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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Network Security

The easiest way for an external threat to get to your private data is through your network. The easiest way to eliminate that threat? Get your data out of the network. Of course, we know you wouldn’t want to do that. We also know that while you may want to sniff every packet for anything suspicious, you wouldn’t want your network to crawl either.

That’s why we’re offering to put up the most efficient checkpoints on every route that leads into and out of your system.

So what can you expect from our brand of network security?

Review of your policies and processes for weaknesses – If we see a loophole, we’ll recommend modifications wherever necessary.
Protection for your applications and infrastructure – Since we’re familiar with both software and hardware-based protection systems, we can recommend which type is best suited for your setup.
Automated identification of business and mission critical applications – They’ll be given priority in your network to ensure bandwidth allocation is optimised.
Automated network audits and vulnerability management – Tired of getting prompted by pesky vulnerability notices and don’t know what to do with them? Well, that’s why we’re here.
Customisable security reports that contain only relevant and accurate data.

We can also help you with the following:

ESOS ? Why we must have it

The 9,000 big UK businesses directly affected by the new Energy Saving Opportunity Scheme could save UK?250 million between them, or an average UK?27,000 each, if they reduced electricity consumption by just 1%. The total amount is equal to the output of five power stations, at a time when Britain?s grid is under strain.
On 26 November 2014, UK Energy and Climate Change Secretary Ed Davey met with over 100 opinion makers from businesses, charities and universities at the Institute of Directors. The gist of what he presented was:

?Britain?s big firms are spending around ?2.8 billion extra each year on inefficient energy technologies ? the equivalent output of nearly five power stations;

Now is the time to seize the opportunity with ESOS ? and organisations up and down the country are already gearing up to make changes to save energy, save money and save the environment.

If business did what business is supposed to do [that is innovate to make money] and act and invest, it will save ? and that’s the bottom line.?

The environmental benefits are as important although EcoVaro agrees with Ed Davey for taking a pecuniary approach. Businesses above the threshold of 250 staff and a balance sheet of UK?34 million would have not achieved their status unless they spent their money wisely.
The discussion panel included Rhian Kelly (Director of Business Environment at CBI), and Paul Ekins (Director UCL Institute for Sustainable Resources & Deputy Director of the UK Energy Research Centre). Hugh Jones, Managing Director, Advisory at the Carbon Trust responded to Ed Davey?s remarks by commenting:

?At the Carbon Trust we have already engaged with hundreds of businesses on ESOS, helping to explain how they can achieve compliance while also making significant energy savings and cutting carbon.
Businesses often aren’t aware of opportunities in energy efficiency, or they don’t realise how attractive the paybacks can be. By requiring companies to understand exactly how they can make cost-effective investment in energy efficiency, they are far more likely to take action.
From the interest we have seen so far we expect ESOS to benefit British business by helping companies to reduce overheads and increase competitiveness.

The UK?s Energy Saving Opportunity Scheme ESOS is a gold mine of opportunities for big business, the environment and the population that breathes the air. Measurement of critical energy throughputs is the beginning of the process. EcoVaro is standing by to help you convert your data to meaningful information.

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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