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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What is Business Intelligence?

How well do you know your customers? That is, can you actually pinpoint which among them are you most profitable with and which are making you spend more? Are you content with the accuracy of your forecasts and market predictions? Do you feel you’re spending more on legal costs and regulatory compliance than you should?

Your IT department may be handling these concerns pretty well but perhaps you’d like to know how you can further improve things.

What we’ve got is an IT solution wrapped in a fancy name called ‘Business Intelligence’ or BI. If you think that’s too strong a term, we invite you to read more below, then you be the judge.

Dashboards – Determine the health of your business at a glance

Most drivers rarely make use of their car’s dashboard. After all, you can still reach your destination by just using the steering wheel, pedals, gear stick and so on. But that’s not exactly the most efficient way to drive, right?

If you want to save on fuel, you’ll want to glance on the RPM and speedometer from time to time. You might also want to utilise the trip meter to determine which route is the shortest to a given destination. Other dashboard components like the fuel gauge, tire pressure gauge, engine temperature indicator, and volt meter can likewise provide information about your car’s health.

The same concept applies to business management. If you want to run your business intelligently, you can make use of BI dashboards. These are tools in a typical business intelligence package that will allow you to determine the health of your business via a set of smartly configured gauges and other intuitive graphical representations.

So that, literally, at a mere glance, you’ll already know whether various units in your company are working efficiently. A dashboard will also give you instant feedback of the strategies you’ve recently implemented; to let you know if things are working as planned.

If you want more information than a dashboard can provide, our BI packages also include highly customised reports.

Reports that help you decide faster

Dashboards are great for getting valuable information at a glance but they won’t tell you everything. For more details, you’ll need to view highly customised reports. Our reports are tailor made for each user. We see to it that, by default, each person gets the information he needs the most.

If you belong to the sales department, you normally won’t need a presentation of the data that is appropriate for people in accounting. That way, you don’t spend time filtering. Instead, you and your people can move on to making well-informed decisions.

Our BI systems make use of your vast collection of data to provide reports that will organise your regulatory requirements and call your attention to approaching deadlines. The same system will provide the right information for your people on the field. If your team members are equipped with smart phones and Pocket PCs, they can retrieve whatever it is they need to know to close deals, make sales, and serve clients faster than the competition.

Generating logical information from disparate sources of data scattered over an enterprise-wide organisation is no easy task. But we’ll make it look simple. That’s because we’ve got the expertise to bring it all together into a robust data warehouse and to extract them in the form of reports and dashboards through OLAP.

OLAP and Data Warehousing – Powering the generation of actionable information

Want to know how to generate reports with the highest degree of accuracy and reliability? In theory, what you need is a single repository or a data warehouse. That is, order receipts, sales invoices, as well as customer & supplier data is integrated with regulatory details, personnel data, and others. These are all specially organised for future reporting and analysis.

However, data, no matter how all-embracing, is useless until it is processed into actionable information. Through OLAP or Online Analytical Processing, you can seamlessly collect all relevant data from your vast repository to answer queries like “What is our company’s profitability for the 2nd quarter in all identified key cities for our top-of-the-line products?”.

The strength of OLAP lies in its inherent ability to perform data analysis and very complex calculations, thus enabling it to return complex queries much faster than other database technologies. It is therefore suitable for very large data sources, i.e., data warehouses.

Dashboards and reports will only give your organisation the edge if the information retrieved is reliable, fast, and accurate – exactly the kind OLAP is so good at.

Mobile BI – Step back and see the big picture anytime, anywhere

Spreadsheets are great for displaying detailed information. However, in today’s highly competitive market, retrieving information that matters the most in the shortest possible time is vital in maintaining a sizeable lead over the competition. To step back and see the big picture, you’ll need insightful tools like dashboards and automatically generated reports.

Reports can be beamed to mobile devices such as smart phones and Pocket PCs. They can also be viewed on eBook readers as well. You can also do the same tasks with spreadsheets. But imagine how you’d need to scroll over a large spreadsheet on any of these mobile devices just to know which customer in your current location has performed well over the last month.

If you really want to make quick, well-informed decisions, BI dashboards for mobile devices is the way to go. You can make use of various business objects such as drill-able charts, performance metrics, and metric trend graphs to make crucial decisions even when on you’re in the field.

Becoming Nimble the Agile Project Management Way

In dictionary terms, ?agile? means ?able to move quickly and easily?. In project management terms, the definition is ?project management characterized by division of tasks into short work phases called ?sprints?, with frequent reassessments and adaptation of plans?. This technique is popular in software development but is also useful when rolling out other projects.

Managing the Seven Agile Development Phases

Stage 1: Vision. Define the software product in terms of how it will support the company vision and strategy, and what value it will provide the user. Customer satisfaction is of paramount value including accommodating user requirement changes.
Stage 2: Product Roadmap. Appoint a product owner responsible for liaising with the customer, business stakeholders and the development team. Task the owner with writing a high-level product description, creating a loose time frame and estimating effort for each phase.
Stage 3: Release Plan. Agile always looks ahead towards the benefits that will flow. Once agreed, the Product Road-map becomes the target deadline for delivery. With Vision, Road Map and Release Plan in place the next stage is to divide the project into manageable chunks, which may be parallel or serial.
Stage 4: Sprint Plans. Manage each of these phases as individual ?sprints?, with emphasis on speed and meeting targets. Before the development team starts working, make sure it agrees a common goal, identifies requirements and lists the tasks it will perform.
Stage 5: Daily Meetings. Meet with the development team each morning for a 15-minute review. Discuss what happened yesterday, identify and celebrate progress, and find a way to resolve or work around roadblocks. The goal is to get to alpha phase quickly. Nice-to-haves can be part of subsequent upgrades.
Stage 6: Sprint Review. When the phase of the project is complete, facilitate a sprint review with the team to confirm this. Invite the customer, business stakeholders and development team to a presentation where you demonstrate the project/ project phase that is implemented.
Stage 7: Sprint Retrospective. Call the team together again (the next day if possible) for a project review to discuss lessons learned. Focus on achievements and how to do even better next time. Document and implement process changes.

The Seven Agile Development Phases ? Conclusions and Thoughts

The Agile method is an excellent way of motivating project teams, achieving goals and building result-based communities. It is however, not a static system. The product owner must conduct regular, separate reviews with the customer too.

Is Change Management a Myth or a Possibility

The theory that it is possible to manage organisational change (Change Management) in a particular direction has done the rounds for quite some time, but is it true about Change Management. Was Barrack Obama correct when he said, ?Change will not come if we wait for some other person or some other time. We are the ones we have been waiting for. We are the change that we seek.?
Or, was business coach Kelly A Morgan more on the button when she commented, ?Changes are inevitable and not always controllable. What can be controlled is how you manage, react to, and work through the change process.? Let us consult the evidence and see what statisticians say.

What the Melcrum Report Tells Us

Melcrum are ?internal communication specialists who work alongside leaders and teams around the globe to build skills and best practice in internal communication.? They published a report after researching over 1,000 companies that attempted change management and advised:

? More than 50% report improved customer satisfaction

? 33% report higher productivity

? 28% report improvements in employee advocacy

? 27% improved status as a great place to work

? 27% report increased profitability

? 25% report improved absenteeism

Sounds great until we flip the mirror around and consider what the majority apparently said:

? 50% had no improvement in customer service

? 67% did not report increased productivity

? 72% did not note improvements in employee advocacy

? 73% had no improved status among job seekers

? 73% did not report increased profitability

? 75% did not report any reduction of employee absenteeism

This shows it is still a great idea to hear what all parties have to say before reaching a conclusion. You may be interested to know the Melcrum report gave rise to the legend that 70% of organisation change initiatives fail. This finding has repeated numerous times. Let’s hear what the psychologists have to say next.

There is a certain amount of truth in the old adage that says, ?You can lead a horse to water but you cannot make him drink.? Which of us has not said, ?Another flavour of the week ? better keep heads down until it passes? during a spell in the corporate world. You cannot change an organisation, but you can change an individual.

At the height of the Nazi occupation of 1942, French philosopher-writer Antoine de Saint-Exup?ry said, ?A rock pile ceases to be a rock pile the moment a single man contemplates it, bearing within him the image of a cathedral?. Psychology Today suggests five false assumptions change management rests upon, THAT ARE SIMPLY NOT TRUE.

1. The external world is orderly, stable, predictable and can be managed

2. Change managers are objective, and do not import their personal bias

3. The world is static and orderly and can be changed in linear steps

4. There is a neutral starting point where we can gather all participants

5. Change is worthy in itself, because all change is an improvement

Leo Tolstoy wrote, ?Everyone thinks of changing the world, but no one thinks of changing himself.? A prophet can work no miracles unless the people believe. From the foregoing, it is evident that change management of an organisation is a 70% impossibility, but encouraging an individual to grow is another matter.

A McKinsey Report titled Change Leader, Change Thyself fingers unbelieving managers as the most effective stumbling stones to change management. To change as individuals ? and perhaps collectively change as organisations ? we need to ?come to our own full richness?, and as shepherds lead our flock to their ?promised land?, whatever that may be. Conversely, herding our flock with a pack of sheepdogs extinguishes that most precious thing of all, human inspiration.

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