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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The Connection Between Six Sigma and CRM

Six Sigma is an industrial business strategy directed at improving the quality of process outputs by eliminating errors and system variables. The end objective is to achieve a state where 99.99966% of events are likely to be defect free. This would yield a statistical rating of Sigma 6 hence the name.

The process itself is thankfully more user-friendly. It presents a model for evaluating and improving customer relationships based on data provided by an automated customer relations management (CRM) system. However in the nature of human interaction we doubt the 99.99966% is practically achievable.

Six Sigma Fundamentals

The basic tenets of the business doctrine and the features that set off are generally accepted to be the following:

Continuous improvement is essential for success

Business processes can be measured and improved

Top down commitment is fundamental to sustained improvement

Claims of progress must be quantifiable and yield financial benefits

Management must lead with enthusiasm and passion

Verifiable data is a non-negotiable (no guessing)

Steps Towards the Goal

The five basic steps in Six Sigma are define the system, measure key aspects, analyse the relevant data, improve the method, and control the process to sustain improvements. There are a number of variations to this DMAIC model, however it serves the purpose of this article. To create a bridge across to customer relationships management let us assume our CRM data has thrown out a report that average service times in our fast food chicken outlets are as follows.

<2 Minutes	3 to 8 Minutes	9 to 10 Minutes	>10 Minutes
45%	30%	20%	5%
Table: Servicing Tickets in Chippy?s Chicken Caf?s

Using DMAIC to unravel the reasons behind this might proceed as follows

Define the system in order to understand the process. How are customers prioritised up front, and does the back of store follow suit?

Break the system up into manageable process chunks. How long should each take on average? Where are bottlenecks most likely to occur?

Analyse the ticket servicing data by store, by time of day, by time of week and by season. Does the type of food ordered have a bearing?

Examine all these variables carefully. Should there for example be separate queues for fast and slower orders, are there some recipes needing rejigging

Set a goal of 90% of tickets serviced within 8 minutes. Monitor progress carefully. Relate this to individual store profitability. Provide recognition.

Conclusion

A symbiotic relation between CRM and a process improvement system can provide a powerful vehicle for evidencing customer care and providing feedback through measurable results. Denizon has contributed to many strategically important systems.?

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User-Friendly RASCI Accountability Matrices

Right now, you’re probably thinking that’s a statement of opposites. Something dreamed up by a consultant to impress, or just to fill a blog page. But wait. What if I taught you to create order in procedural chaos in five minutes flat? ?Would you be interested then?

The first step is to create a story line ?

Let’s imagine five friends decide to row a boat across a river to an island. Mary is in charge and responsible for steering in the right direction. John on the other hand is going to do the rowing, while Sue who once watched a rowing competition will be on hand to give advice. James will sit up front so he can tell Mary when they have arrived. Finally Kevin is going to have a snooze but wants James to wake him up just before they reach the island.

That’s kind of hard to follow, isn’t it ?

Let’s see if we can make some sense of it with a basic RASCI diagram ?

Responsibility Matrix: Rowing to the Island
Activity	Responsible	Accountable	Supportive	Consulted	Informed
Person	John	Mary	Sue	James	Kevin
Role	Oarsman	Captain	Consultant	Navigator	Sleeper

Now let’s add a simple timeline ?

Responsibility Matrix: Rowing to the Island
?	Sue	John	Mary	James	Kevin
Gives Direction	?	?	A	?	?
Rows the Boat	?	R	?	?	?
Provides Advice	S	?	?	?	?
Announces Arrival	?	?	A	C	?
Surfaces From Sleep	?	?	?	C	I
Ties Boat to Tree	?	?	A	?	?

Things are more complicated in reality ?

Quite correct. Although if I had jumped in at the detail end I might have lost you. Here?s a more serious example.

There?s absolutely no necessity for you so examine the diagram in any detail, other to note the method is even more valuable in large, corporate environments. This one is actually a RACI diagram because there are no supportive roles (which is the way the system was originally configured).

Other varieties you may come across include PACSI (perform, accountable, control, suggest, inform), and RACI-VS that adds verifier and signatory to the original mix. There are several more you can look at Wikipedia if you like.

Convert visits to sales to repeat purchases

The moment you start seeing more than a thousand unique visitors in just one day, we won’t be surprised if you’d be grinning ear to ear the entire week. But when weeks turn into months, you’ll then remember why you started off on this venture in the first place … and it wasn’t about just owning an immensely popular website.

People, like you, who’ve chosen to invest in eCommerce were most likely thinking along the lines of great ROI, revenues, and profits. Now that you have thousands of visitors, how would you like to have, say for a start, 1% of them buying the products on your site?

You know more about your own product prices; you do the math. But what might really interest you is that a slight change in that 1% conversion rate can already spell a big difference in your profits. Now imagine bringing that 1% up to at least 10%. That’s possible, but not if you simply rely on guesswork.

We rely on tests applicable to complex multi-variable systems, just like today’s typical eCommerce websites, in determining which combination of copy text, landing page images, form layouts, and background colours generate higher conversion rates.

Here’s how we’ll convert your visitors into buyers:

We’ll conduct A/B or even multivariate tests on your eCommerce website, thus eliminating guesswork in determining how to increase those conversion rates.
We’ll perform on-site and off-site web analytics to gain a deeper understanding of web usage to aid in our optimisation operations.
Through our expertise in copywriting, graphics and web designing, UI designing, and website QA, we can enhance and fine tune your site to give each visitor a uniquely engaging browsing experience.
We can also integrate CRM (Customer Relationship Management) systems so that you’ll have the technical advantage to turn one-time buyers into repeat customers.