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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How DevOps Could Change Your Business

Henry Ford turned the U.S. auto industry on its head when he introduced the idea of prefabricating components at remote sites, and then putting them together on a production line. Despite many industries following suit, software lagged behind until 2008, when Andrew Clay Shafer and Patrick Debois told the Agile Conference there was a better way to develop code:
– Write the Code
– Test the Code
– Use the Code
– Evaluate, Schedule for Next Review

The term ?DevOps? is short for Development and Operations. It first appeared in Belgium, where developers refined Shafer and Depois? ideas. Since then, DevOps became a counter movement against the belief that software development is a linear process and has largely overwhelmed it.

DevOps – A Better Way

DevOps emerged at an exciting time in the IT industry, with new technology benefiting from a faster internet. However, the 2008 world recession was also beginning to bite. Developers scampered to lower their human resource costs and get to market sooner.

The DevOps method enabled them to colloborate across organizational boundaries and work together to write, quality assure and performance test each piece of code produced in parallel.
DevOps? greater time-efficiency got them to market sooner and helped them steal a march on the competition.

There are many advantages to DevOps when we work in this collaborative way. Cooperation improves relationships between developers, quality assurers and end users. This helps ensure a better understanding of the other drivers and a more time-effective product.

Summary of DevOps Objectives

DevOps spans the entire delivery pipeline, and increases the frequency with which progress is reviewed, and updates are deployed. The benefits of this include:

? Faster time to market and implementation

? Lower failure rate of new releases

? Shortened lead time for bug fixes and updates

The Psycho-Social Implications of DevOps

DevOps drills through organization borders and traditional work roles. Participants must welcome change and take on board new skills. Its interdepartmental approach requires closer collaboration across structural boundaries and greater focus on overarching business goals.

Outsourcing the detail to freelancers on the Internet adds a further layer of opportunity. Cultures and time zones vary, requiring advanced project management skills. Although cloud-based project management software provides adequate tools, it needs an astute mind to build teams that are never going to meet.

The DevOps movement is thus primarily a culture changer, where parties to a project accept the good intentions of their collaborators, while perhaps tactfully proposing alternatives. There is more to accepting a culture than using a new tool. We have to blend different ways of thinking together. We conclude by discussing three different methods to achieve this.

Three Ways to Deploy DevOps in your?Organisation

If you foresee regular DevOps-based projects, consider running your entire organisation through an awareness program to redirect thinking. This will help non-participants understand why DevOps members may be ?off limits? when they are occupied with project work. Outsourcing tasks to contracting freelancers can mitigate this effect.

There are three implementation models associated with DevOps although these are not mutually exclusive.

? Use systems thinking. Adopt DevOps as company culture and apply it to every change regardless of whether the process is digital, or not

? Drive the process via increased understanding and feedback from key receivers. Allow this to auto-generate participative DevOps projects

? Adopt a continuous improvement culture. DevOps is not only for mega upgrades. Feedback between role players is paramount for success everywhere we go.

You can use the DevOps concept everywhere you go and whenever you need a bridge to better understanding of new ideas. We diminish DevOps when we restrict its usefulness to the vital role it plays in software development. The philosophy behind it belongs in every business.

Advanced Business Management

Our consultants are highly trained to provide complex management solutions and strategy planning for your business. You can count on us to improve performance and your business skills, while cutting costs.

We ensure full support in a broad range of business management areas, such as:

Business Strategy

Knowing how and when to make the right strategic move is critical to your success in today?s dynamic environment. Our Strategic Management Consultants provide solutions for a tighter integration of your vision, values, and mission statements with the strategic management process.

The result is a stronger alignment of your operating activities with your goals, and also an improved internal infrastructure to support and manage the strategic management process.

Business Process Improvements

In our years of activity, we have developed a robust process to ensure Business Process Improvements projects are implemented successfully. To achieve a positive outcome a number of factors must exist and we?ll make sure your company manages to get the right mix of: sponsorship management and commitment, process improvement goals, right motivations, cultural issues management, provision of adequate resources and funding, and availability of standards and procedures.

Performance Management

An effective performance management system integrates all aspects of the organisation from a shared vision, through a common language, and establishes a culture of accountability and results. It provides more of a holistic way of managing your organization that is more powerful than its individual parts, and without forsaking the values of the organisation.

Change Management Services

Economic downturns, fast rising new competitors, and even climate change, can force companies to scale down, engage in mergers & acquisitions, or transfer to a new location. We?ll help you through every step of the change process, from: evaluating the required change by conducting diagnostics such as change complexity, causal, structural, and context analysis, managing stakeholders including your sponsors, top executives, managers, and personnel, planning for the change, and managing the change process itself.

Project Management

Whether you need help for a single project or much more, we’ve got you covered. With us you get a coordinated, presence-of-mind approach to project management that will point all of your projects to an overall strategic direction, no matter how complex or simple these might be. Our services incorporate all project-related activities including: programme management, project risk management, project review and audit, project rescue, and project governance.

Interim Management

Our resources have an MBA and/or professional accounting qualifications with an average of 10 ? 30 years of progressive work experience with public companies, in complex private equity environments, and/or privately-held middle market companies. We not only offer the most highly qualified project / interim resources to our clients, but we also allow for an interim-to-hire provision in our contracts.

It has proved mutually beneficial to our consultants and clients to have the option for longer term employment opportunities after having worked together on a project / interim basis.

Is Your Project Agile, a Scrum or a Kanban?

Few projects pan out the way we expect when starting out. This is normal in any creative planning phase. We half suspect the ones that follow a straight line are the exceptions to the rule. Urban legend has it; Edison made a thousand prototypes before his first bulb lit up, and then went on to comment, ?genius is 1% inspiration, 99% perspiration?. Later, he added that many of life’s failures are people who did not realise just how close they were to success when they gave up.

So be it to this day, and so be it with project planning too. There is no one size fits all approach when it comes to it. Agile, Scrum and Kanban each have their supporters and places where they do well. Project planning often works best when we use a sequential combination of them, appropriate to what is currently happening on the ground.

Of the three, Agile is by far the most comprehensive. It provides a structure that begins with project vision / conceptualisation, and goes as far as celebration when the job is over, and retrospective discussion afterwards. However, the emphasis on daily planning meetings may dent freethinking, and even smother it.

Scrum on the other hand says ?forget all that bureaucracy?. There is a job to do and today is the day we are going to do it. Although the core Agile teamwork is still there it ignores macro project planning, and could not be bothered with staying in touch with customers. If using Scrum, it is best to give those jobs to someone else.

The joker in the pack is Kanban, It believes that rules are there to substitute for thought, and that true progress only comes from responsible freedom. It belongs in mature organisations that have passed through Scrum and Agile phases and have embarked on a voyage towards perfection.

That said, there can be no substitute for human leadership, especially when defined as the social influence that binds the efforts of others towards a single task.