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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Scrumming Down to Complete Projects

Everybody knows about rugby union scrums. For our purposes, perhaps it is best to view them as mini projects where the goal is to get the ball back to the fly-half no matter what the opposition does. Some scrums are set pieces where players follow planned manoeuvres. Loose / rolling scrums develop on the fly where the team responds as best according to the situation. If that sounds to you like software project management then read on, because there are more similarities?.

Isn’t Scrum Project Management the Same as Agile?

No it’s not, because Scrum is disinterested in customer liaison or project planning, although the team members may be happy to receive the accolades following success. In the same way that rugby players let somebody else decide the rules and arrange the fixtures, a software Scrum team just wants the action.

Scrum does however align closely ? dare I say interchangeably with Agile?s sprints. Stripping it of all the other stages frees the observer up to analyse it more closely in the context of a rough and tumble project, where every morning can begin with a backlog of revised requirements to back fit.

The 3 Main Phases of a Scrum

A Scrum is a single day in the life of a project, building onto what went before and setting the stage for what will happen the following day. The desired output is a block of component software that can be tested separately and inserted later. Scrumming is also a useful technique for managing any project that can be broken into discreet phases. The construction industry is a good example.

Phase 1 – Define the Backlog. A Scrum Team?s day begins with a 15 minute planning meeting where team members agree individual to-do lists called ?backlogs?.

Phase 2 – Sprint Towards the Goal. The team separates to allow each member to complete their individual lines of code. Little or no discussion is needed as this stage.

Phase 3 – Review Meeting. At the end of each working day, the team reconvenes to walk down what has been achieved, and check the interconnected functionality.

The 3 Main Phases of a Scrum ? Conclusions and Thoughts

Scrum is a great way to liberate a competent project team from unnecessary constraints that liberate creativity. The question you need to ask yourself as manager is, are you comfortable enough to watch proceedings from the side lines without rushing onto the field to grab the ball.

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Energy efficiency- succeed and benefit

Energy is neither created nor destroyed; it is only transformed. This being the law of conservation of energy, and given that the process of transforming energy is inefficient resulting in loss of usable energy in the process of transforming one form of energy into another form, Energy Efficiency finds a home.
Talking of Energy efficiency, think of how much useful energy can be obtained from a system or a particular technology. It is also about the use of technology that requires a lesser amount of energy to carry out the same task.

Energy efficiency is the responsibility of both demand side and supply side. Supply-side energy efficiency refers to a set of actions taken to ensure efficiency through the electricity supply chain. Supply side efficiency measures are about efficiency in electricity generation; be it operation and maintenance of existing equipment or upgrading existing equipment with state-of-the-art energy-efficient generating equipment.

The demand side energy efficiency on the other hand refers to the actions taken to use less/demand less energy. Think of less energy usage in relation to improvement of energy efficiency in buildings, solar water heaters, energy efficient lighting systems such as Compact Fluorescent Lamps, conducting energy audits to identify potential energy saving opportunities, efficient water heating systems and the list is endless.

Success of energy efficiency is a win ? win to YOU-ME-US – the energy consumers, to THEM the energy producers and suppliers and to our precious ENVIRONMENT.
Gain to energy suppliers: – Less energy usage and better energy usage patterns among consumers consequently reduces the customer load which reduces losses on the supply side. Less energy loss creates capacity on the system to serve more customers.

Gain to you-me-us: – Less energy usage and better energy usage patterns Benefits the customer through reduced Electricity bills / $ savings through lower bills.

Benefits to the environment: – Usage of less energy reduces use of fossil fuels, hence reduction in GHG emissions hence conserving our environment. Companies look at means to make rational use of their least efficient generating equipment. The objective is to improve the operation and maintenance of existing equipment or upgrade it with state-of-the-art energy-efficient technologies. Some companies have on-site electricity generation alternatives and thus tend to consider the supply side in addition to demand-side energy efficiency.

What Heijunka is & How it Smooths Call Centre Production

The Japanese word Heijunka, pronounced hi-JUNE-kuh means ?levelling? in the sense of balancing workflows. It helps lean organizations shift priorities in the face of fluctuating customer demand. The goal is to have the entire operation working at the same pace throughout, by continuously adjusting the balance between predictability, flexibility, and stability to level out demand.

Henry Ford turned the American motor manufacturing industry upside down by mass-producing his iconic black motor cars on two separate production lines. In this photograph, body shells manufactured upstairs come down a ramp and drop onto a procession of cars almost ready to roll in 1913.

Smoothing Production in the Call Centre Industry

Call Centres work best in small teams, each with a supervisor to take over complex conversations. In the past, these tended to operate in silos with each group in semi-isolation representing a different set of clients. Calls came through to operators the instant the previous ones concluded. By the law of averages, inevitably one had more workload than the rest at a particular point in time as per this example.

Modern telecoms technology makes it possible to switch incoming lines to different call centre teams, provided these are multi-skilled. A central operator controls this manually by observing imbalanced workflows on a visual system called a Heijunka Box. The following example comes from a different industry, and highlights how eight teams share uneven demand for six products.

This departure from building handmade automobiles allowed Henry to move his workforce around to eliminate bottlenecks. For example, if rolls of seat leather arrived late he could send extra hands upstairs to speed up the work there, while simultaneously slowing chassis production. Ford had the further advantage of a virtual monopoly in the affordable car market. He made his cars at the rate that suited him best, with waiting lists extending for months.

A Modern, More Flexible Approach

Forces of open competition and the Six Sigma drive for as-close-to-zero defects dictates a more flexible approach, as embodied in this image published by the Six Sigma organisation. This represents an ideal state. In reality, one force usually has greater influence, for example decreasing stability enforces a more flexible approach.

Years ago, Japanese car manufacturer Toyota moved away from batching in favour of a more customer-centric approach, whereby buyers could customise orders from options held in stock for different variations of the same basic model. The most effective approach lies somewhere between Henry Ford?s inflexibility and Toyota?s openness, subject to the circumstances at the moment.

A Worked Factory Example

The following diagram suggests a practical Heijunka application in a factory producing three colours of identical hats. There are two machines for each option, one or both of which may be running. In the event of a large order for say blue hats, the company has the option of shifting some blue raw material to the red and green lines so to have the entire operation working at a similar rate.

Predictability, Flexibility, and Stability at Call Centre Service

The rate of incoming calls is a moving average characterised by spikes in demand. Since the caller has no knowledge whether high activity advisories are genuine, it is important to service them as quickly as possible. Lean process engineering provides technology to facilitate flexibility. Depending on individual circumstances, each call centre may have its own definition of what constitutes an acceptably stable situation.

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