Helpful Ideas

The Consultant Pharmacist is published by the
American Society of Consultant Pharmacists.

Helpful Ideas

Five Essential Steps to Y2K Readiness

Problem: I want to make absolutely certain our pharmacy is fully prepared for the Year 2000 computer challenge-and January 1 is drawing near.
Solution: The Health Care Financing Administration recommends that health care providers follow a basic five-step approach to assessing, achieving, and confirming full Y2K compliance.
Despite several years of media hype about the impending Year 2000 (Y2K) crisis, some pharmacies and other health care organizations may still be lagging in their effort to address Y2K vulnerabilities in billing, order processing, and other systems and processes. Some may even fail to see or fully grasp the scope of their potential vulnerabilities. According to the Health Care Financing Administration (HCFA), that’s wishful thinking: “You will be affected, either directly or indirectly, by the Year 2000 challenge. Taking proactive steps to identify and address potential impacts will be key to your success and meeting the needs of the patients you serve,” agency officials emphasized in a recent memo targeting health care providers.

HCFA stressed that effective Y2K preparation must encompass not only the provider’s systems, but those of all payers and other entities to which it submits claims or does business: “If your systems and those with which you interface are not Y2K ready, the transfer of information—including claims processing information—could be affected and therefore, so could your cash flow. If you bill claims to multiple entities (e.g., Medicare, Medicaid, private insurance companies, and managed care organizations), you could face problems if you do not ensure your readiness with each of these entities.”

In a recently released package of Y2K resource materials, HCFA says health care providers’ compliance activities should include, but not necessarily be limited to, the following five steps:

Awareness

The first step toward full Y2K readiness is to consider the wide range of procedures and systems that might be affected. This includes everything from elevators and phone systems to payroll systems, referral and order forms, and office security systems—in short, anything dependent on a microchip or date entry (see checklist). Particularly important is a thorough inventory of computer hardware and software, with an emphasis on “mission critical items.”

Assessment

With a complete list of potential Y2K vulnerabilities in hand, health care organizations should assess their readiness in all areas in collaboration with hardware and software vendors, as well as maintenance and service contractors; they are best positioned to recommend systems upgrade or replacement options. “If your particular software program or form is not Y2K ready, you need to decide whether you really need to invest in an upgrade or replacement,” HCFA noted. “In making this decision, bear in mind the potential challenges you could face if changes/upgrades are not made, particularly to programs that support your key business processes.”

Renovation

Based on the completion of a thorough readiness assessment, HCFA said, health care organizations should move as expeditiously as possible to update or replace systems and software they deem essential for continued Medicare or Medicaid participation and “business continuity.”

Testing

Once all vulnerable systems have been upgraded or replaced, meticulous testing is necessary to confirm their Y2K readiness. For added safety, arrange “dry runs” with Medicare fiscal intermediaries, Medicaid agencies, and managed care organizations. Documentation of test plans, procedures, and results is important to help detect and correct any problems that might arise once the systems are fully operational. Take nothing for granted: “Do not assume a system or a software program is ready just because someone said it was,” HCFA emphasized.

Contingency Planning

The last basic step is development of contingency and continuity plans for handling possible failures of critical systems and processes. Problems warranting formal contingency plans might include the following:

Claims cannot be sent in the right format to a third-party payer
Medical equipment required by your patients doesn’t function properly
Laboratory or diagnostic facilities are unable to identify and accurately report to insurers the dates you submit your orders
Outputs and readings from monitoring and reporting equipment and systems are not complete or accurate
Electronic remittances from Medicare or Medicaid are not retrievable
Accounts receivable systems do not function properly
Checks cannot be deposited in your account or credited accurately
Payroll systems do not function properly.

Y2K Compliance Resources

In addition to the readiness checklist presented here, HCFA has assembled a variety of other compliance information and resources, including a detailed timetable for Y2K-related Medicare Part A and Part B claims processing changes and a listing of Web sites of major hardware and software vendors and other organizations offering consultant services and information. These resources can be accessed at HCFA’s Web site (www.hcfa.gov/y2k).

David K. Buerger
Senior Editor