Introduction

The purpose of a Risk Assessment is to identify threats and vulnerabilities and develop a plan to mitigate the risks identified within the assessment. Like all processes, we can make it easy or extremely complicated and difficult. Planning is the key.

C-I-A Triad

The C-I-A triad consists of three elements: Confidentiality, Integrity and Availability of data and data systems.

Confidentiality simply means controlling access to those who have a legitimate need to know. Integrity is ensuring that the data hasn’t been altered; and Availability means the data can be accessed and used by those who need to access the data.

This is a relatively simple concept that has far-reaching impact in the world of Healthcare and HIPAA.

A Risk Assessment will help administrators and compliance personnel identify risks to their medical practices before they become a problem.

An annual Risk Analysis is required by the Department of Health and Human Services.

Risk Analysis and the Security Rule

The Department of Health and Human Services through its lower level agencies requires an annual Risk Assessment. This Risk Assessment is based on Special Publication 800-66, by the National Institute of Standards and Technology, which provides instructions for conducting a Risk Analysis as defined by the HIPAA Security Rule.

The outcome of the Risk Analysis is critical to discovering and mitigating actual and potential vulnerabilities from your information systems and workflow practices.

Failure to comply may cost your business money due to fines and penalties.

Risk Analysis Process

Like anything else conducting a Risk Analysis is a process and your first one can make it seem like an overwhelming task. Let’s tame this beast.

The first step is to understand the basic information and definitions regarding conducting a Risk Assessment.

Definitions

Have you heard the old joke about how do you eat an elephant? Answer: One bite at a time.

This punch line could have been expressly written for conducting risk assessments.

First, we need to know the jargon used in the process. We need to develop a baseline for understanding what we are going to do, how we do it, and finally what are we going to do with it.

Vulnerability

NIST SP 800-33 defines vulnerability as a… ” flaw or weakness in system security procedures, design, implementation, or internal controls that could be exercised (accidentally triggered or intentionally exploited) and result in a security breach or a violation of the system security policy.”

No system is without vulnerabilities. Vulnerabilities arise out of coding errors, changes to procedures, system or software updates, and changes of threats over time. The analyst must be aware of evolving threats and vulnerabilities, while actively working to resolve currently defines problems.

This process never ends.

Threats

A threat is “the potential for a person or thing to exercise (accidentally trigger or intentionally exploit) a specific vulnerability.

A vulnerability isn’t necessarily an issue until there is a threat to exploit the vulnerability. Common natural threats are fires, floods, or tornados. Human threats are computer hacks, careless control of ePHI, or inadvertent data exposure. Environmental threats are things like power failures.

Risks

Risk is defined by the presence of a vulnerability that can be exploited by an appropriate threat. You can’t have one without the other.

The level of risk is determined by the expected level of damage that could result from the vulnerability being exploited combined with the likelihood of the vulnerability being exploited.

Risk = Severity of potential damage + Likelihood of the Threat

Elements of a Risk Assessment

By breaking the Risk Assessment process into smaller, more manageable pieces, we can complete our task quickly and efficiently. Well at least efficiently.

Scope

The Scope of a Risk Analysis in an understanding of what the analyst is attempting to determine. Different industries have difference requirements so the Analyst must be up to date on their processes and procedures.

In the scope, the analyst and the business entity clearly define the goals of the project. They determine how to accomplish those goals, and how the required data can be gathered based during the Risk Management process.

Data Collection

Care must be taken to not compromise ePHI during this data collection process. Part of the data collecting process refers to how protected data is stored and should be treated like any other data point.

Identify Potential Threats and Vulnerabilities

As each threat or vulnerability is identified, it must be recorded for evaluation. This evaluation should include, level of risk should the threat or vulnerability be exploited.

The analyst can only mitigate risks that are known. This is why it is critical that the Risk Assessment Team have access to the data.

Assess Current Security and Potential Measures

All identified risks, threats and vulnerabilities must be evaluated. Some risk will always be present. The analyst must categorize what is harmful and what is possible, and then develop security measures to correct the perceived risk.

Determine the Likelihood of Threat Occurrence

Likelihood is based on how likely the vulnerability is to be exploited. If the likelihood is low then it is less likely to happen. If so, then the risk is lower.

Determine the Potential Impact

Putting everything together allows the analyst to determine the potential impact of a specific event. For example, if your area is prone to flooding, how would that affect your business?

Determine the Level of Risk

Combining all the data you have collected into a Risk Matrix or Risk Register will help you determine the potential for damage.

For example: If your identified risk is low, the potential for damage is low and the likelihood of occurrence is low; then your risk will be low. However, should one of these items be high or medium impact or likelihood, then your potential for risk will be increased.

Using a risk register is essential to completing your risk assessment properly.

Finalize the Document and Report

After gathering and analyzing your data you will need to present a report Risk Assessment. This report must be clear and concise, detailing all activities that took place, their outcomes and potential risks.

The HHS website has some tools to assist with this effort.

Risk Mitigation

Risk mitigation is often the hardest part of completing a Risk Analysis in that now actual resources and money must be allocated. Establishing a priority list here is essential.

Your goal is to mitigate all negative issues. You probably won’t reach that goal, but you should try. At the very least, you should start you mitigation process with the most dangerous processes first and work your way down the list in order of severity.

Continuous Updates

By conducting an annual Risk Assessment, you can ensure you are meeting compliance standards, protecting your patients, and minimizing the overall risk to your medical practice.

Conclusion

Risk Assessments aren’t glamorous or even fun, but they are necessary to help prevent security related problems and meet governmental regulations.

Creating an outline of your Risk Analysis plan and breaking it into smaller pieces will help you complete it with the least amount of time and frustration. Unfortunately, the larger your medical practice, the more complicated the Risk Assessment.

The department of Health and Human services has several tools to help you conduct your own Risk Assessment. Oh, and remember Risk Assessments are required!

I recently found this in the MGMA Knowledge Center Forum from a member: “I recently ran across an implementation where the practice administrator threatened to charge each staff member $1.00 for every registration error they out in the system. She was serious about this and the staff became terrified of making a mistake. It also was mistake in interpretation of how required fields needed to be entered. This is akin to a swear jar. How enforceable is this and how legal is it? Just curious of HR repercussions with this concept.”

Retha Reeves, a consulting administrator in Houston, Texas and a frequent contributor to MGMA forums, replied with “I’ll leave the legal question for a lawyer. As for HR, didn’t we all learn a very long time ago that management by fear and intimidation is, at best, a disaster? The only successful management style is to work every day toward creating and maintaining a team. A team that believes in the mission of the practice, respects and feels respected by management, and takes great pride in accomplishments. I’ve always counseled that an important part of management is to help your staff be successful in their roles. With a manager such as you described, (s)he totally misunderstands that critical piece and will only breed poor morale, paranoia, and minimal production.”

I completely support Retha’s point of view. I have been a member of teams with autocratic leaders and those who listen to and support the team members. My own experience is that those teams who meet Ms. Reeve’s criteria function best and achieve the best outcomes for patients and clients. I am presently a member of a team that is building a program to prevent falls in elderly people in the community. This team is a part of the Calvin College Rehabilitation Services in Grand Rapids, MI. Recently the team met to fill in a work plan template that included the key activities and how to measure them. Each team member freely contributed ideas for the plan and asked questions to clarify an idea if needed. A great deal of planning was accomplished and I left feeling like my contributions were valuable and welcomed.

The American Medical Association also sees teamwork as benefitting practices by increasing productivity and patient satisfaction as well as employee satisfaction. The success or failure of a practice depends upon the practice’s culture. The AMA believes that practices should focus on improving team culture continuously. They have rolled out on their web site a free online module as part of its STEPS Forward collection that can help practices build a positive team culture. You can find it at by clicking this link.

In the module the AMA lists ten steps for building a strong team culture:

1. Diagnose the current state of your team culture

2. Discuss the results and brainstorm possible improvements

3. Create a staff compact as a group

4. Create opportunities for team communication throughout the day

5. Meet regularly

6. Strengthen the team by focusing on individual development

7. Get to know your team members

8. Teach leaders to be mentors, not managers

9. Create an environment that supports continual learning

10. Engage patients

The module begins by asking practice administrators to assess the culture of their practice by having each team member take an anonymous survey that is provided online. A couple of the questions are (1) Team members say what they really think and (2) All team members participate in making decisions about the work of the team. The module begins with this assessment because it is understood that “you can’t move forward unless you know where you have been”, a common wisdom.

After the staff takes the survey and the results are analyzed by a trusted staff member or a third party quality expert, leaders of the practice should have team meetings that discuss how to move forward. The first thing task for the team meeting should be to write a goal that states the purpose of the meeting and future meetings. It should center on building a culture that values teamwork.

The ‘culture team’ in the first meeting can brainstorm ideas of how to improve the culture of the practice in concrete ways that can be implemented by the leaders and the rest of the staff. I believe that it would be a good idea to use the survey again in the future to see what growth has occurred and to make adjustments that will lead to even better teamwork.

One of the benefits of improving teamwork is that the team can work together more effectively to improve the practice’s processes. Team members can meet to focus on processes that effect patient outcomes, such as processes that improve patient satisfaction and patient engagement. Having practice staff involved in improving processes such as these will lead to markedly better results than if only one or two people are involved. Team members can generate ideas, for instance, in improving patient engagement, and then designate a team member to own the process of implementing their ideas. The outcomes should be measured and reported back to the team.

The development of teamwork among clinicians is taking place in colleges across the U.S. Colleges have created courses that support interprofessional practices. This is the IPE movement. In September 2017 Grand Valley State University in Michigan is hosting a two day conference devoted to Interprofessional Practice, Education and Research. One of the focuses this year of the conference will be telehealth. John Scott, Medical Director and Telehealth Associate Director of the Harborview Medial Center at the University of Washington will be a keynote speaker. One of the breakout sessions at the conference will focus on the collaboration of graduate students in healthcare with Answer Health on Demand, a local telehealth provider in Grand Rapids.

As you can see there are many supporters of the development of teamwork in the healthcare field. The benefits of developing a strong team culture are many, including hitting the Triple Aim of healthcare-better care at a lower cost with improved patient satisfaction. Focusing on teamwork at a practice site will help in the transition to value-based care.

Digital media is pervasive today and customers have access to information any time, any where. Be it for shopping, news, entertainment or social interaction, consumers are now exposed to a wide variety of information, and therefore, companies must amp up their digital marketing services to retain customer attention.

Managing customer relationships across various digital channels is extremely important for brands today. Effective digital media services can always lead to customer engagement and business ROI. However, the digital strategies have to be relevant and of great quality, in order to attract customers towards a particular product. Some of the strategies include brand strategy, content marketing, data analytics, relevant advertising campaigns, digital media planning and buying, search engine optimization, social media marketing and technology. Creative and world-class digital strategies can help in amping up the returns of a business significantly.

It is important for companies to unleash the potential of online marketing and how it can impact customer behaviour. Insights-driven strategies, performance driven search marketing, powerful technology and eye-catching graphs, can all contribute to effective marketing.

Nowadays, there are companies which outsource digital media services to online marketing agencies. Such an agency is equipped with experts who are skilled enough to implement effectual digital tools and strategies for best business results. Such a marketing agency eases the job of big brands by creating content that forges a deeper connection with the brand. What makes the digital consumers follow and connect with a brand are some of the following digital strategies:

Brand strategy: It takes access to insights and data for effective brand building strategies. Creating a connected brand requires the right mix of marketing across various digital channels. A full suite of strategic digital services can help a brand connect with the customers better. Understanding the brand’s strengths and weaknesses and realizing why should audiences engage with the brand is really important. Accordingly, digital strategies can be tailored to suit the business requirements.

Data Analytics: Merely collecting data is not enough. Brands need to make optimizations after data collection, in order to create powerful impact on the business ROI. Brands need to take digital initiatives that involve mining and analysis. Through such audience analysis, brands must build people-focused marketing techniques and work towards attracting more customers.

Content Marketing: Smart digital marketers know the power of content and the way it can drive engagement and brand performance. Creating good quality content, optimizing it, packaging it right for relevant audiences and making it shareable, is the key to good online marketing. Companies are also resorting to mobile-first technologies for sharing top-tier content, which, in turn, is heightening audience awareness about a brand and its services.

Social Media Marketing: It’s important to stand out from the rest by not only producing great quality content but also floating them in specific social media platforms where your audiences will consume the content.

Search Engine Optimization: People use search to cut out the middleman and go straight to the pages that they want to see. And for this, staying visible online is really important. As a result, a comprehensive search engine optimization strategy is really important. Speaking your customers’ language and offering them what they’re looking for is of prime importance. And this can only be achieved by studying customer behaviour and implementing a marketing strategy to maximize ROI.

There are digital marketing offshore companies too offering advanced solutions to your brands’ digital needs. They help companies keep pace in this fast-paced digital landscape and create a digital roadmap for their organization. So, build a digital transformation playbook for your company, target your audience with pinpoint accuracy and increase your client base in the process.

The past several weeks have been abuzz with the mergers and acquisitions in the healthcare arena. CVS has purchased Aetna for a cool 69 billion dollars and went through the regulatory process with flying colors. Amazon (on their quest for world domination) has teamed up with Warren Buffett, CEO of Berkshire Hathaway and financial powerhouse J.P. Morgan to use their resources, influence and power to, according to Buffett, “tackle healthcare costs in our nation.” Buffet also said that because the U.S., at 18% of our gross domestic product, the U.S. is at a competitive disadvantage, at 3.3 trillion dollars annually. He believes the private sector can handle healthcare better than the government.

Albertson’s, a grocery company, is ready to acquire retail pharmacy giant Rite Aid. And now, Cigna, the insurance behemoth, is buying Express Scripts in a deal for upwards of 50 billion. Software giant Apple is dipping their toe into employee health, while things are starting to rumble at Wal-Mart, the retail monster.

After all of that information, you need a breather. But will a disruption by these companies be the thing that makes healthcare better in the U.S.?

Yet, as a patient advocate and caregiver supporter, my main concern is this: Will all of this be a win for patients, caregivers and families? You know – the healthcare customers?

While the shake-up in healthcare is oh-so-long overdue, is the combination of behemoths the right way?

First, this healthcare shake-up won’t be the last of the behemoths to combine. I would be willing to bet on that. We have yet to hear from the likes of Microsoft, Walgreens, Google or any of the Generals (Electric, Motors, Mills). What about other insurers? Where is Humana or United Healthcare in this game?

Many companies will follow suit. It’s just a matter of time. I liken it to the most popular girl in high school getting into a relationship with the most popular boy and becoming a force to be reckoned with. Everyone will see the trend, its benefits and potential, and jump into it. Sorry for the high school analogy.

The point is everyone sees that it is time for change in healthcare.

So what’s in it for patients/customers?

Something we must question is this: Are these corporations in it for the billions of dollars that healthcare is worth or do they really want better conditions, cost and efficiency for patients? Will the combination of all these behemoths reach past their employees and meet the needs of all patients in our nation? What are their motives?

My mission is to empower patients and caregivers to navigate healthcare confidently and correctly, to save them and all parties involved time, money and frustration. I show them that they have rights and responsibilities in their Healthcare journey and must take a strong and active role in their care. Patients are the lifeblood of the healthcare system.

None of these behemoth combinations will be successful without patient/customer buy-in. They’d better put all of their goals into a nice and helpful package for patients so they feel supported and empowered. If these corporations can show how the patient will be helped and how their alliances can save money for all parties involved, they should have no trouble in the regulatory processes they face.

But I implore all of you behemoths… DO SOMETHING.

Do something for the 64% of Americans who avoid getting care because they are afraid of the costs.

Do something for the working poor who make too much for Medicaid and not enough to afford skyrocketing healthcare premiums.

Do something that shows how healthcare can actually be affordable and where service prices do not have to be excessive.

Do something to empower patients and establish real healthcare cost transparency.

Do something about actual care and system processes to show that it doesn’t have to be as difficult or time-consuming as it is currently.

You behemoths have the power to change healthcare for the better for the foreseeable future and possibly, forever. Please don’t look down from your Ivory Towers upon us mere mortals and pity us or hope for the best. Do something.

Make it a win for patients, and we all will win.

When asked about the purpose of medical billing, most people answer that it exists to get doctors paid. But physicians get paid routinely in some countries that have no medical billing. So the conventional wisdom goes, if getting paid was the only reason for medical billing, then it should be relatively easy to eliminate it and even save billions (see Dr. Ezekiel Emanuel’s article in the New York Times on November 12, 2011). Although medical billing does get physicians paid, its function is much broader. This short article attempts to better define the role medical billing plays in our society.

Three Basic Questions About Healthcare

First, doctors have the legal ability to offer any medical therapy they choose. It can be helpful, harmful, or just useless. As Dr. Doug Cassel noted, “a physician can treat your pancreatic cancer with organic turmeric, order weekly MRI’s scans for headaches, perform twenty plastic surgery procedures at once, or give you Propofol to sleep.” How can we discover if doctors deliver quality care or if they practice outside of our expectations?

Next, documenting and reading every individual patient encounter to all of its detail would exceed our resources because of tens of thousands of disease entities, diagnostic studies and treatments, and countless individual variation. How can we document every encounter accurately, specifically, and concisely enough and still afford rapid identification of its correctness and payment scale?

Third, covering the entire population with the same plan would be wasteful (or insufficient) as different population segments require different coverage. How can we ensure a variety of coverage for different people?

What is the role of Medical Billing today?

In finance, the efficient-market hypothesis asserts that financial markets are “informationally efficient,” which means that the prices reflect all the information available to the market participants. A market efficiency mechanism collects and delivers all relevant information to the market participants.

Medical billing is a healthcare market efficiency mechanism that

1. ensures treatment quality,
2. documents treatment,
3. reins in out of control physicians, and
4. offers patients alternatives.

Instead of writing payment protocols for every possible patient encounter, we have codified diagnosis and treatments. These two sets of codes along with a mapping system of the codes to the payment schedule allow us to test if appropriate tests and therapy are performed for a given problem. Further, the sets of codes and the mapping system are digitized, allowing fast processing of vast amounts of data.

This mapping system easily identifies physicians who practice outside of its expectations. Medicare and insurance companies verify treatment adequacy to problems using this mapping system, often called billing rules.

Additionally, ICD codes for diagnostics and CPT codes for treatments represent the DNA for medical records. For many medical issues, a physician needs to know little more than what is contained in the billing record. To quote Dr. Doug Cassel, “virtually all of the benefits that… can come from electronic medical records, including treatment evaluation and demographic data, are contained in billing records, which have been electronic for years.”

Finally, one insurance plan will never fit all. A young person has far different medical needs than a middle age family with three children, or an elderly diabetic. So, insurance plans differ in coverage and costs. Some insurance plans cover elective surgery at a higher cost, while others exclude such coverage. Different people choose to spend their healthcare dollars differently, and medical billing is the tool we use to differentiate between plans and levels of care. Getting physicians paid is a secondary or perhaps even a tertiary aspect medical billing. It’s the only mechanism that ensures patients can get the care they want.

From the past 20 years, information technology has brought many major transformations in almost all fields of the world and healthcare is simply not an exception. While the revolutions of science are ruling on all parts of our lives, it has also brought a positive change in medical and healthcare by introducing health information technology.

Health information technology has absolutely changed the notion of addressing the healthcare issues. With the help of the transformation of information technology in health section, you will get benefit in your overall healthcare circle including relationships of your doctors, your hospital records, your pharmacy and other important medical information. Like all other information technology systems, the health IT system also needs proper configuration, network security consulting, solution & specialist to make the workflow risk-free.

Benefits of Health IT

The smart and efficient exchange of healthcare information through information technology is advantageous and beneficial in many ways. Following are some of the benefits that healthcare IT can offer:

Better information means quality healthcare

Better and effective exchange of information means safer and quality healthcare. With the help of electronic health records and information exchange, practitioners will be able to review the complete picture of patient’s medical history which eventually improves health care quality. With detailed health records, the risks of improper medications can be avoided and chances of medical errors will be reduced.

Assurance of efficient and accurate treatment

Once the health information technology has the complete medical record of the patient, it will assure that the treatment will be provided faster and efficiently. It will be easier for practitioner to decide tests based on the prior provided information. The clearer picture will help the consultant to give more accurate prescriptions and reduced unnecessary medical tests.

Ease up the administration

While compiling and managing the paperwork is certainly a tough call, healthcare IT makes the things easier. With the help of electronic medical records and management system, the administrative tasks have become hassle-free and efficient, which has subsequently lower down the administrative costs. However, to ensure the authenticity of information, administrative bodies have to be particular about network security consulting, solution & specialist.

Ensure the security of information

While the health information technology has reduced the burdens of paperwork, it has also ensured the safety and security of medical records of the patients. With the help of healthcare information system, all the medical records and relevant information can be saved and secured, as unlike the conventional paperwork system, electronic health records are safe and easy to transferred and accessed electronically. Though, paperwork of medical records are unrecoverable in tragic situations, but one has to ensure proper network security consulting, solution & specialist to ensure the security of electronic health records.

A result of birth or pregnancy complications, viral infections in uterus or genetic malformation, Congenital Anomalies is also known as birth defects. The term congenital is something that is present at the time of birth; however, it may manifest only much later in life. Anomaly could be also called a developmental deformity, and is a condition not present at birth.

The Chapter 17 of ICD-10-CM talks about Congenital Malformations, Deformations and Chromosomal Abnormalities. These below-mentioned categories may be the principal or first-listed diagnoses.

• Q00-Q07 Nervous system
• Q10-Q18 Eye, ear, face, neck
• Q20-Q28 Circulatory system
• Q30-Q34 Respiratory system
• Q35-Q37 Tip and cleft palate
• Q38-Q45 Other information of the digestive system
• Q50-Q56 Genital Organs
• Q60-Q64 Urinary system
• Q65-Q79 Deformations of musculoskeletal system
• Q80-Q89 Other congenital information
• Q90-Q99 Chromosomal abnormalities not classified else where

The congenital malformations, chromosomal abnormalities and deformations are so arranged in Chapter 17 of ICD-10-CM to easily identify the groups of the condition types. The chapter will have greater specificity than what was present in ICD-9-CM.

These syndromes may be symptom sets of multiple syndromes or malfunctions. If there are no specific codes available, a code for each syndrome manifestation needs to be assigned. When a specific code exists for a syndrome, additional codes may be assigned to manifestations which are not included in the specific syndrome code.

The patient can use Chapter 17 codes throughout his life. Once the congenital malformation and deformity is corrected, it is important to use a personal history code. If any chromosomal abnormality or deformation or malformation is present at birth but is not diagnosed by a physician until later in life, it is important to report codes Q00 – Q99 in such cases.

The Z38 (Liveborn infants) appropriate category code per place of birth and delivery type need be sequenced in a way that the principal diagnosis for birth admission have to be followed by appropriate congenital anomaly codes Q00 – Q89 which are assigned as secondary codes.

Let’s check a coding example:

1. Diagnosis: Cleft package involving both soft and hard palates with bilateral client lip.

Answer: Q37.4 Cleft, (congenital) lip (unilateral), bilateral, with cleft palate, hard with soft

Rationale: The document is carefully reviewed to select one specific code which combines these conditions. Cleft lip and palate come under congenital defects which are inflicted when bones and tissues don’t merge together in utero. The roof of the mouth is known as palate which consists of soft and hard palates. Normally, both cleft lip and palate are both present and a cleft lip is bilateral or unilateral. The left unilateral cleft lip has a gap either under the left or right nostril on one side. But the bilateral cleft lip has gap on both sides of the lip. ICD 10 classifies cleft palate to be hard with soft, hard, soft, unspecified or uvular. It also uses the term bilateral, unilateral or median.

Clinical trial management system is a software system used by biotechnology and pharmaceutical industries to manage clinical trials in clinical research. This system maintains and manages performing, planning and reporting functions, along with the relevant information of participants, like contact information, tracking deadlines, and milestones.

The system comprises of protocol development, site selection & trial preparation, subject identification & enrolment, collection, monitoring & processing of data, data analysis & reporting, pharmacovigilance, and submission for review. Data is collected during the process of trials and is stored in the database. The data is then reviewed to decide upon the safety parameter of the drug.

How is clinical trial management useful?

· Real-time Insights into Operations: It is a system that provides a central place for recording operational activity, which offers easy access to important information.

· Stronger Financial management: It supports consistency in budgeting across the enterprise and provides access to all financial information.

· Increased staff efficiency: It reduces duplicate data entry, and thus only relevant information is present in the software. This saves time for the staff and increases accuracy and consistency of data.

They are experiments done in clinical research to determine medicines or procedures that will/will not benefit the patient. Chronic heart ailments, cancer, diabetes, stroke, and arthritis have long-lasting effects, persistent for more than three months after treatment. Globally, chronic diseases kill more than 38 million people each year. Cardiovascular diseases account for most deaths, approximately 17.5 million people annually, followed by cancers (8.2 million), respiratory diseases (4 million), and diabetes (1.5 million). These four groups account for 82% of the chronic disorder mortalities. New medicines and procedures need to be developed to tackle these diseases. In addition to this, communicable diseases, like Ebola, swine flu, etc. still do not have effective cures. Owing to all these factors, the number of clinical trials performed has increased significantly in the past decade.

A report by a market research firm estimates double-digit growth rate for Clinical Trial Management Market

Increasing incidences of chronic diseases, increase in R&D to implement localized research programs, increased clinical research outsourcing, and implementation of clinical trials by Contract Research Organizations and Synchronization of Hospital Information System (HIS) with CTMS are some of the factors driving the market growth.

Hurdles for Market: Data security issues, lack of qualified and skilled labor to handle CTMS, increasing rate of clinical trial failure in Phase II and Phase III, and the high cost of customized CTMS are some of the factors hindering the growth of the market.

Way Ahead: The future involves the development of advanced software with high accuracy and efficiency, which will likely provide lucrative opportunities for market growth.

What if there was a simple, effective way to drastically reduce the costs of Canada’s Medicare program? There is. It’s called hypnosis.

Hypnosis could:

Lower the number of patients

Shorten hospital stays

Reduce the amount of prescribed medications

Hypnosis, or more precisely, hypnotherapy, is an ideal complement to medical care. Here are some of the ways in which it could drastically reduce visits to family doctors, emergency rooms and hospitals:

Stop smoking

Lose weight

Reduce anxiety (including panic attacks)

Compliance with prescribed meds

Reduce stress (and therefore heart attacks etc)

Encourage exercise

Change eating habits

End phobias of needles and MRIs

For example, a study conducted at Mount Sinai School of Medicine in New York found that when women participated in a hypnosis session before breast surgery, they experienced less nausea and required less pain medication than the control group. Patients in the hypnosis group also cost the hospital $772 less.

Potency

What a doctor or nurse says to her patients carries a powerful impact. When medical professionals learn how to talk in a positively hypnotic manner to patients:

Conversations will be quicker, thus saving the health care people time.

Patients will better absorb information about their prognosis.

Pre-operation hypnotic explanations will reduce patients’ anxiety.

Patient anxiety and blood pressure will be significantly reduced.

Patients will be more compliant.

Nurses and doctors will be less stressed, and

Most of all, patients will recover faster.

Hypnotic Self-help for Patients and Staff

Patients who are taught simple self-help hypnotic techniques will have less need for medical aid and hospitalizations.

Similarly, doctors and nurses who use hypnosis to relax themselves, to handle stress on the job, to deal with difficult patients and colleagues, will be more efficient. Thus time will be saved, less overtime required and staff will enjoy their work more.

How To Implement This Safe, Simple Solution

Twenty-two years ago while I was recovering from an 8-bypass operation I listened to a hypnotic recording created by a colleague. The Head Nurse told my wife “I don’t know what he’s listening to, but everyone should have one.” Sadly, the Head Nurse never followed up.

But now, as the health care crisis heats up in Canada and we can look forward to either the collapse of a Medicare overburdened with elderly people, or increases in taxes on an already heavily-taxed population, surely the time has come to apply the safe process of hypnotherapy to the sick vehicle of social medicine.

An easy way to train doctors, nurses and the public at large in the easy-to-learn hypnotic techniques that could revolutionise health care in Canada would be to ask hypnotherapists across this great country to put on free workshops in hospitals and clinics.

A second tactic would be to teach high school students (the medical professionals and patients of the future) the benefits of lowering their own stress levels and building healthy habits with self-hypnosis.

The Internet is awash with hypnotic MP3s, DVDs, eBooks and CDs, many of them free. This is the 21st century way for patients and health care providers to enjoy self-hypnosis — and therefore better physical and mental health.

All it would take for students, nurses and doctors is one hour to acquire hypnotic self-help techniques that would last a lifetime.

The digital transformation process has seen an increase in the complexity of software. This is due to the fact that a software application has to work in a multi-dimensional environment comprising of processes, devices, networks, operating systems, frameworks, servers, IDE’s, and others. Besides, each component of the environment can be further divided thereby increasing its complexity. Technology is changing at a rapid pace and each and every software built on it needs to perform at its optimum level. The software interface to technologies such as the cloud, mobility, big data, and analytics, AI or IoT should be robust enough to deliver quality and meet the user expectations.

Given the increase in software complexity, technology changes and the shifting dynamics of user behaviour, the quality of software or application should be top notch. To ensure the quality of software across dimensions, paradigms and disciplines, the quality assurance process needs to undergo a change. It is no longer about software testing alone, but implementing software quality engineering. The idea is not merely about identifying the glitches during the testing phase but eliminating them altogether during the design and development stages.

What is software quality engineering?

As opposed to software testing that involves the testing of specific functions or parts of a software against predefined outcomes, software QA engineering is much more diverse and all encompassing. A software quality engineer works with the development team to design and develop the source codes. He or she conducts other allied tasks such as testing, integrating and deploying the software.

A QA analyst of a quality engineering company as part of his or her responsibility sets up verifiable testing goals. He or she does so in consultation with all the stakeholders. The software quality engineer oversees the entire SDLC and creates a quality culture where each and every stakeholder is aware of the quality objectives. The underlying philosophy of QA engineering is to work on the codes at the designing phase in order to eliminate glitches or vulnerabilities.

Also, the software quality engineer ensures the delivery of software within time constraints. The timely deployment of a software application goes a long way in meeting the expectations of customers. Notably, the all-encompassing software QA engineering includes software testing as well.

Five rules of software quality engineering

The approach of QA engineering has moved towards shift-left testing. The term means rigorously testing the codes during the development phase to identify and eliminate the glitches. The five rules that a QA engineer should follow for the successful implementation of a quality engineering process are:

1. Functional testing: The process involves testing the UI and API to see if they meet the design specifications. This automation testing exercise validates the core functions, inputs, installation, and menus. To illustrate further, a functional testing includes

• Checking the input fields by entering data consisting of strings, special characters, extended characters and non-Latin scripts
• Checking the basic API functionality and core application parameters against pre-defined outcomes
• Setting up the application on local machines running on different operating systems
• Checking of text functions like copying, pasting and editing
• Checking the short cuts by using hot keys

2. Peer review of code: The source code should be reviewed by another test engineer to gain a better perspective. However, it is advisable to follow the basic functional testing exercise before going for a peer review.

3. Static code analysis: Use specific tools to look for security and other vulnerabilities. Such tools can check a static code without actually executing it. Perform static code analysis to check if the codes meet the required coding standards or conform to the security regulations.

4. Unit testing: The process involves the checking of a unit comprising of a component, class or method against valid or invalid inputs. In a DevOps environment, a unit test should be conducted every time a change is made to the code. Ensure the unit test to be an extensive one to nip the glitches in the bud. The process can use virtualization with the entry of dummy inputs to check each and every test scenario.

5. User performance testing: The testing should involve a single user and check for any load and performance issues. The test area should include testing the application for quicker loading and execution.

Conclusion

The five key rules of Quality engineering ensure that the codes meet the desired business objectives and user expectations. Any quality engineering company would do well to include the five key rules in its strategy. By doing so, the company helps to remove glitches at the development stage of a software. This leads to the deployment of a better quality software within time and budget constraints.