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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Using Pull Systems to Optimise Work Flows in Call Centres

When call centres emerged towards the end of the 20th century, they deserved their name ?the sweatshops of the nineties?. A new brand of low-paid workers crammed into tiny cubicles to interact with consumers who were still trying to understand the system. Supervisors followed ?scientific management? principles aimed at maximising call-agent activity. When there was sudden surge in incoming calls, systems and customer care fell over.

The flow is nowadays in the opposite direction. Systems borrowed from manufacturing like Kanban, Pull, and Levelling are in place enabling a more customer-oriented approach. In this short article, our focus is on Pull Systems. We discuss what are they, and how they can make modern call centres even better for both sets of stakeholders.

Pull Systems from a Manufacturing Perspective

Manufacturing has traditionally been push-based. Sums are done, demand predicted, raw materials ordered and the machines turned on. Manufacturers send out representatives to obtain orders and push out stock. If the sums turn out wrong inventories rise, and stock holding costs increase. The consumer is on the receiving end again and the accountant is irritable all day long.

Just-in-time thinking has evolved a pull-based approach to manufacturing. This limits inventories to anticipated demand in the time it takes to manufacture more, plus a cushion as a trigger. When the cushion is gone, demand-pull spurs the factory into action. This approach brings us closer to only making what we can sell. The consumer benefits from a lower price and the accountant smiles again.

Are Pull Systems Possible in Dual Call Centres

There are many comments in the public domain regarding the practicality of using lean pull systems to regulate call centre workflow. Critics point to the practical impossibility of limiting the number of incoming callers. They believe a call centre must answer all inbound calls within a target period, or lose its clients to the competition.

In this world-view customers are often the losers. At peak times, operators can seem keen to shrug them off with canned answers. When things are quiet, they languidly explain things to keep their occupancy levels high. But this is not the end of the discussion, because modern call centres do more than just take inbound calls.

Using the Pull System Approach in Dual Call Centres

Most call centre support-desks originally focused are handling technical queries on behalf of a number of clients. When these clients? customers called in, their staff used operator?s guides to help them answer specific queries. Financial models?determined staffing levels and the number of ?man-hours? available daily. Using a manufacturing analogy, they used a push-approach to decide the amount of effort they were going to put out, and that is where they planted their standard.

Since these early 1990 days, advanced telephony on the internet has empowered call centres to provide additional remote services in any country with these networks. They have added sales and marketing to their business models, and increased their revenue through commissions. They have control over activity levels in this part of their business. They have the power to decide how many calls they are going to make, and within reason when they are going to make them.

This dichotomy of being passive regarding incoming traffic on the one hand, and having active control over outgoing calls on the other, opens up the possibility of a partly pull-based lean approach to call centre operation. In this model, a switching mechanism moves dual trained operators between call centre duties and marketing activities, as required by the volume of call centre traffic, thus making a pull system viable in dual call centres.

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The Child at Work: Fun Team Builds with LEGO SERIOUS PLAY

There is a child just below the surface in all of us. When were kids, adults lopped off the sharp bits that intruded into their ?genteel? society. Schools, to their everlasting shame sanded away our unique free spirits, as they stuck us into uniforms and imposed a daily classroom discipline. We received badges and prizes if we obeyed, and strict sanctions when we did not. This produced a generation of middle-age managers who no longer know how to play.

Life can be so deadly serious ?

Things work pretty much the same in business. Life is deadly serious. If we want to keep our jobs, we must deliver on the bottom line in our departments. There is little time for fun outside the Christmas party, when we may, within the limits of decorum engage in activity for enjoyment and recreation, rather than a serious or practical purpose.

Team builds (and strategic planning sessions) can be deadly boring affairs that proceed down narrow funnels defined by human resource facilitators. No matter how hard HR they may try, the structural hierarchy will remain intact, unless they find a way to set it aside during the program. Injecting fun into the occasion liberates independent thought, and this is why.

? But not for a little child at play

Next time you dine out at a branded family restaurant, select a seat that allows you observe the kiddies? play zone. Notice how inventive children become, when the family hierarchy is not there to tell them what to do (although parents may try from the wrong side of the soundproof glass). The ?serious play? side of fun team-builds aims to liberate managers by releasing their child for the duration. Shall we dig a little deeper into this and discover the dynamics?

Many of us have less than perfect oral communication skills. This is one of the great impediments to modern business meetings. We may not have sufficient time to formulate our thoughts for them to remain relevant when we speak. When we express them, we sense the group?s impatience for us to hurry up, so other members can have their opportunity to contribute.

Sharing better thinking with LEGO? bricks

Most of us feel an urge to click the brightly coloured plastic bricks together that carpenter Ole Kirk Christiansen released into a war-weary world in 1949. The basic kit is a great leveller because the blocks are all the same, and the discriminators are the colours and the power of our imagination. Watching a free-form LEGO builder in action is equally fascinating, as we wonder ?what they will do next? and ?what is happening in their mind.?

Examples of LEGO Serious PLAY in action

Instead of asking team members to describe themselves in a minute, a LEGO? SERIOUS PLAY? facilitator may gather them around a table piled high with LEGO bricks instead, and ask them to each build a model of themselves. The atmosphere is informal with interaction and banter encouraged. It is still serious play though, as team members get to know each other, and their own personalities better

The system is equally effective in strategic sessions, where the facilitator provides specially selected building blocks for the team to experiment with as they learn to listen, and share. This enables them to deconstruct a problem into its component parts, and share solutions regardless of seniority, culture, and communication skills.

Creating problem- and solution-landscapes three dimensionally this way, enables open conversations that keep the focus on the problem. Participants at these team builds do not only reach effective consensus faster. They are also busy building better communication skills as they do.

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How the Dodd-Frank Act affects Investment Banking

The regulatory reform known as the Dodd-Frank Act has been hailed as the most revolutionary, comprehensive financial policy implemented in the United States since the years of the Great Depression. Created to protect consumers and investors, the Dodd-Frank Act is made up of a set of regulations and restrictions overseen by a number of specific government departments. As a result of this continuous scrutiny, banks and financial institutions are now subject to more-stringent accountability and full-disclosure transparency in all transactions.

The Dodd-Frank Act was also created to keep checks and balances on mega-giant financial firms that were considered too big to crash or default. This was especially deemed crucial after the collapse of the powerhouse financial institution Lehman Brothers in 2008. The intended result is to bring an end to the recent rash of bailouts that have plagued the U.S. financial system.

Additionally, the Dodd-Frank Act was created to protect consumers from unethical, abusive practices in the financial services industry. In recent years, reports of many of these abuses have centered around unethical lending practices and astronomically-high interest rates from mortgage lenders and banks.

Originally created by Representative Barney Frank, Senator Chris Dodd and Senator Dick Durbin, the Dodd-Frank Wall Street Reform and Consumer Protection Act, as it is officially called, originated as a response to the problems and financial abuses that had been exposed during the nation’s economic recession, which began to worsen in 2008. The bill was signed into law and enacted by President Obama on July 21, 2010.

Although it may seem complicated, the Dodd-Frank Act can be more easily comprehended if broken down to its most essential points, especially the points that most affect investment banking. Here are some of the component acts within the Dodd-Frank Act that directly involve regulation for investment banks and lending institutions:

* Financial Stability Oversight Council (FSOC): The FSOC is a committee of nine member departments, including the Securities and Exchange Commission, the Federal Reserve and the Consumer Financial Protection Bureau. With the Treasury Secretary as chairman, the FSOC determines whether or not a bank is getting too big. If it is, the Federal Reserve can request that a bank increase its reserve requirement, which is made up of funds in reserve that aren’t being used for business or lending costs. The FSOC also has contingencies for banks in case they become insolvent in any way.

? The Volcker Rule: The Volcker Rule bans banks from investing, owning or trading any funds for their own profit. This includes sponsoring hedge funds, maintaining private equity funds, and any other sort of similar trading or investing. As an exception, banks will still be allowed to do trading under certain conditions, such as currency trading to circulate and offset their own foreign currency holdings. The primary purpose of the Volcker Rule is to prohibit banks from trading for their own financial gain, rather than trading for the benefit of their clients. The Volcker Rule also serves to prohibit banks from putting their own capital in high-risk investments, particularly since the government is guaranteeing all of their deposits. For the next two years, the government has given banks a grace period to restructure their own funding system so as to comply with this rule.

? Commodity Futures Trading Commission (CFTC): The CFTC regulates derivative trades and requires them to be made in public. Derivative trades, such as credit default swaps, are regularly transacted among financial institutions, but the new regulation insures that all such trades must now be done under full disclosure.

? Consumer Financial Protection Bureau (CFPB): The CFPB was created to protect customers and consumers from unscrupulous, unethical business practices by banks and other financial institutions. One way the CFPB works is by providing a toll-free hotline for consumers with questions about mortgage loans and other credit and lending issues. The 24- hour hotline also allows consumers to report any problems they have with specific financial services and institutions.

? Whistle-Blowing Provision: As part of its plan to eradicate corrupt insider trading practices, the Dodd-Frank Act has a proviso allowing anyone with information about these types of violations to come forward. Consumers can report these irregularities directly to the government, and may be eligible to receive a financial reward for doing so.

Critics of the Dodd-Frank Act feel that these regulations are too harsh, and speculate that the enactment of these restrictions will only serve to send more business to European investment banks. Nevertheless, there is general agreement that the Dodd-Frank Act became necessary because of the unscrupulous behaviour of the financial institutions themselves. Although these irregular and ultimately unethical practices resulted in the downfall of some institutions, others survived or were bailed out at the government’s expense.

Because of these factors, there was more than the usual bi-partisan support for the Dodd-Frank Act. As a means of checks and balances, the hope is that the new regulations will make the world of investment banking a safer place for the consumer.

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