Year 2000 Computing Crisis: Leadership Needed to Collect and Disseminate
Critical Biomedical Equipment Information (Testimony, 09/24/98,
GAO/T-AIMD-98-310).

Biomedical equipment that relies on computers or computer chips, from
cardiac monitoring systems to electronic imaging machines, may be
adversely affected by the Year 2000 problem. Although this situation has
serious implications for the delivery of health care to the nation's
veterans, the Veterans Health Administration (VHA) still does not know
the full extent of its Year 2000 problem or the cost to overcome it.
This is because it has yet to receive compliance information from 27
percent of the biomedical equipment manufacturers on its list of
suppliers or from the nearly 100 other manufacturers that VHA discovered
were no longer in business. According to VHA, most manufacturers
reporting noncompliant equipment cited incorrect display of date or time
as problems--albeit ones that health care providers can work around.
Some manufacturers, however, cited more serious problems that could
jeopardize patient safety. For example, a miscalculation by a radiation
therapy planning computer could cause a patient to receive a hazardous
radiation dose. The Food and Administration (FDA), which oversees and
regulates medical devices, has sent letters to biomedical equipment
manufacturers asking for information on products affected by the Year
2000 problem. The response rate to FDA has been disappointing. It is
critical that such information be obtained and publicized. This
testimony summarizes the September 1998 report, GAO/AIMD-98-240.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-AIMD-98-310
     TITLE:  Year 2000 Computing Crisis: Leadership Needed to Collect 
             and Disseminate Critical Biomedical Equipment
             Information
      DATE:  09/24/98
   SUBJECT:  Y2K
             Strategic information systems planning
             Systems compatibility
             Medical equipment
             Health care services
             Medical information systems
             Systems conversions
             Computer software verification and validation
             Computer software
             Embedded computer systems
IDENTIFIER:  VA Year 2000 Strategy
             VA Veterans Integrated Service Network
             Y2K
             Magnetic Resonance Imaging
             
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Cover
================================================================ COVER


Before the Subcommittee on Oversight and Investigations, Committee on
Veterans' Affairs, House of Representatives

For Release on Delivery
Expected at
9:30 a.m.
Thursday,
September 24, 1998

YEAR 2000 COMPUTING CRISIS -
LEADERSHIP NEEDED TO COLLECT AND
DISSEMINATE CRITICAL BIOMEDICAL
EQUIPMENT INFORMATION

Statement of Joel C.  Willemssen
Director, Civil Agencies Information Systems
Accounting and Information Management Division

GAO/T-AIMD-98-310

GAO/AIMD-98-310T


(511262)


Abbreviations
=============================================================== ABBREV

  CIO - x
  DFAS - x
  DLA - x
  DOD - x
  EFT99 - x
  FAA - x
  FDA - x
  HHS - x
  IRS - x
  LSSC - x
  MRI - x
  NRC - x
  OMB - x
  SEC - x
  SSG - x
  USDA - x
  VA - x
  VBA - x
  VHA - x
  VISN - x
  Y2K - x

============================================================ Chapter 0

Mr.  Chairman and Members of the Subcommittee: 

We are pleased to be here today to discuss the Year 2000 compliance
status of biomedical equipment.\1 The question of whether medical
devices such as magnetic resonance imaging (MRI) systems, x-ray
machines, pacemakers, and cardiac monitoring equipment can be counted
on to work reliably on and after January 1, 2000, is obviously of
critical importance to our nation's health care.  To the extent that
biomedical equipment uses computer chips, it is vulnerable to the
Year 2000 problem that we and others have been focusing on for over a
year.\2 In the medical arena, such vulnerability carries with it
possible safety risks. 

The Department of Veterans Affairs (VA)--specifically, the Veterans
Health Administration (VHA)--is attempting to determine the Year 2000
compliance status of biomedical equipment in use in its medical
centers, outpatient clinics, nursing homes, and domiciliaries. 
Within the Department of Health and Human Services (HHS), the Food
and Drug Administration (FDA) oversees and regulates medical devices
in the private sector.  Both organizations are employing the same
strategy:  relying on information provided by equipment
manufacturers.  Our report being released at this hearing details the
status of VHA's and FDA's biomedical equipment programs.\3

In brief, VHA has made progress in implementing its Year 2000
strategy for biomedical equipment, but it still does not know how
pervasive the problem is.  This is because it has not received
compliance and cost information from many of the manufacturers on its
list of suppliers, as well as from the nearly 100 additional
manufacturers no longer in business.  Like VHA, FDA has sent letters
to biomedical equipment manufacturers, requesting information on
products affected by the Year 2000 problem.  The response rate to FDA
has been disappointing.  Failure to obtain timely compliance
information from the manufacturers increases the risk to health care
providers and biomedical equipment users that such equipment may not
operate properly after the turn of the century.  It is critical that
such information be obtained and publicized; while many reported
noncompliant equipment items do not present a risk to patient safety,
some could present such risks. 

My testimony today will discuss (1) the progress that VHA and FDA
have made in determining the compliance status of biomedical
equipment and (2) further actions they need to take to minimize
associated Year 2000 risks. 


--------------------
\1 Biomedical equipment refers both to medical devices regulated by
the Food and Drug Administration (FDA), and scientific and research
instruments, which are not subject to FDA regulation. 

\2 The Year 2000 problem will affect everyone because it is rooted in
how dates are recorded and computed.  For the past several decades,
computer systems have typically used two digits to represent the
year, such as "98" for 1998, in order to conserve electronic data
storage and reduce operating costs.  In this format, however, 2000 is
indistinguishable from 1900 because both are represented as "00." As
a result, if not modified, systems or applications that use dates or
perform date- or time-sensitive calculations may generate incorrect
results beyond 1999.  A listing of our publications on the Year 2000
problem is included as an attachment to this statement. 

\3 Year 2000 Computing Crisis:  Compliance Status of Many Biomedical
Equipment Items Still Unknown (GAO/AIMD-98-240, September 18, 1998). 


   BACKGROUND
---------------------------------------------------------- Chapter 0:1

Biomedical equipment is indispensable; it plays a central role in
virtually all health care.  It can be defined as any tool that can
record, process, analyze, display, and/or transmit medical data--some
of which may even be implanted in patients--and laboratory research
instruments, such as blood gas and glucose analyzers.  Such equipment
may use a computer for calibration or for day-to-day operation.  If
any type of date or time calculation is performed, susceptibility to
a Year 2000 problem exists, whether the computer is a personal
computer that connects to the equipment remotely or a microprocessor
chip embedded within the equipment.  This could range from the more
benign--such as incorrect formatting of a printout--to the most
serious--incorrect operation of equipment with the potential to
decrease patient safety.  The degree of risk depends on the role of
the equipment in the patient's care. 

As a health care provider, VHA is a key stakeholder in determining
the potential effect the Year 2000 computer problem could have on its
biomedical equipment.  Because VHA, like other health care providers
in the private and public sectors, relies on manufacturers to
validate, test, and certify that their equipment is compliant, it is
critical that manufacturers provide this information so that VHA may
take prompt action on noncompliant equipment in its inventory. 
Another key stakeholder in determining the status of equipment
compliance is FDA, which has oversight and regulatory responsibility
for domestic and imported medical devices. 


   VHA:  PROGRESS, BUT SIGNIFICANT
   RISKS REMAIN
---------------------------------------------------------- Chapter 0:2

VHA's strategy for identifying and remedying noncompliant biomedical
equipment comprises five steps:  (1) increased awareness and
continual education of VHA chief information officers (CIO), the
Veterans Integrated Service Networks (VISN),\4 and health care
facilities on biomedical issues, (2) establishment of an expert
working group to provide guidance, (3) development of a database of
biomedical equipment manufacturers that supply equipment to VHA, (4)
surveying of these manufacturers to identify compliance status and
solutions for noncompliant items, and (5) communication of survey
results to the field for use in determining the compliance status of
biomedical equipment at medical facilities.\5

Much of the rationale behind VHA's reliance on biomedical equipment
manufacturers to validate, test, and certify that their equipment is
Year 2000 compliant stems from the position taken by some
manufacturers that VHA should not attempt to conduct in-depth testing
by manipulating the software embedded inside the equipment. 
According to a VHA official, such testing could void the
manufacturer's certification to FDA that the equipment is safe for
use on patients, thereby exposing VHA to legal liability in the event
that a patient's health is harmed by equipment that malfunctions
following VHA testing. 

As part of VHA's strategy, its Year 2000 Project Office sent a series
of letters to biomedical equipment manufacturers requesting Year 2000
compliance status information.  The first letter was sent on
September 9, 1997, to approximately 1,600 manufacturers in VHA's
database of suppliers.  Follow-up letters were subsequently sent in
October and November 1997 and June 1998 to those not previously
responding.  Upon receipt of responses to these letters, VHA
categorized the compliance status provided by the manufacturers for
equipment items, as illustrated in table 1. 



                                Table 1
                
                  VHA Biomedical Equipment Compliance
                               Categories

Category              Explanation
--------------------  ------------------------------------------------
Compliant             Equipment will function properly in all aspects
                      upon the change to the year 2000, without any
                      modification or revision.

Noncompliant          Equipment will not function properly upon the
                      change to the year 2000, and no manufacturer
                      remedy is available. In some cases, improper
                      function involves an incorrect date-time stamp
                      on the output of the equipment, but the
                      equipment's clinical function is not impaired.

Conditional-          Equipment requires some form of user
compliant             intervention to function properly after the year
                      2000. Such intervention includes the
                      installation of manufacturer-provided software
                      or hardware or a one-time user action (such as
                      turning the equipment on and off after the year
                      2000).

Pending               Manufacturers reported to VHA that they have not
                      completed the Year 2000 assessment of their
                      product line.
----------------------------------------------------------------------
Source:  Veterans Health Administration. 

As shown in table 2, manufacturers have provided VHA with compliance
information on a wide range of biomedical equipment. 



                                Table 2
                
                Reported Biomedical Equipment Year 2000
                  Compliance Categories, as of June 1,
                          1998, With Examples

                                     Number of      Examples of
                                     equipment      equipment "types"
Compliance          Number of      "types" within   within this
category          manufacturers    this category    category\a
---------------  ---------------  ----------------  ------------------
Compliant              694             3,873        Examples: intra-
                                                     aortic balloon
                                                     pump, dialysis
                                                     machine
Noncompliant           34               182         Examples:
                                                     defibrillator
                                                     monitor,
                                                     cardiology
                                                     monitor
Conditional-           102              673         Examples:
 compliant                                           electrocardiograph
                                                     machine,
                                                     defibrillator
Pending                53               157         Examples:
                                                     ultrasound
                                                     system,
                                                     ventilator
Manufacturer           187               \b
 merged or
 bought out
======================================================================
Total                 1,070            4,885
----------------------------------------------------------------------
\a Inclusion of a specific type of biomedical equipment in the
compliant, noncompliant, conditional-compliant, or pending category
does not necessarily mean that all equipment of this type in VHA's
inventory was reported by the manufacturer; similar equipment made by
other manufacturers could fall into different categories. 

\b The biomedical equipment reported by these manufacturers has
already been accounted for in one of the above compliance categories. 

Source:  Veterans Health Administration.  We did not independently
verify these data. 

Of the nearly 1,600 manufacturers in VHA's initial mailing over a
year ago, about 100 were no longer in business, and a small number
responded that the Year 2000 issue did not apply to their products. 
Accordingly, VHA revised its list of manufacturers to 1,490 as of
July 29, 1998; it received compliance status information from about
1,100 (73 percent) of these manufacturers.  As shown in table 3, just
under half of the 1,490 reported that all of their devices were Year
2000 compliant. 



                                Table 3
                
                 Status of Manufacturer Responses as of
                             July 29, 1998

                                                             Number of
Status of response                                       manufacturers
------------------------------------------------  --------------------
Compliant manufacturers\a                                          701
Noncompliant manufacturers\b                                        43
Conditional-compliant manufacturers\c                              106
Pending manufacturers\d                                             47
Manufacturer merged or bought out                                  195
Nonresponsive manufacturers\e                                      398
======================================================================
Total                                                            1,490
----------------------------------------------------------------------
\a For inclusion in this category, 100 percent of a manufacturer's
products had to be considered compliant. 

\b For inclusion in this category, only one of a manufacturer's
products had to be considered noncompliant. 

\c For inclusion in this category, the manufacturer had to have no
noncompliant equipment, no pending equipment, and at least one
conditional-compliant equipment item. 

\d For inclusion in this category, the manufacturer had to have no
noncompliant equipment and at least one equipment item pending. 

\e For inclusion in this category, VHA had to have received no
compliance information from the manufacturer. 

Source:  Veterans Health Administration.  We did not independently
verify these data. 

VHA did not receive responses from 398 manufacturers.  According to a
VHA official, letters sent to 227 of these manufacturers were
returned by the U.S.  Postal Service marked "no forwarding address."
Further, as noted in table 3, an additional 47 manufacturers that did
respond are in the pending category because they reported that they
had not completed their assessments and therefore did not yet know if
their products were compliant.  Among the manufacturers who have yet
to respond or complete their assessments is one who supplies
high-dollar, high-value equipment, such as radiology systems and
electronic imaging systems, to VHA. 

According to VHA officials, most of the manufacturers that reported
one or more of their biomedical equipment products as noncompliant
cited incorrect display of date and/or time as the main problems. 
For example, a noncompliant electrocardiograph machine, used to
monitor heart signals, would print charts with two-digit dates,
showing the year 2000 as "00." According to a VHA official, these
cases do not generally lead to the

device's failing to operate and do not present a risk to patient
safety because health care providers, such as physicians and nurses,
are able to work around such problems. 

Conversely, VHA recognizes that incorrect date-time representation or
use could pose a risk when the date is used in a calculation or when
records generated by the equipment are sorted automatically to
present a patient's condition, over a period of time, to a physician
for diagnosis and treatment.  Specifically, when records are sorted
by date of recording, the accuracy of such dates can be critical to a
physician's monitoring of patient progress in, for example, the case
of blood sugar readings.  If readings were taken, for example, on
December 25, 27, and 30, 1999, and again on January 1, 2000, the
ordering might appear with the last entry first, if it were
abbreviated as "00" and read as January 1, 1900.  If the physician or
other clinician did not pay close attention, a diagnosis or treatment
decision could be made based on a misreading of the data trend. 

VHA also recognizes that an equipment function that depends on a
calculation involving a date, and that is performed incorrectly as a
result of a date problem, could present a risk to the patient.  One
example reported by a manufacturer is a product used for planning the
delivery of radiation treatment using a radioactive isotope as the
source.  An error in the calculation of the radiation source's
strength on the day the therapy is to be delivered could result in
inappropriate treatment--either too low or too high a dosage --and
could have an adverse effect on the patient.  Therefore, until VHA
receives compliance information from all of its manufacturers, it
will be stymied from making decisions as to whether to replace,
retire, or continue to use certain biomedical equipment items in its
inventory. 

Another area of concern is the lack of complete cost information for
the replacement or retirement of noncompliant equipment.  Last month,
VA estimated this cost at $40 million.\6 This estimate, however, was
not based on updated cost information from medical facilities, and
VHA did not know the replacement and repair cost for biomedical
equipment for the manufacturers that have not yet reported compliance
and cost information, as well as for the nearly 100 manufacturers no
longer in business.  VHA has acknowledged the shortcomings of its
cost estimate, and just recently began using a new reporting process
to capture the cost to replace or repair its noncompliant equipment. 

In light of the uncertainties surrounding the compliance status of
VHA's biomedical equipment and the potential effect on patient health
and safety, it is crucial that VHA medical facilities develop
business continuity and contingency plans to minimize risks
associated with the Year 2000 problem.  VHA's medical facilities have
not completed plans of this type, and its Year 2000 Project Office
has not finalized a contingency plan guidebook to assist the medical
facilities in their attempts to come to terms with this risk. 


--------------------
\4 There are 22 VISNs, which encompass 172 VHA medical centers, 376
outpatient clinics, 133 nursing homes, and 30 domiciliaries--a total
of 711 facilities. 

\5 On a monthly basis, each medical facility is expected to report to
VHA's Year 2000 Project Office its strategies for dealing with
noncompliant and conditional-compliant equipment in its inventory
(see table 1 for definition), and the cost to accomplish this. 

\6 We did not independently verify the $40 million cost estimate. 


   FDA:  LIMITED PROGRESS IN
   DETERMINING COMPLIANCE STATUS
   OF BIOMEDICAL EQUIPMENT
---------------------------------------------------------- Chapter 0:3

To assist health care facilities in the public and private sectors,
HHS--on behalf of the CIO Council's Subcommittee on the Year 2000 for
Biomedical Equipment and FDA--sent letters to approximately 16,000
biomedical equipment manufacturers\7 in January of this year,
requesting information on the Year 2000 compliance of their complete
product line.  On June 29, FDA sent a second letter to 1,935 medical
device manufacturers that had not previously responded to its inquiry
and that FDA believed had products that might employ computers or
embedded systems.  After being provided to FDA, this information was
to be made available to the public and to government purchasers and
users of these products through an Internet World Wide Web page. 

The response rate to these letters has been disappointing; as of July
30, 1998, only about 12 percent (1,975 out of 16,000 letters) had
responded.  Of the 628 manufacturers reporting that their products do
employ a date/time function, about 100 indicated that one or more of
their products was not compliant. 

According to FDA, it does not perform technical evaluations of
manufacturers' responses to determine their adequacy.  Rather, it
reviews the responses only to determine whether all questions posed
in the letters were answered.  This may explain why FDA's web page
includes this disclaimer: 

     "Inclusion of information in this database indicates that the
     manufacturer has certified that the data is complete and
     accurate.  The Food and Drug Administration, however, cannot and
     does not make any independent assurances or guarantees as to the
     accuracy or completeness of this data."\8

Further, except for diagnostic x-ray equipment, FDA does not test new
medical devices entering the market.  It also does not test devices
for Year 2000 compliance.  According to an FDA official, the agency
does review the test results submitted by manufacturers requesting
pre-market approval of their medical devices to see whether the
manufacturers have demonstrated that their products are safe and
effective for their intended uses.  However, FDA does not plan to
request test results from manufacturers that have renovated medical
devices and/or scientific and research instruments that are not Year
2000 compliant.  Accordingly, no assurances exist that manufacturers'
compliance certifications are accurate. 

While FDA is making compliance information from biomedical equipment
manufacturers available to the public, some users have expressed
concern that information on the FDA web site is not detailed enough
to be useful.  Specifically, FDA's list of compliant equipment
contains no information on the equipment's make or model.  In
contrast, VHA's list of compliant equipment generally contains such
information. 

Further, the Year 2000 compliance information publicly available
through FDA does not include responses from many of the manufacturers
that have responded to VHA.  For example, we selected, on a random
basis, a sample of 53 manufacturers in VHA's database that reported
their products to be Year 2000 compliant; 48 of them were not listed
in the FDA database.  We likewise selected a sample of 13
manufacturers in VHA's database that reported that their products
were not Year 2000 compliant; 12 of these were not listed in the FDA
database.  These manufacturers' products include cardiology
equipment, defibrillator monitors, and ultrasound equipment. 

An FDA official acknowledged that the biomedical equipment
manufacturers were more responsive to VHA's requests for compliance
information.  He stated his belief that the primary reason for this
was VHA's position as a large-volume customer that could take future
action toward the manufacturer if information was not forthcoming. 
He also noted that FDA requested information on manufacturers'
complete product lines, while VHA requested information from
manufacturers only on its list of suppliers. 


--------------------
\7 FDA developed its mailing list from manufacturers that have
registered their products with FDA and from the mailing lists of two
scientific and research instrument manufacturing associations. 
Accordingly, this list included manufacturers that do not employ
computers or embedded systems in their products (e.g., products such
as rubber gloves, tongue depressors, and eyeglasses). 

\8 Food and Drug Administration, Year 2000 Impact on Biomedical
Equipment (Washington, D.C., FDA),
http://www.fda.gov/cdrh/yr2000/y2kintro.html (cited March 19, 1998). 


   VHA PLANS TO MAKE COMPLIANCE
   INFORMATION AVAILABLE TO THE
   PUBLIC
---------------------------------------------------------- Chapter 0:4

Unlike FDA, VHA has not made information from biomedical equipment
manufacturers available via the Internet.  This is because (1) when
VHA requested the information from manufacturers, it did not disclose
its intention to release it outside of the federal government and (2)
VHA had concerns regarding the possibly proprietary nature of some of
the information provided. 

VHA is currently in the process of resolving these concerns. 
Specifically, on the advice of VA's Acting General Counsel, VHA
informed manufacturers in a June 1998 letter that it plans to release
information that the manufacturers provided and that VHA has
determined not to be confidential commercial information.  This is an
important step, as compliance information from biomedical equipment
manufacturers is of interest to all health care providers and users. 

VA has not yet decided how and when a clearinghouse of compliance
information provided to VHA from manufacturers will be made available
to the public.  FDA and VA have, however, discussed using FDA's web
site as such a clearinghouse. 


   FURTHER ACTIONS NEEDED TO
   MINIMIZE RISKS OF YEAR 2000
   FAILURES
---------------------------------------------------------- Chapter 0:5

Given that some noncompliant biomedical equipment items could pose a
risk to patient safety and that the Year 2000 compliance status of
many equipment items in its inventory is unknown, VHA may not be able
to handle Year 2000 failures affecting its biomedical equipment. 
Because of this, in our report being released today we recommend that
the Secretary of Veterans Affairs direct the Under Secretary for
Health to provide a Year 2000 contingency guidebook for biomedical
equipment to all VHA medical facilities, and ensure that they
complete Year 2000 business continuity and contingency planning for
all biomedical equipment in their inventories. 

It is also crucial that all health care providers and users of
biomedical equipment have access to compliance information from the
manufacturers in order that they may take prompt action on
noncompliant and conditional-compliant equipment in their
inventories.  Accordingly, we recommend that the Secretaries of
Veterans Affairs and Health and Human Services work together in
developing a single data clearinghouse that provides compliance
information to all users of biomedical equipment.  Model-specific
information should be included, along with the names of equipment
manufacturers that have not responded, manufacturers that are no
longer in business, and those that have not provided test results
certifying Year 2000 compliance.  VA and HHS have generally agreed to
implement this recommendation. 

HHS, however, stated its belief that it is neither necessary nor
cost-effective to list all compliant products.  It asserted that
information at the individual model level is only needed for
noncompliant products.  We disagree.  Model-specific information will
provide users with detailed data on the reported compliance status of
their products, especially for those manufacturers that VA has
determined to have merged or been bought out by other manufacturers. 
In this way, rather than taking it on faith that all of a
manufacturer's equipment has been deemed compliant, users will have
greater assurance by seeing the specific model number listed. 

Last, because health care providers rely on manufacturers to
validate, test, and certify that their equipment is compliant, there
are no assurances that manufacturers have adequately addressed the
Year 2000 problem for noncompliant equipment, especially since FDA
does not require manufacturers to submit test results certifying
compliance.  To address this concern, we recommend that the
Secretaries of Veterans Affairs and Health and Human Services, in
conjunction with VA's Under Secretary for Health and the Commissioner
of the Food and Drug Administration, (1) determine what actions
should be taken regarding biomedical equipment manufacturers that
have not responded to their requests for compliance information, (2)
determine what actions are needed to address equipment produced by
manufacturers no longer in business, (3) take prudent steps to review
test results for critical care/life support equipment once determined
to be noncompliant but now judged by the manufacturers to be
compliant, and (4) determine what legislative, regulatory, or other
changes are necessary to obtain assurances that the manufacturers'
equipment is compliant, including performing independent verification
and validation of the manufacturers' certifications. 

VA stated that it has no legislative or regulatory authority to
implement the recommendation and deferred to HHS.  HHS agreed to
implement two components of the recommendation:  specifically, to
determine the actions that should be taken with respect to those
manufacturers who fail to respond to requests for compliance
information, and to include in the clearinghouse database the
identity of defunct manufacturers, along with the known types, makes,
and models of devices that they manufactured.  It did not agree to
reviewing test results supporting manufacturers' certifications.  It
stated that the submission of appropriate certifications of
compliance is sufficient to ensure that the certifying manufacturers
are in compliance.  We disagree that this is sufficient.  Through
independent reviews of the manufacturers' test results, users of the
medical devices are provided with a greater level of confidence that
the devices are Year 2000 compliant. 

In summary, VHA and FDA do not yet know the full extent of the Year
2000 problem with biomedical equipment because they have not received
compliance information from many of the manufacturers.  Further, they
have not reviewed test results supporting manufacturers'
certifications to provide the American public with a high level of
confidence that biomedical equipment will work as intended.  While
some aspects of equipment noncompliance may not affect patient
safety, some may; we do not know for sure.  Therefore, VHA and FDA
need to work together--along with others in the health care
industry--to make this information available to the public quickly so
that appropriate action can be taken to remedy any potential risks to
patient safety. 


-------------------------------------------------------- Chapter 0:5.1

Mr.  Chairman, this completes my statement.  I would be pleased to
respond to any questions that you or other Members of the
Subcommittee may have at this time. 



GAO REPORTS AND TESTIMONY
ADDRESSING THE YEAR 2000 CRISIS
=================================================== Chapter Attachment

Year 2000 Computing Crisis:  Federal Reserve Is Acting to Ensure
Financial Institutions Are Fixing Systems, But Challenges Remain
(GAO/AIMD-98-248, September 17, 1998). 

Year 2000 Computing Crisis:  Federal Depository Institution
Regulators Are Making Progress, But Challenges Remain
(GAO/T-AIMD-98-305, September 17, 1998). 

Year 2000 Computing Crisis:  Progress Made at Department of Labor,
But Key Systems at Risk (GAO/T-AIMD-98-303, September 17, 1998). 

Year 2000 Computing Crisis:  Significant Risks Remain to Department
of Education's Student Financial Aid Systems (GAO/T-AIMD-98-302,
September 17, 1998). 

Year 2000 Computing Crisis:  Severity of Problem Calls for Strong
Leadership and Effective Partnerships (GAO/T-AIMD-98-278, September
3, 1998). 

Year 2000 Computing Crisis:  Strong Leadership and Effective
Partnerships Needed to Reduce Likelihood of Adverse Impact
(GAO/T-AIMD-98-277, September 2, 1998). 

Year 2000 Computing Crisis:  Strong Leadership and Effective
Partnerships Needed to Mitigate Risks (GAO/T-AIMD-98-276, September
1, 1998). 

Year 2000 Computing Crisis:  State Department Needs To Make
Fundamental Improvements To Its Year 2000 Program (GAO/AIMD-98-162,
August 28, 1998). 

Year 2000 Computing:  EFT99 Is Not Expected to Affect Year 2000
Remediation Efforts (GAO/AIMD-98-272R, August 28, 1998). 

Year 2000 Computing Crisis:  Progress Made in Compliance of VA
Systems, But Concerns Remain (GAO/AIMD-98-237, August 21, 1998). 

Year 2000 Computing Crisis:  Avoiding Major Disruptions Will Require
Strong Leadership and Effective Partnerships (GAO/T-AIMD-98-267,
August 19, 1998). 

Year 2000 Computing Crisis:  Strong Leadership and Partnerships
Needed to Address Risk of Major Disruptions (GAO/T-AIMD-98-266,
August 17, 1998). 

Year 2000 Computing Crisis:  Strong Leadership and Partnerships
Needed to Mitigate Risk of Major Disruptions (GAO/T-AIMD-98-262,
August 13, 1998). 

FAA Systems:  Serious Challenges Remain in Resolving Year 2000 and
Computer Security Problems (GAO/T-AIMD-98-251, August 6, 1998). 

Year 2000 Computing Crisis:  Business Continuity and Contingency
Planning (GAO/AIMD-10.1.19, August 1998). 

Internal Revenue Service:  Impact of the IRS Restructuring and Reform
Act on Year 2000 Efforts (GAO/GGD-98-158R, August 4, 1998). 

Social Security Administration:  Subcommittee Questions Concerning
Information Technology Challenges Facing the Commissioner
(GAO/AIMD-98-235R, July 10, 1998). 

Year 2000 Computing Crisis:  Actions Needed on Electronic Data
Exchanges (GAO/AIMD-98-124, July 1, 1998). 

Defense Computers:  Year 2000 Computer Problems Put Navy Operations
at Risk (GAO/AIMD-98-150, June 30, 1998). 

Year 2000 Computing Crisis:  A Testing Guide (GAO/AIMD-10.1.21,
Exposure Draft, June 1998). 

Year 2000 Computing Crisis:  Testing and Other Challenges Confronting
Federal Agencies (GAO/T-AIMD-98-218, June 22, 1998). 

Year 2000 Computing Crisis:  Telecommunications Readiness Critical,
Yet Overall Status Largely Unknown (GAO/T-AIMD-98-212, June 16,
1998). 

GAO Views on Year 2000 Testing Metrics (GAO/AIMD-98-217R, June 16,
1998). 

IRS' Year 2000 Efforts:  Business Continuity Planning Needed for
Potential Year 2000 System Failures (GAO/GGD-98-138, June 15, 1998). 

Year 2000 Computing Crisis:  Actions Must Be Taken Now to Address
Slow Pace of Federal Progress (GAO/T-AIMD-98-205, June 10, 1998). 

Defense Computers:  Army Needs to Greatly Strengthen Its Year 2000
Program (GAO/AIMD-98-53, May 29, 1998). 

Year 2000 Computing Crisis:  USDA Faces Tremendous Challenges in
Ensuring That Vital Public Services Are Not Disrupted
(GAO/T-AIMD-98-167, May 14, 1998). 

Securities Pricing:  Actions Needed for Conversion to Decimals
(GAO/T-GGD-98-121, May 8, 1998). 

Year 2000 Computing Crisis:  Continuing Risks of Disruption to Social
Security, Medicare, and Treasury Programs (GAO/T-AIMD-98-161, May 7,
1998). 

IRS' Year 2000 Efforts:  Status and Risks (GAO/T-GGD-98-123, May 7,
1998). 

Air Traffic Control:  FAA Plans to Replace Its Host Computer System
Because Future Availability Cannot Be Assured (GAO/AIMD-98-138R, May
1, 1998). 

Year 2000 Computing Crisis:  Potential for Widespread Disruption
Calls for Strong Leadership and Partnerships (GAO/AIMD-98-85, April
30, 1998). 

Defense Computers:  Year 2000 Computer Problems Threaten DOD
Operations (GAO/AIMD-98-72, April 30, 1998). 

Department of the Interior:  Year 2000 Computing Crisis Presents Risk
of Disruption to Key Operations (GAO/T-AIMD-98-149, April 22, 1998). 

Tax Administration:  IRS' Fiscal Year 1999 Budget Request and Fiscal
Year 1998 Filing Season (GAO/T-GGD/AIMD-98-114, March 31, 1998). 

Year 2000 Computing Crisis:  Strong Leadership Needed to Avoid
Disruption of Essential Services (GAO/T-AIMD-98-117, March 24, 1998). 

Year 2000 Computing Crisis:  Federal Regulatory Efforts to Ensure
Financial Institution Systems Are Year 2000 Compliant
(GAO/T-AIMD-98-116, March 24, 1998). 

Year 2000 Computing Crisis:  Office of Thrift Supervision's Efforts
to Ensure Thrift Systems Are Year 2000 Compliant (GAO/T-AIMD-98-102,
March 18, 1998). 

Year 2000 Computing Crisis:  Strong Leadership and Effective
Public/Private Cooperation Needed to Avoid Major Disruptions
(GAO/T-AIMD-98-101, March 18, 1998). 

Post-Hearing Questions on the Federal Deposit Insurance Corporation's
Year 2000 (Y2K) Preparedness (AIMD-98-108R, March 18, 1998). 

SEC Year 2000 Report:  Future Reports Could Provide More Detailed
Information (GAO/GGD/AIMD-98-51, March 6, 1998). 

Year 2000 Readiness:  NRC's Proposed Approach Regarding Nuclear
Powerplants (GAO/AIMD-98-90R, March 6, 1998). 

Year 2000 Computing Crisis:  Federal Deposit Insurance Corporation's
Efforts to Ensure Bank Systems Are Year 2000 Compliant
(GAO/T-AIMD-98-73, February 10, 1998). 

Year 2000 Computing Crisis:  FAA Must Act Quickly to Prevent Systems
Failures (GAO/T-AIMD-98-63, February 4, 1998). 

FAA Computer Systems:  Limited Progress on Year 2000 Issue Increases
Risk Dramatically (GAO/AIMD-98-45, January 30, 1998). 

Defense Computers:  Air Force Needs to Strengthen Year 2000 Oversight
(GAO/AIMD-98-35, January 16, 1998). 

Year 2000 Computing Crisis:  Actions Needed to Address Credit Union
Systems' Year 2000 Problem (GAO/AIMD-98-48, January 7, 1998). 

Veterans Health Administration Facility Systems:  Some Progress Made
In Ensuring Year 2000 Compliance, But Challenges Remain
(GAO/AIMD-98-31R, November 7, 1997). 

Year 2000 Computing Crisis:  National Credit Union Administration's
Efforts to Ensure Credit Union Systems Are Year 2000 Compliant
(GAO/T-AIMD-98-20, October 22, 1997). 

Social Security Administration:  Significant Progress Made in Year
2000 Effort, But Key Risks Remain (GAO/AIMD-98-6, October 22, 1997). 

Defense Computers:  Technical Support Is Key to Naval Supply Year
2000 Success (GAO/AIMD-98-7R, October 21, 1997). 

Defense Computers:  LSSC Needs to Confront Significant Year 2000
Issues (GAO/AIMD-97-149, September 26, 1997). 

Veterans Affairs Computer Systems:  Action Underway Yet Much Work
Remains To Resolve Year 2000 Crisis (GAO/T-AIMD-97-174, September 25,
1997). 

Year 2000 Computing Crisis:  Success Depends Upon Strong Management
and Structured Approach (GAO/T-AIMD-97-173, September 25, 1997). 

Year 2000 Computing Crisis:  An Assessment Guide (GAO/AIMD-10.1.14,
September 1997). 

Defense Computers:  SSG Needs to Sustain Year 2000 Progress
(GAO/AIMD-97-120R, August 19, 1997). 

Defense Computers:  Improvements to DOD Systems Inventory Needed for
Year 2000 Effort (GAO/AIMD-97-112, August 13, 1997). 

Defense Computers:  Issues Confronting DLA in Addressing Year 2000
Problems (GAO/AIMD-97-106, August 12, 1997). 

Defense Computers:  DFAS Faces Challenges in Solving the Year 2000
Problem (GAO/AIMD-97-117, August 11, 1997). 

Year 2000 Computing Crisis:  Time Is Running Out for Federal Agencies
to Prepare for the New Millennium (GAO/T-AIMD-97-129, July 10, 1997). 

Veterans Benefits Computer Systems:  Uninterrupted Delivery of
Benefits Depends on Timely Correction of Year-2000 Problems
(GAO/T-AIMD-97-114, June 26, 1997). 

Veterans Benefits Computer Systems:  Risks of VBA's Year-2000 Efforts
(GAO/AIMD-97-79, May 30, 1997). 

Medicare Transaction System:  Success Depends Upon Correcting
Critical Managerial and Technical Weaknesses (GAO/AIMD-97-78, May 16,
1997). 

Medicare Transaction System:  Serious Managerial and Technical
Weaknesses Threaten Modernization (GAO/T-AIMD-97-91, May 16, 1997). 

Year 2000 Computing Crisis:  Risk of Serious Disruption to Essential
Government Functions Calls for Agency Action Now (GAO/T-AIMD-97-52,
February 27, 1997). 

Year 2000 Computing Crisis:  Strong Leadership Today Needed To
Prevent Future Disruption of Government Services (GAO/T-AIMD-97-51,
February 24, 1997). 

High-Risk Series:  Information Management and Technology
(GAO/HR-97-9, February 1997). 


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