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

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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 Accenture Keeps Rolling Out Sustainability

Multinational management-consulting and technology-services company Accenture has a good eye for sniffing out new business, with 305,000 employees advancing its interests in more than 200 cities in 56 countries evidence. Last year, it netted US$30 billion profit that is a tidy sum of money in anybody?s books.

Accenture also practices what it preaches. This is maximum business efficiency within moral standards. It tracks its carbon emissions from its offices around the world. Being a technology services company it is unsurprising that it automated the process. Being management consultants it can drill down to finest detail in its search for continuous improvement.

As a forward-thinking company Accenture is committed to transplanting its business skills into other organizations, in order to drive higher performance and sustain greater profits in the long term. It works with clients across borders and industries to integrate sustainability into their business models, and find effective ways to lighten carbon footprints.

The City of Seattle in Washington is a case in point. Following a proud history of nature and energy conservation, it engaged Accenture in 2013 to help it reduce downtown power consumption by 25%. Other project members were Microsoft supplying software, the local power utility for technical advice, and a non-profit to set up a smart building program. The initiative uses cloud services to process the big data generated by a host of building management services, plus a multitude of sensors, controls and meters.

The project is vital for the City. It wants to continue expanding but needs to avoid another power plant polluting its skyline. At the time of writing, the pilot sites had proved successful and the program was rolling out. Seattle?s next challenge is to acquire 15% of its energy from renewable sources by 2020.

The smart building solutions Seattle trialled in five downtown buildings, had a further welcome spinoff; by reducing operating times, facility managers can look forward to extended equipment life and fewer maintenance downtimes. The green building philosophy is alive and well in the City of Seattle, driven both by necessity and vision.

It is a no longer as question of if – but when – other urban communities follow suit. EcoVaro believes it is time long due for individual companies to start enjoying lower energy costs plus the prospect of profitably trading carbon credits. The process begins with measuring what you have and identifying cost-effective savings.

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How to be cleaner and greener indoors

The supply of water on planet earth is finite hence the need to conserve this precious resource. Water is a utility that is often used in and outdoors and for that reason, water conservation activities should be undertaken everywhere.

Get greener everywhere
Water saving can be achieved through various ways. Of utmost importance, fixing leaks should be undertaken in all areas. Small household leaks can add up to gallons of water lost every day. It is therefore important to check all water system fixtures and ensure that there are no leakages.

Greener bathroom habits
Turning off taps- this should be practised in the bathroom especially while shaving and brushing teeth. One could also consider using showers instead of baths since showers use less water and get into the habit of taking shorter showers.

Clean and green dishes
The kitchen is one of the areas where a lot of water is used. Some of the ways through which water can be conserved in the kitchen are:

Use of basins when washing dishes by hand
Using a dishwasher – when using the dish washer, it is important to make sure it’s fully loaded. Scraping plates instead of rinsing before loading it into the dishwasher will also go a long way in the conservation of the valuable commodity called water

Green your laundry and earn green bucks
The other area where water saving can be made is the laundry room. Washing only full loads of laundry will ensure that your washing machine is running at full efficiency hence you will be able to maximise your washer for energy efficiency. Always ensure you use the appropriate water level or load size selection on the washing machine. All these will not only save water but energy too and since savings are earnings you can smile all the way to the bank where some green bucks will be credited to your account.

A Business Case for Sharing

We blogged about sharing services in a decentralised business context recently, and explained why we think why these should be IT-Based for speedy delivery. This is not to say that all shared services projects worldwide have been resounding successes. This is often down to the lack of a solid business case up front. We decided to lay out the logic behind this process.

Management Overview ? The overview includes a clear definition of why the current situation is unacceptable, the anticipated benefits of sharing, and an implementation plan were it to go ahead. The project should not proceed until the stakeholders have considered and agreed on this.

Alternatives Considered ? The next stage is to get closer to the other options in order to determine whether an alternative might perhaps be preferable. Substitutes for shared services are often doing nothing, improving the current method, and outsourcing the service to a third party.

The Bottom Line in Business ? Sharing services comes at an initial cost of infrastructure changes, and the impact on human capital (the latter deserves its own blog). The following need careful consideration from the financial angle:

Numbers to Work Through

Manpower to design and roll the project out in parallel with the existing organisation.

Capital for creating facilities at the central point including civil works, furniture and equipment and IT infrastructure.

The costs of travel, feeding and accommodation. These can be significant depending on the time that implementation takes.

The opportunity loss of diverting key staff – and the cost of temporary replacements – if appointing line staff to the project team.

Crystal-clear project metrics including (a) the direct, realisable savings (b) the medium and long-term effects on profit and (c) where to deploy the savings

Risk Management

Shared services projects don’t go equally smoothly, although planning should reduce the risk to manageable levels. Nonetheless it is important to imagine potential snags, decide how to mitigate them and what the cost might be.

We believe in implementing shared services on a pilot basis in the business unit that eventually provides them. We recommend building these out to other branches only when new processes are working smoothly.

Moving On From a Decision

We recommend you revisit your management overview, the logic behind it, the assumptions you made, and the costs and benefits you envisage before deciding to go ahead

The final step in proving a business case is doable should be fleshing out your roadmap into a detailed operations plan with dependencies on a spreadsheet.