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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Succeed at Transformation

Despite the pomp and fanfare associated with launching corporate transformation programs, in reality very few of them succeed. According to a recent report by McKinsey the success rate is pegged below 40%. In addition, the same research indicates that defensive transformations – those undertaken as part of crisis management – have lower chances of success than progressive ones – those launched to streamline operations and foster growth. However, adopting certain strategies, like setting clear and high goals, and maintaining energy and engagement throughout the implementation phase, can really boost the project’s success rate. A key aspect of business transformation is IT transformation. This can be attributed to the fact that significant business change is either driven or influenced by technological change.

So what is IT Transformation?

IT transformation is basically a holistic reorganisation of the existing technological infrastructure that supports the company’s mission critical functions. In essence, IT transformation is not all about effecting change for the sake of change but involves systematic steps that align IT systems to business functions. To appreciate this approach, it is important to explore current trends in the business world where human resource, finance and IT transformations are being carried out in unison. This is being done to develop strong corporate centres that are leaner, agile and more productive that enhance greater synergies across all business functions.

IT transformation inevitably results in major changes of the information system’s technology, involving both hardware and software components of the system, the architecture of the system, the manner in which data is structured or accessed, IT control and command governance, and the components supporting the system. From this scope of works it is evident that IT transformation is a huge project that requires proper planning and implementation in order to succeed.

Tips to Improve Success in IT transformations Projects

1. Focus on Benefits not Functionality

The project plan should be more focused on benefits that can be accrued if the system is implemented successfully rather than system functionality. The benefits should be in line with business goals, for instance cost reduction and value addition. The emphasis should be on the envisaged benefits which are defined and outlined during the project authorisation. The business benefits outlined should be clear, feasible, compelling and quantifiable. Measures should be put in place to ensure that the benefits are clearly linked to the new system functionality.

2. Adopt a Multiple Release Approach

Typically most IT projects are planned with focus on a big launch date set in years to come. This approach is highly favoured because it simplifies stakeholder expectation management and avoids the complexity associated with multiple incremental releases. However, this approach misses the benefit of getting early critical feedback on functioning of the system. In addition, the long lead times often result in changes in project scope and loss of critical team members and stakeholders. IT transformation projects should be planned to deliver discrete portions of functionality in several releases. The benefit of multiple release approach is that it reduces project risks and most importantly allows earlier lessons learnt to be incorporated in future releases.

3. Capacity of the Organisation to confront Change

As pointed out, IT transformations result in significant changes in business operations and functions. Hence it is important that all business stakeholders should be reading from the same script in regards to changes expected. In addition, key stakeholders should be involved in crucial project stages and their feedback incorporated to ensure that the system is not only functional but business focused.

IT Systems Implementation

Are you ready to find out how your newly accepted IT system fares in the real world? Although a rigorous Acceptance testing process can spot a wide spectrum of flaws in a newly constructed IT system, there is no way it can identify all possible defects. The moment the IT system is delivered into the hands of actual end users and other stakeholders, it is effectively stepping out of a controlled and secure environment.

Thus, it is during this phase wherein issues having direct impact on the business can arise.

It is our duty to ensure that the Systems Implementation phase is carried out as thoroughly, professionally, and efficiently as possible.

Thoroughly, because we need to include all relevant data and other deliverables, eliminate hard-to-detect miscalculated results, and substantially reduce the probability of business and mission critical issues popping up in the future;

Professionally, because it is the best way to address the sensitive process of turning over a new system to users who have gotten used to the old one;

And efficiently, because we want to minimise the duration over which all stakeholders have to adapt to the new system and allow them to move on to the process of growing the business.

Preparation

Louis Pasteur once said, “Luck favours the mind that is prepared.”

While we certainly won’t leave anything to chance, we do put substantial weight on the Preparation stage of Systems Implementation. We’re so confident with the strategies we employ in Preparation, that we can assure you of an utterly seamless Deployment and Transition phase.

By this we mean that issues that may arise during Deployment and Transition will be handled smoothly and efficiently because your people will know exactly what to do.

Here’s how we will prepare your organisation for Deployment:

Identify all key players for the Systems Implementation phase and orient them on their specific roles. We’ll make sure they know what possible hitches may come their way and how to deal with them.
Identify all end users and their corresponding functions, then assign appropriate access rights.
Draw multi-layered contingency plans to capture and address each possible concern that may crop up during Deployment.
Prepare a systematic step-by-step procedure and checklist for the entire Deployment stage. Both of them should have been copied from a similar procedure and checklist used in the Acceptance testing phase.
Make all stakeholders understand the conditions required before Deployment can commence.
Set the appropriate environment so that all stakeholders know what to expect and when to expect them the moment Deployment commences.
Prepare Technical Services and Technical Support personnel for the gruelling mission ahead.
Make sure all communication processes are well coordinated so that everyone affected will know who to contact and how to get in touch with them when a problem arises.
Plan and schedule training sessions so that they can be conducted “just in time”. Training sessions conducted way ahead of Deployment are often useless because the trainees tend to forget about what they learned when the time comes to apply them. Similarly, training sessions conducted way after Deployment also become useless because trainees are seldom able to internalise instructions delivered during crash courses.

Deployment

There are two sets of issues to keep an eye on during Deployment:

Issues directly related to the technology itself, e.g. application functionality and data integrity, and
Issues emanating from the end users, i.e., their unwillingness to use the new system. One reason may be because they find the interface and procedures too confusing. Another would be due to other inconveniences that come with adapting to a new set of procedures.

Despite all the meticulous scrutiny employed during Acceptance testing, there are just some problems that are made obvious only during Deployment. Issues belonging to the first set are dealt with easily because of the plans and procedures we put in place during the Preparation stage. As an added measure, our team will be on hand to make sure contingency plans are executed accordingly.

While the second set of issues is often neglected by many IT consultancy companies, we choose to meet it head on.

We fully understand that end users are most sensitive to the major changes that accompany a new system. It is precisely for this reason why our training activities during Deployment are designed not only to educate them but also to make them fully appreciate the necessity of both the new system and the familiarisation phase they will need to go through.

The faster we can bring your end users to accept the new system, the faster they can refocus on your company’s business objectives.

Here’s what we’ll do to guarantee the smoothest Deployment process you’ve ever experienced.

Employ the procedure and checklist formulated during the Preparation stage.
Ensure all end users are well acquainted with any additional tasks they would need to perform (e.g. filling up manual logs).
Assess which legacy systems can still be used alongside the new technology and which ones have to be retired.
Supervise the installation and optimal configuration of all supporting hardware and software to make sure the likelihood of errors originating from them are brought to near-zero levels.
Supervise the installation and optimal configuration of the products themselves.
Carry out data migration tasks if necessary.
Organise and oversee parallel runs to check for data and report inconsistencies.
Conduct training sessions in a professional and well-timed manner to eliminate end-users’ feelings of agitation and to take advantage of memory absorption and retention duration as with regards to their assigned duties and responsibilities.

Transition

Do you often feel uneasy whenever the reins to a newly purchased IT system are handed over to you? Perhaps there are some issues that you feel haven’t been fully settled but, at the same time, find it too late to back out, having already invested so much time and resources.

Alright, so maybe the thought of “backing up” never crossed your mind. However, the concern of being “not yet ready” is raised by many organisations towards the tail end of most Deployment stages. This usually drags the Deployment stage into a never-ending process.

Our team of highly experienced specialists will make sure you reach this point with utmost confidence to proceed on your own.

To wrap up our comprehensive IT Systems Implementation offering, we’ll take charge of the following:

Verify that all deliverables, including training materials and other technical documentation, are accomplished and expected outcomes are realised.
Make sure all technical documentation are placed in a secure and accessible location.
Institute best practices to ensure the IT system becomes fully utilised and to reduce its exposure to avoidable risks.
Establish open communication lines with the Technical Support team to enable quick resolution of issues.
Ensure complete knowledge transfer has been fully achieved so that your people will spend less time calling Technical Support and more on operations contributory to business growth.

Month End Accounting the way it should Be Today

Month end accounting has always been a business critical exercise. Without the balance sheet, income statement, and other financial reports this exercise ultimately produces, management could not make informed decisions to keep the company in the right direction and at the ideal operational speed.

Now, in order to maintain optimal business velocity, month end activities have to be carried out as swiftly and as accurately as possible. Delays will only inhibit managers from reacting and effecting necessary adjustments in time. Inaccurate information, on the other hand, obviously lead to bad decisions.

But that’s not all. Never has the month end close been as demanding as it is today. Regulations like the Sarbanes-Oxley Act, Solvency II, Dodd-Frank Act, and others, which call for more stringent controls and more robust risk management practices, are now forcing companies to find better ways to face the end of the month.

Sticking to old month-end practices while striving to achieve regulation compliance can either cost a company more (if they add manpower) or simply bog it down (if they don’t). Among the worst of these practices is the use of spreadsheets.

These User Developed Applications (UDAs) are very susceptible to errors. (See spreadsheet risks)

What’s more, consolidating data from spreadsheets as well as carrying out reconciliations on them is very time consuming. These activities usually require data from outside sources – i.e. a workstation in a different department, building, or (in the case of really large corporations) geographical locations.

Furthermore, if one of these sources fail, the financial reports won’t be complete. This is not a far-fetched scenario, considering that spreadsheet storage and backup is typically carried out by the average end user. This leaves the spreadsheet data vulnerable to hard disk crashes, virus attacks, and unexpected disasters.

Thus, in order to produce accurate financial reports on time all the time, you need a financial/IT solution that offers optimal provisions for risk management, collaboration, backup, and business continuity. Learn about server-based solutions and discover a better way to carry out month end accounting.