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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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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Why DevOps Matters: Things You Need to Know

DevOps creates an agile relationship between system development and operating departments, so the two collaborate in providing results that are technically effective, and work well for customers and users. This is an improvement over the traditional model where development delivers a complete design ? and then spends weeks and even months afterwards, fixing client side problems that should never have occurred.
Writing for Tech Radar Nigel Wilson explains why it is important to roll out innovation quickly to leverage advantage. This implies the need for a flexible organisation capable of thinking on its feet and forming matrix-based project teams to ensure that development is reliable and cost effective.
Skirmishes in Boardrooms
This cooperative approach runs counter to traditional silo thinking, where Operations does not understand Development, while Development treats the former as problem children. This is a natural outcome of team-centred psychology. It is also the reason why different functions pull up drawbridges at the entrance to their silos. This situation needs managing before it corrodes organization effectiveness. DevOps aims to cut through this spider web of conflict and produce faster results.

The Seeds of Collaboration

Social and personal relationships work best when the strengths of each party compensate the deficiencies of the other. In the case of development and operations, development lacks full understanding of the daily practicalities operating staff face. Conversely, operations lacks ? and should lack knowledge of the nuances of digital automation, for the very reason it is not their business.
DevOps straddles the gap between these silos by building bridges towards a co-operative way of thinking, in which matrix-teams work together to define a problem, translate it into needs and spec the system to resolve these. It is more a culture than a method. Behavioural change naturally leads to contiguous delivery and ongoing deployment. Needless to say only the very best need apply for the roles of client representative, functional tester and developer lead.

Is DevOps Worth the Pain of Change?

Breaking down silos encroaches on individual managers? turf. We should only automate to improve quality and save money. These savings often distil into organisational change. The matrix team may find itself in the middle of a catfight. Despite the pain associated with change resistance, DevOps more than pays its way in terms of benefits gained. We close by considering what these advantages are.

An Agile Matrix Structure ? Technical innovation is happening at a blistering rate. The IT industry can no longer afford to churn out inferior designs that take longer to fix than to create. We cannot afford to allow office politics to stand in the way of progress. Silos and team builds are custodians of routine and that does not sit well with development.

An Integrated Organization ? DevOps not only delivers operational systems faster through contiguous testing. It also creates an environment whereby cross-border teams work together towards achieving a shared objective. When development understands the challenges that operations faces ? and operations understands the technical limiters – a new perspective emerges of ?we are in this together?.

The Final Word ? With understanding of human dynamics pocketed, a DevOps project may be easier to commission than you first think. The traditional way of doing development – and the waterfall delivery at the end is akin to a two-phase production line, in which liaison is the weakest link and loss of quality inevitable.

DevOps avoids this risk by having parties work side-by-side. We need them both to produce the desired results. This is least until robotics takes over and there is no longer a human element in play.

When Carrefour Pushed the Right Buttons

Retail giant Carrefour based in Boulogne Billancourt, France is big business in anybody?s numbers. Europe?s #1 retailer opened its first store in 1958 near a crossroads (Carrefour means ?crossroad? in French) and has largely not looked back since then. The slogan for the hypermarket chain with more than 1,500 outlets and close to a half million employees is ?choice and quality for everyone?. Our story begins when Carrefour decided these things belong at home too.

The company implemented a worldwide universal responsibility program firmly anchored on a tripod of goals for environmental, economic and social progress. Its first step was to appoint a five-person project team tasked with liaising with program delegates in all thirty countries in which it operates, and who had responsibility for driving these goals.

The team?s job was to make sure that policies, standards, procedures and key performance areas were common visions throughout Carrefour. By contrast, the local managers? were tasked with aligning these specifics to local conditions in terms of environmental, political and social issues. The project team checked the fit quarterly via video conferences.

The Triple Bottom Line Goals were woven through with Carrefour?s Seven Core Values, namely Freedom, Responsibility, Sharing, Respect, Integrity, Solidarity and Progress. Constant contact was maintained with staff and other stakeholders through ?awareness training? seminars and other dialogues. As the program took hold and flourished, it became evident that the retail giant needed help with managing the constant stream of metrics flowing in.

After reviewing options, Carrefour appointed a software provider to monitor progress against its primary focuses on energy, water, waste, refrigeration, paper, disposable checkout bags, hygiene & quality, management gender parity, disabled people and logistics. This enabled it to track progress online against past performance, and produce meaningful reports.

The Environmental Manager in the Corporate Sustainability Department waxed lyrical when he said, ?We believe that our sustainability strategy and software solution have powerfully improved collaboration, innovation, and overall performance?. He went on to describe how it was helping drive cost down and profitability up, while simultaneously growing brand.

Non-conformance costs can be high and run counter to the imperative to make a profit – while simultaneously ensuring a better world for our children?s children. In Carrefour?s case, having a consultant to measure progress was the key that unblocked the administrative bottleneck. Irish company Ecovaro does this for companies around the world. Click here. Discover what we will do for you.

Authentication and Access Control

Threats to your data can come from external or internal sources.

There are individuals who don’t have the authorisation but are driven by malicious intentions to gain access to certain information. This may refer to individuals who already belong to your organisation (but don’t have the necessary access rights) as well as those who don’t.
There are individuals who have both the authorisation and, unfortunately, the malicious intentions over certain information.
Finally, there are individuals who have the authorisation, no malicious intentions, but have accidentally exposed the information in question to those without the proper authority.

While curbing threats 2 and 3 would require other methods, threat #1 can be countered if the right authentication and access control systems are in place.

Here’s what we can do for you:

Work with your key personnel to determine who gets access to what.
Help you decide whether a single factor or a two-factor authentication (2FA) is appropriate for your organisation and recommend which factors are most suitable. Login methods may include but are not limited to the following:
- biometric devices
- Kerberos tickets
- mobile phones
- passwords
- PKI certificates
- proximity cards
- smart cards
- tokens
Install the necessary infrastructure needed for the factors chosen. For instance, if you opt to use biometrics, then biometric scanners will be installed. We’ll make sure that the authentication terminals are situated in places where achieving optimal traffic and work flow has been taken into consideration.

Other defences we’re capable of putting up include: