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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How to create a custom form with Field Elite

A common requirement for most Field Service Workers is to complete various forms and paper based inspection checklists when visiting customer sites and remote area locations. Often the data collected is often used in collaboration efforts across multiple teams and organisations.

Using paper forms, binders, cameras, and filing cabinets can make this process complicated, frustrating, and often, near impossible.

If you consider that, even though we are entering the third decade of the new millennium and despite the proliferation of Smart Phones and Tablet computing an incredibly large percentage of field service teams are still making use of paper based systems!

Read more about the benefits of digital forms data collection

Field Elite Customised forms

Field Elite enables Field Service organisations to easily create their own customised forms which can be attached jobs.

The creation of forms can be done using the Web Based Administration Portal which is provided as standard to all customers when signing up for an account.

To access the form builder from Side Navigation navigate Settings –> Form Templates –> Create Form

You will then be presented with Form Builder utility which will contain an Empty Default Form and a list of fields types you are able to insert.

There are a variety of fields you can use to create all manner of forms. There is no restriction on the number of fields or field types you can choose to create forms suitable for your purpose.

If you can think it you can create it

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In the example, we’ll work through, we are going to create a Simple Conference Room Inspection Report, to be used by Facility Managers to assist in carrying room inspection reports for conference centres.

To add fields to your form simply Drag and Drop the fields onto the form.

Once you have completed adding which fields you require to your form and you are satisfied with the layout.

Select Settings tab to provide a meaningful name for your form.

You can also select a Form Layout you wish for your form. For the purpose of this post we are going to leave it as Vertical.

Once you are satisfied with your form you can select Save Form

Once your form has been saved it will be available for selection when defining jobs in the system.

Summary

It is really easy to define custom forms using the Field Elite from templates module. The Form Template module enables you to create any manner of forms your organisation may require.

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.

How DevOps oils the Value Chain

DevOps ? a clipped compound of development and operations – is a way of working whereby software developers are in a team with project beneficiaries. A client centred approach extends the project plan to include the life cycle of the product or service, for which the software is developed.

We can then no longer speak of a software project for say Joe?s Accounting App. The software has no intrinsic value of its own. It follows that the software engineers are building an accounting app product. This is a small, crucially important distinction, because they are no longer in a silo with different business interests.

To take the analogy further, the developers are no longer contractors possibly trying to stretch out the process. They are members of Joe?s accounting company, and they are just as keen to get to market fast as Joe is to start earning income. DevOps uses this synergy to achieve the overarching business goal.

A Brief Introduction to OpsDev

You can skip this section if you already read this article. If not then you need to know that DevOps is a culture, not a working method. The three ?members? are the software developers, the beneficiaries, and a quality control mechanism. The developers break their task into smaller chunks instead of releasing the code to quality control as a single batch. As a result, the review process happens contiguously along these simplified lines.

Code	QC	Test	?	?	?
?	Code	QC	Test	?	?
?	?	Code	QC	Test	?
?	?	?	Code	QC	Test

Colour Key

Developers

Quality Control

Beneficiary

This is a marked improvement over the previously cumbersome method below.

Write the Code	?	Test the Code	?	Use the Code
?	Evaluate, Schedule for Next Review			?

Working quickly and releasing smaller amounts of code means the OpsDev team learns quickly from mistakes, and should come to product release ahead of any competitor using the older, more linear method. The shared method of working releases huge resources in terms of user experience and in-line QC practices. Instead of being in a silo working on its own, development finds it has a richer brief and more support from being ?on the same side of the organisation?.

The Key Role that Application Program Interfaces Play

Application Program Interfaces, or API?s for short, are building blocks for software applications. Using proprietary software-bridges speeds this process up. A good example would be the PayPal applications that we find on so many websites today. API?s are not just for commercial sites, and they can reduce costs and improve efficiency considerably.

The following diagram courtesy of TIBCO illustrates how second-party applications integrate with PayPal architecture via an API fa?ade.

The DevOps Revolution Continues ?

We close with some important insights from an interview with Jim Stoneham. He was general manager of the Yahoo Communities business unit, at the time Flickr became a part. ?Flickr was a codebase,? Jim recalls, ?that evolved to operate at high scale over 7 years – and continuing to scale while adding and refining features was no small challenge. During this transition, it was a huge advantage that there was such an integrated dev and ops team?

The ?maturity model? as engineers refer to DevOps status currently, enables developers to learn faster, and deploy upgrades ahead of their competitors. This means the client reaches and exceeds break-even sooner. DevOps lubricates the value chain so companies add value to a product faster. One reason it worked so well with Flickr, was the immense trust between Dev and Ops, and that is a lesson we should learn.

?We transformed from a team of employees to a team of owners. When you move at that speed, and are looking at the numbers and the results daily, your investment level radically changes. This just can’t happen in teams that release quarterly, and it’s difficult even with monthly cycles.? (Jim Stoneham)

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