Disadvantages of Spreadsheets – Obstacles to Compliance in the Healthcare Industry

Most of the regulatory compliance issues we talked about concerning spreadsheets have been related to financial data. But there are other kinds of data that are stored in spreadsheets which may also cause regulatory problems in the future.

In the US, a legislation known as HIPAA or Health Insurance Portability and Accountability Act is changing the way health care establishments and practitioners handle patient records. The HIPAA Privacy Rule is aimed at protecting the privacy of individually identifiable health information a.k.a. protected health information (PHI).

Examples of PHI include common identifiers like a patient’s name, address, Social Security Number, and so on, which can be used to identify the patient. HIPAA covers a wide range of health care organisations and service providers, including: health plan payers, health care clearing houses, hospitals, doctors, dentists, etc.

To protect the confidentiality, integrity, and availability of PHI, covered entities are required to implement technical policies such as access controls, authentication, and audit controls. These can easily be implemented on server-based systems.

Sad to say, many health care organisations who have started storing data electronically still rely on spreadsheet-based systems. Those policies are hard to implement in spreadsheet-based systems, where files are handled by end-users who are overloaded with their main line of work (i.e. health care) and have very little concern for data security.

In some of these systems, spreadsheet files containing PHI may have multiple versions in different workstations. Chances are, none of these files have any access control or user authentication mechanism whatsoever. Thus, changes can easily be made without proper documentation as to who carried out the changes.

And because the files are normally easily accessible, unauthorised disclosures – whether done intentionally or accidentally – will always be a lingering threat. Remember that HIPAA covered entities who are caught disclosing PHI can be fined from $50,000 up to $500,000 plus jail time.

But that’s not all. Through the HITECH Act of 2009, business associates of covered entities will now have to comply with HIPAA standards as well. Business associates are those companies who are performing functions and services for covered entities.

Examples of business associates are accounting firms, law firms, consultants, and so on. They automatically need to comply with the standards the moment they too deal with PHI.

More Spreadsheet Blogs

Spreadsheet Risks in Banks

Top 10 Disadvantages of Spreadsheets

Disadvantages of Spreadsheets – obstacles to compliance in the Healthcare Industry

How Internal Auditors can win the War against Spreadsheet Fraud

Spreadsheet Reporting – No Room in your company in an age of Business Intelligence

Still looking for a Way to Consolidate Excel Spreadsheets?

Disadvantages of Spreadsheets

Spreadsheet woes – ill equipped for an Agile Business Environment

Spreadsheet Fraud

Spreadsheet Woes – Limited features for easy adoption of a control framework

Spreadsheet woes – Burden in SOX Compliance and other Regulations

Spreadsheet Risk Issues

Server Application Solutions – Don’t let Spreadsheets hold your Business back

Why Spreadsheets can send the pillars of Solvency II crashing down

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Green Business!

Carbon emissions reduction has evolved beyond simply good citizenship to being a business tool. Implementing ?green? initiatives is now a competitive weapon which defines real business opportunities and bottom line savings that can contribute significant financial value to the organisation while meeting demanding customer requirements for sustainable and low-carbon products.

Energy efficiency is a low cost resource for achieving carbon emissions reduction. Better energy efficiency simply translates to lesser carbon emissions and less energy usage which translates into saved costs.

Reduction of an organisations carbon footprint is each and everyone?s responsibility. Human activities are the key responsibility for the release of greenhouse gas emissions into the atmosphere. These include usage of electricity generated from fossil fuel, heating or driving.

At the corporate level, various measures can be instigated to increase energy efficiency. Some of these can be, having zone lighting with sensors to minimise unnecessary office lighting, timers on large IT equipment, promoting energy efficient behaviour in the office, asking staff to switch off and unplug appliances when not in use and minimising staff travel.
At the individual level; it is the small habits that count; cultivating the habit of switching off unnecessary lights, plugging out appliances that are not in use, using video conferencing or online chatting instead of having to travel to meetings, using public transport instead of taking a taxi/ personal car and using energy efficient cars.

All these initiatives assist organisations in their corporate social responsibility reports and play a role in sustainability rankings which is instrumental to customers who are increasingly considering sustainability rankings in investment decisions, while achieving the goal of cost reduction internally.

Making Click-and-Collect click

In my previous post, I introduced you to integrated e-commerce and explained why it is the right way to extend your business online. If you already have a brick-and-mortar retailing business and you’re looking to improve your online presence, you could start offering a click-and-collect service.

With click-and-collect, customers order online and then collect their merchandise from one of the retailer?s local branches. Why would they want to do that?

Apparently, there are buyers who now prefer a click-and-collect service over the delivery service of a purely online retailer. With the latter, they sometimes have to wait forever for the delivery van to arrive or contend with a missed-delivery card.

Basically, customers who want both the convenience of placing orders online and better control of their time find click-and-collect a better option.

Last December 2011, IMRG (Interactive Media in Retail Group) reported a ?significant rise in the percentage of click-and-collect e-retail sales in the 3rd quarter of 2011?. This accounted for 10.4% of all e-retail sales in that quarter. More specifically, the gain was 7.4%, which was also the strongest quarterly gain since IMRG started collecting this data.

Clearly, this particular service is gaining popularity. But how do you meet the rising demand in this area?

A click-and-collect service requires a highly synchronised ecosystem. You don’t want to have a customer order items from your online store, drive a couple of minutes from his house to your nearest outlet, only to find out that one of the items is no longer available.

This can only work if all systems involved are interconnected. Changes in the inventory in your individual outlets should reflect on your database in real time. In turn, these changes have to be reflected instantly on your online store. Conversely, once a buyer has picked items online and is already directed to a local outlet, those items have to be reserved there.

But that’s not all. Your system has to be seamless enough to support fast and reliable service. You don’t want your buyer to have to wait a long time before the items are ready for pick-up. It also has to be capable of tracking the status of ordered products, handling uncollected orders, and monitoring inventory.

By implementing an integrated e-commerce system, these won’t be the only things you?d be able to do. You can even add more value to your service. For example, you can connect to your CRM and learn more about your customers? purchase history, buying habits, and preferences.

That way, it would be easier for you to provide a faster and more convenient buying experience for them in the future.

Click-and-collect is a very promising way to increase your sales and improve customer loyalty.

The Connection Between Six Sigma and CRM

Six Sigma is an industrial business strategy directed at improving the quality of process outputs by eliminating errors and system variables. The end objective is to achieve a state where 99.99966% of events are likely to be defect free. This would yield a statistical rating of Sigma 6 hence the name.

The process itself is thankfully more user-friendly. It presents a model for evaluating and improving customer relationships based on data provided by an automated customer relations management (CRM) system. However in the nature of human interaction we doubt the 99.99966% is practically achievable.

Six Sigma Fundamentals

The basic tenets of the business doctrine and the features that set off are generally accepted to be the following:

Continuous improvement is essential for success

Business processes can be measured and improved

Top down commitment is fundamental to sustained improvement

Claims of progress must be quantifiable and yield financial benefits

Management must lead with enthusiasm and passion

Verifiable data is a non-negotiable (no guessing)

Steps Towards the Goal

The five basic steps in Six Sigma are define the system, measure key aspects, analyse the relevant data, improve the method, and control the process to sustain improvements. There are a number of variations to this DMAIC model, however it serves the purpose of this article. To create a bridge across to customer relationships management let us assume our CRM data has thrown out a report that average service times in our fast food chicken outlets are as follows.

<2 Minutes	3 to 8 Minutes	9 to 10 Minutes	>10 Minutes
45%	30%	20%	5%
Table: Servicing Tickets in Chippy?s Chicken Caf?s

Using DMAIC to unravel the reasons behind this might proceed as follows

Define the system in order to understand the process. How are customers prioritised up front, and does the back of store follow suit?

Break the system up into manageable process chunks. How long should each take on average? Where are bottlenecks most likely to occur?

Analyse the ticket servicing data by store, by time of day, by time of week and by season. Does the type of food ordered have a bearing?

Examine all these variables carefully. Should there for example be separate queues for fast and slower orders, are there some recipes needing rejigging

Set a goal of 90% of tickets serviced within 8 minutes. Monitor progress carefully. Relate this to individual store profitability. Provide recognition.

Conclusion

A symbiotic relation between CRM and a process improvement system can provide a powerful vehicle for evidencing customer care and providing feedback through measurable results. Denizon has contributed to many strategically important systems.?

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