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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Saving Energy Step 3 ? Towards a Variable Energy Bill

Do you remember the days when energy was so cheap we paid the bill almost without thinking about it? Things have changed and we have the additional duty of reducing consumption to help save the planet. This is the third article in our mini-series on saving energy. It follows on from the first that explored implementing a management system, and the second listing practical things to implement on the shop floor. These open up the possibility of the variable energy bill we expand on as follows.

If ?variable energy bill? sounds strange to you, I used the unusual turn of phrase to encourage you to view things in a different light. We need to move on from the ?pie chart? mentality where we focus on the biggest numbers like materials, facilities and labour, and zoom in on energy where we can achieve similar gains faster with less pain. But first, we need to see beyond the jargon that governments and consultants love, and get to grips with the reality that we can vary our energy bill and bring cost down.

As executives we recognise this, although other pressures distract us from accepting it as a personal goal. And so we delegate it down the organisation to a level where it becomes ?another crazy management idea? we have to follow to stay out of trouble. I read somewhere that half the world?s organisations do not have energy as a defined objective to monitor in the C Suite. No wonder commerce is only pecking away at energy wastage at a rate of 1% per year.

Find out where you are ?spending energy? and relate this to your core business. If there are places where you are unable to make a connection, challenge the activity?s right to exist. Following the energy trail produces unexpected benefits because it permeates everything we do.

  • Improved product design reducing time spent in factory
  • Streamlined production schedules reducing machine run times
  • Less wear on equipment reducing costly maintenance
  • A more motivated workforce that is prouder of ?what we do?

As you achieve energy savings you can pass these on in terms of lower prices and greater market share. All this and more is possible when you focus on the variables behind your energy bill. Run the numbers. It deserves more attention than it often gets.

Scrumming Down to Complete Projects

Everybody knows about rugby union scrums. For our purposes, perhaps it is best to view them as mini projects where the goal is to get the ball back to the fly-half no matter what the opposition does. Some scrums are set pieces where players follow planned manoeuvres. Loose / rolling scrums develop on the fly where the team responds as best according to the situation. If that sounds to you like software project management then read on, because there are more similarities?.

Isn’t Scrum Project Management the Same as Agile?

No it’s not, because Scrum is disinterested in customer liaison or project planning, although the team members may be happy to receive the accolades following success. In the same way that rugby players let somebody else decide the rules and arrange the fixtures, a software Scrum team just wants the action.

Scrum does however align closely ? dare I say interchangeably with Agile?s sprints. Stripping it of all the other stages frees the observer up to analyse it more closely in the context of a rough and tumble project, where every morning can begin with a backlog of revised requirements to back fit.

The 3 Main Phases of a Scrum

A Scrum is a single day in the life of a project, building onto what went before and setting the stage for what will happen the following day. The desired output is a block of component software that can be tested separately and inserted later. Scrumming is also a useful technique for managing any project that can be broken into discreet phases. The construction industry is a good example.

Phase 1 – Define the Backlog. A Scrum Team?s day begins with a 15 minute planning meeting where team members agree individual to-do lists called ?backlogs?.

Phase 2 – Sprint Towards the Goal. The team separates to allow each member to complete their individual lines of code. Little or no discussion is needed as this stage.

Phase 3 – Review Meeting. At the end of each working day, the team reconvenes to walk down what has been achieved, and check the interconnected functionality.

The 3 Main Phases of a Scrum ? Conclusions and Thoughts

Scrum is a great way to liberate a competent project team from unnecessary constraints that liberate creativity. The question you need to ask yourself as manager is, are you comfortable enough to watch proceedings from the side lines without rushing onto the field to grab the ball.

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Implementing Large-Scale Complex Business Change

Sometimes, driving your people to work harder is not enough for your organisation to withstand the pressures laying siege to it. With uncertain economic conditions, unpredictable fresh competition, and looming threats from the environment or even pandemic-grade diseases, empowering your people to not only ‘think’ but also to ‘step’ out of the box is currently the name of the game.

However, such initiatives typically require sweeping changes throughout your entire organisation … and to think even the slightest change is often met with hard resistance.

Whether you’re about to undergo an M&A, relocate due to a major catastrophe, scale down to a skeletal workforce, or implement a brand-new company-wide strategy, our systematic approach to large-scale complex business change can help you make the transition as seamless as possible.

We understand the importance of the human aspect in change management. That is why we’ll focus on making your people appreciate the benefits of having to learn new skills, perform new tasks, employ modern technologies, and go through new processes in order to tone down the resistance level.

Our entire process spans from top to bottom, wherein we’ll start with your sponsors, down to your managers, and then to other stakeholders in making them appreciative of the needed changes and in order to achieve alignment with your organisation’s goals. Our top to bottom approach is also aimed at casting a positive “shadow of the leader” on people down the line, enabling them with an optimistic view despite the gruelling tasks before them.

We invite you to have a look at the steps we take in implementing large-scale complex business change to win over a strong and lasting commitment to it.

Evaluating the Required Change

Large-scale complex business change initiatives can be implemented expeditiously and economically if you’ve clearly defined the scope of the change as well as the forces that shape your organisation. You’ll want to know which areas yield easily and which are hard to change to determine where and how you’re going to focus more of your efforts on.

To arrive at a sound and systematic plan, we first gather as much information as needed and analyse them. We determine whether your departments have the required capabilities and how we can arrive at a clear organisational alignment. That way, we don’t waste time, effort and resources when the moment comes to carry out the plan.

These are some of the diagnostic procedures we perform in evaluating the required change.

  • Change complexity analysis. We’ll assess the contribution of people and task factors to the overall complexity of the change project. This will help us determine how to approach the problem efficiently.
  • Causal analysis. By establishing cause and effect relationships, we can identify root or circular causes. This will allow us to pinpoint problem areas and prevent a repetition of past mistakes.
  • Structural analysis. Any company is propped up by a number of structures: organisational, process, motivational, social, and physical, among others. Understanding the structures that drive, motivate, hamper, connect, and influence your people’s behaviours can provide insights as to how or where structural change can best be executed.
  • Context analysis. We’ll look into market forces as well as political, economic, social, technological, legal, and environmental factors enveloping your business. We’ll also analyse your driving objectives, organisational alignment, and organizational capabilities. By analysing the internal and external environment in which your business currently operates, we can formulate a customised strategic and effective plan of action.

Managing Stakeholders

Change initiatives won’t prosper without total commitment from all stakeholders. Stakeholders refer to people in your organisation who either have interests in the change project or can be affected by it.

We deal with your stakeholders starting from the top because if we can’t gain full commitment from those already in the best position to spur the diverse entities in your company into active cooperation, striving to secure commitment from other areas will be futile.

That is, if you don’t have the full support of your key and principal sponsors, i.e. the people who have the biggest say and have greatest control over resources in your organisation, you can’t hope to sustain the change endeavour, let alone provide the much needed spark to get it started.

Here’s how we carry out our stakeholder management actions.

  • Conduct research to identify all stakeholders: the sponsors, your internal and external partners, the main targets of the change, and all interested parties. That way you can “switch on” implementors of each change action in the proper sequence.
  • Not everyone will offer resistance to your change endeavours. We’ll help you identify those stakeholders and sponsors who are willing to offer support, evaluate the level of support they are willing to give, harness all available supports and utilise them extensively to benefit the change.
  • Gain a deeper understanding as to why certain stakeholders are willing to lend support. In doing so, we can implement the right strategies that will encourage them to continue supporting you.
  • Assemble a leadership team that will champion your change initiatives. We’ll facilitate effective collaboration among its team members, transforming them into a cohesive force designed to carry out plans and motivate everyone else down the line.
  • Upon realisation of the change project, we’ll see to it that all stakeholders get a taste of the carrot at the end of the stick. This will encourage them to continue active cooperation in future change initiatives.

Planning for the Change

Anyone who has experienced having their car stuck in the mud knows that stepping on the accelerator will only get the vehicle trapped even deeper. Without the aid of a towing truck, getting the car out will require careful planning since different combinations of pulling, pushing, lifting, rocking to-and-fro, and stepping on the accelerator may be needed.

Of course, some combinations are just better than others. The same principle holds when effecting change.

Our approach to change management typically varies depending upon the information we obtain from the different analyses performed earlier. For instance, since not all organisations are suitable for a collaborative approach, we will employ either collaborative, consultative, directive, or coercive change management strategies wherever applicable.

A well-planned change will result in a smoother, less costly, and less disruptive transition. Here’s how we’ll help you plan your change initiatives.

  • When put in a predicament similar to the car-in-the-mud, the basic strategy entails identifying the current resisting forces and predicting what other resisting forces may be encountered along the way. After researching and pointing out your organisation’s resistance forces, we’ll lay out the most appropriate facilitation, education, and negotiation techniques.
  • To bring down wastage to the lowest possible levels, we’ll engineer a change delivery plan that involves the most cost-effective sequence of driver, process, technology, organisational, and people alignment.
  • To win and maintain a high level of trust, confidence and commitment from all sponsors and stakeholders, we’ll present a clear road map of the change process as well as landmarks that will prove how far we will have gone. These landmarks will then be brought to each sponsor’s and stakeholder’s attention each time they are arrived at in order to build up assurance and continued commitment.
  • We’ll design measurement tools and schedule reporting deadlines so that you’ll know what to look forward to and when to expect them.

Managing the Change

Your company will hold a better chance of maintaining a sizeable lead over the rest of the pack if you constantly establish a rally point and instil in your stakeholders the drive to rally to that point from the get-go. To make this happen, your company must undertake the unfreezing, transition, and refreezing phases of change skilfully in order to bring all stakeholders into the right mindset.

Our specialists’ systematic and efficient methods for each of these phases are designed to simplify the management of each phase as well as provide a seamless shift from one phase to the next. This is what we’ll do:

  • Set up a change project management office to ensure that everything associated with the change initiative is given the needed attention and resources even while all the other usual processes in your organisation run concurrently.
  • To unfreeze your people and get them started on the road of change, we’ll employ unfreezing techniques wherever they are most appropriate. We’ll resort to different kinds of methods ranging from presenting persuasive evidence justifying the need for change to showing a motivational vision for inspiring your people to embark on the change process.
  • Since it is during the transition phase when your people can find themselves groping in the dark, we’ll offer executive coaches for your senior managers; facilitators to provide guidance during team meetings and other change activities; coaches to educate and inspire them to meet the change with the right attitude; trainers to teach new systems, procedures, and technologies; as well as employ a variety of other techniques in order to make the transition phase as seamless as possible.
  • Although your people should always be ready to undertake the next major change after a previous one, there should be points in between where they can taste the spirit of success, establish a temporary base to rejuvenate, and immediately gain a deeper understanding of the nearby terrain so as to envision the next rally point. We’ll see to it that this vital phase of change is carried out completely.

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