address Y2K issues because their business deals directly with human life. Their main goal is to ensure patient safety. They further state that these facilities are working around the clock to become completely compliant by January 1, 2000.
The primary concerns throughout the industry are product availability and technology compliance. Medical supply manufacturers and the product distributors are concerned with customers stock piling product to ensure availability. Research Questions 4 and 5 address what effect Y2K will have on the medical facilities purchasing patterns and on the medical supply manufacturer. The Health Industry Distributor Association (1999) is one of the agencies that have addressed this issue in several forums. They want to encourage medical facilities to work closely with their distributor or directly through the manufacturer rather than stock piling products. Allegiance Healthcare Corporation (1999) is one of many distributors that are concerned with facilities that chose to stock pile products and cause a shortage of supplies for other customers. Survey Questions 1-4 address the stock piling issues by evaluating the possible changes in ordering patterns associated with Y2K. The results show that overall, the majority of the surveyed facilities intend to keep order levels the same. By maintaining consistent order levels, these medical facilities are helping both the manufacturers and distributors protect the current supply of inventory.
The technological concern of medical facilities is that vital medical equipment or computer systems may fail. The Food and Drug Administration (1999) identified 13,500 medical products that could be affected by Y2K, but very few were actually date dependant for operating purposes. Computer compliance issues however are possible problems with their date sensitive functions of all computer systems. Many medical facilities have budgeted and spent large amounts of money and time to upgrade and install new computers to become compliant. According to results of Survey Question 6, 70 out of the 84 respondents indicated that they are in the testing stage of technology completion. Sixty-four of the 84 respondents answered Survey Question 9 as planning to or have already installed new computers or software to become complaint. Laura Bruce reports in the Human Help is the RX for Y2K Hospital Patients article (1999) that some hospital administrator have chosen to repair or replace their own equipment to lessen the financial strain of using outside computer consultants. The survey results confirm that the majority of medical facilities are on the forefront of the technology compliance.
The survey results clearly show that 94% of the respondents anticipate some type of disruption in workflow based on Survey Question 8. Laura Bruce continues to report that many medical facility executives have taken a proactive approach to vital system failures and developed contingency plans to deal with potential problems. Some facilities plan to have extra staff on hand to watch critical systems that could be life threatening if failure occurred. Out of the facilities surveyed, 98% of the respondents indicated that they are contingency planning to compensate for these possible disruptions.
The survey results and supporting documentation from the literature review confirm the medical industry as a whole view Y2K as an important issue that they are actively addressing. The medical facilities are working with the manufacturers and distributors to ensure product availability and avoiding stock piling products. The medical facilities are continuing to put patient care as their primary objective and striving to become fully compliant by January 1, 2000. These facilities are also attempting to reduce costs by taking internal measures to upgrade and install computer components. The assessment, planning, implementation, and testing processes will ensure minimal problems occur due to Y2K. As Minda Zetlin (1999) indicated, the care that Equiptek takes with ensuring Y2K compliance throughout the industry will in turn deepen the relationships with distributors and customers.
Recommendations
The medical industry is deeply involved in developing Y2K plans in all aspects of their business functions. This industry deals directly with human life, therefore all vital systems must be checked and determined Y2K compliant. All medical facilities both large and small should take initiatives to upgrade computer systems or software to ensure patient records and other information are protected and data transfers can take place. Medical facilities that have access to an internal computer specialist should use that outlet to minimize costs. They can always have their systems audited by an outside source to ensure compliance.
All groups associated with the medical industry should take advantage of the vast network of individual that are already established in Y2K planning. These medical industry leaders are working diligently to be prepared for the new millennium. They have minimized the potential for stock piling products and encouraging medical partners to work together to meet Y2K needs.
Finally, everyone in the industry needs to make some type of contingency plans. These plans could consist of meeting basic needs in any emergency situation. Some facilities have gone as far as scheduling additional individuals to be prepared to manually care for patients attached to life threatening equipment if equipment failure occurs. Regardless of how extensive or minimal the contingency planning may be, a medical facility dealing directly with human life should have one.
The results of this study can be utilized by Equiptek and others in the medical industry to assist in planning for Y2K. Based on these results Equiptek can project some additional inventory requirement to meet the needs of those facilities that do intend to order extra supplies. Further research is necessary to make any substantial decision based on these results.
Equiptek is striving to meet both internal and external goals for Y2K compliance by January 1, 2000. The company has evaluated all critical systems and upgraded computer systems. They have also addressed stock-piling issues and assured customers of product availability. They are daily meeting the needs of customers and setting standards in the medical industry.
Alcorn, Karen (1999, May).
Medical Industry Committed to Ensuring Products Will Function Safely in Y2K. Press release before House Commerce Committee’s Subcommittee on Health and the Environment.
Allegiance Healthcare Corporation (1999).
Y2K Stockpiling…Smart Idea or Fiscal Nightmare? Allegiance – Y2K [On-line]. Available: http://www.allegiance,net/whoweare/y2k/y2kad/htm
American Hospital Association (1999).
Y2K: Mission Critical – An Executive Briefing for CEO’s and Other Health Leaders. Year 2000 Resource Center [On-line] Available: http://www.aha.org/y2k/Year2K/briefing.html
Brown, Fred L. (1999, October).
Statement on HHS Inspector General Y2K Survey of Health Care Providers. American Hospital Association. Press release.
Bruce, Laura A. (1999, July).
Human Help is the Rx for Y2K Hospital Patients. Bankrate.com. [On-line] Available: http://www.bankrate.com/brm/news/y2k/19990723.asp
Cavanaugh, F., Hines, E., & Zinn, T. (1999, February).
Y2K: Ready or Not…Survey: Millennium Bug Is Sapping Time and Resources, But Execs Are Glancing Beyond 2000. Modern Healthcare. [On-line] Available: http://www.rx2000.org/data/publications/survey/htm
City of Grand Prairie, Texas (1999).
Year 2000 Preparation – Health Care. City of Grand Prairie, Texas [On-line] Available:
Dougall, Dionne (1999, March).
Hospitals Confident in Meeting the Y2K Computer Challenge, New Survey Shows. American Society for Healthcare Risk Management [On-line] Available:
Kay, S. Wayne (1999, June).
HIDA Holds Y2K Summit; Guidlelines Developed. Health Care Distributor, 51.6, 32.
Lewis, Carol (1999, November-December).
Y2K and FDA: Preparing for the New Millennium. FDA Consumer Magazine, 1-7.
Luening, Erich (1998, July).
How will Y2K hit hospitals? CNET News.com. [On-line] Available: http://news.cnet.com/news/0-1003-200-331476.html
Snider, Sharon (1999, August).
The Year 2000 Date Problem and Medical Devices. FDA Talk Paper, T99-40, 1-3.
Streck, Ronald J. (1999, April).
Plans Advance for Industry’s Y2K Initiative. Health Care Distributor, 51.4, 10.
The Lipman Report. (1999, April).
Y2K: The Millennium Is Now. Memphis, TN: Guardsmark, Inc.
USA Today (1999, August).
Health Care Faces Y2K Risks. USA Today Tech Report [On-line] Available: http://www.usatoday.com/life/cyber/tech/ctf774/htm
Zetlin, Minda (1998).
The Computer Time Bomb. New York: American Management Association.
Zuckerman, M.J. (1998, July).
What Will Happen When Health Care Meets Y2K? National Center for Policy Analysis. [On-line] Available:
