| LAWRENCE M. SHUER Chief of staff Holiday and Y2K |
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 The end of this year is fraught with more
than the usual symbolism. We will soon enter the final year of a decade, a century and a
millennium. I will ignore the purists who say the century is not complete until the end of
2000 [after all there was no year zero AD], because more than symbolism and historical
perspective awaits us: Y2K is coming!!!A recent presentation to a medical staff committee by Brian May, the new CIO of UCSF Stanford Health Care, demonstrated that a lot of work is being done behind the scenes to make certain we are ready for the next millennium. [See related story]. I am sure many of you are quite aware of the formidable task we face, especially in the information systems arena. There are many horror stories circulating. Some have suggested that we avoid any activity that depends upon computers and other date-sensitive devices when the new century begins. (Interpretation: Stay out of airplanes on New Year's Eve 1999). Rest assured that plenty of resources, money and personnelhours are being devoted to ensuring that we are prepared for this event. Unfortunately, this work has caused some consternation as other information systems projects here have had to take a back seat to the Y2K effort. Staff members have had to physically check every computer system at all four of the hospitals to see that they are Y2K- compliant. What does this mean? Many existing computers and software programs do not have the ability to compute the date change from 12-31-99 to 01-01-00. The computer or software program will not see this as an advance in time but will interpret the date as the year 1900. The computer might simply fail to function - at least properly. Most recently acquired computers and software have been designed to understand and handle this transition. (The Y2K problem stems from a need a few decades ago to conserve computer memory by making all dates two digits - rather than four). Many programs installed before this problem was understood still exist in our organization. Therefore, our information technology personnel face the daunting task of testing each system to determine its ability to handle the changeover. This necessary diversion of resources has certainly delayed our implementation of a new medical information system that will allow us to transition towards an electronic medical record. We have been assured, however, that this need will be top priority once Y2K has been dealt with. Peter Van Etten, CEO of UCSF Stanford Health Care, has suggested that the Y2K phenomenon has inadvertently offered us an opportunity to reevaluate our information systems and perhaps improve upon our plan by utilizing the added time to "do it right." We have learned a great deal through this process. We want to make certain that we have an information system that will meet as many of our needs as possible. This system should allow the orderly transmission of needed information and data throughout all UCSF Stanford facilities. It should improve patient care by having that information available at all times. It should also help us streamline our compliance with all of the regulatory agencies with whom we interact. We hope it also will allow for better data retrieval for clinical studies, which should help support our academic mission. I know many of us have been anxiously awaiting the day when we would have a totally electronic medical record. We need to be patient and recognize that although it has been delayed, it will come and hopefully it will be worth the wait.
We are rapidly approaching the holiday season and by the time you read this, Thanksgiving will be over. There is a lot to be thankful for. We have the privilege of working at a first- class academic medical center. The care provided here is truly cutting edge. Many of the treatments performed at Stanford provide hope, cures and palliation for our patients. Stanford Hospital and Clinics is not just the bricks and mortar. Our most important assets are the people who work here - the doctors, nurses, technologists, secretaries, students and others. I wish to commend and thank each and every one of you for helping make this a remarkable place. In addition to the need to offer thanks, we must also be ready to face multiple challenges. We continue to face the economic pressures of cutting costs without impacting quality of care. We have the added duty of training tomorrow's physicians without adequate compensation from third party payers. The expansion of managed care in our service area continues to cause decreases in reimbursement for care; price competition is causing decreases in the per member/per month algorithm for primary care physicians and others involved in capitated care. Add to this the changes in the documentation requirements to satisfy the federal Health Care Financing Administration for Medicare patients, and you can see why physicians often feel that they are having to do increasingly more for increasingly less. To that end, I think we all need to remember from time to time that despite all of the red tape, hassles and perceived lack of acknowledgment, our work really does make a difference in many lives. No matter what the aggravation may be, in the end, the people who benefit from your skills and work truly do appreciate you. On behalf of all of us in the Medical Staff Office, I wish each of you happy holidays and a joyous New Year! |
COLUMNS Chief of Staff NEWS Pharmacy earns highest ratings Merger results in $38 million in first-year savings Service workers vote for union representation Program available for neurodevelopmental disorders Staying ahead of the Y2K curve offers added clinical benefits New combination therapies recommended by Stanford-led stroke panel PAST ISSUES |
