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Data 101: Making Sense of It AllTrevor JonesInternal Audit Manager Intermountain Healthcare

AHIA 31st Annual Conference – August 26-29, 2012 – Philadelphia PAwww.ahia.org

Introduction2

My backgroundMy backgroundWhy data?AssessmentAssessment

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Why use data in planning and fieldwork?

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Why use data in planning and fieldwork?Introduction to data-analysis tools

ExcelExcelAccessACL / IDEA / PicaloACL / IDEA / PicaloToad

Case studiesCase studies

Where does data reside?

Not always with IT

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Not always with IT

Each department 

Different systems and databasesDifferent systems and databasesFinancial, Inventory, Clinical, HRAS/400 Oracle SQL ServerAS/400, Oracle, SQL Server

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How do I access data?

Audit Charters grant unrestricted access to all

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Audit Charters grant unrestricted access to all functions, records, property, and personnel

ApprovalsppOwner / data steward must approve access

Open Database Connectivity (ODBC)Open Database Connectivity (ODBC)Driver between database management system and applicationpp

Intro to data analysis tools:  how to obtain data

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Pros and Cons – Excel

Excel10

Read/WriteUser friendlyOlder versions ~65K records Newer 1M+Older versions 65K records. Newer 1M+.Pivot tablesNo “live” support; however, most questions/issues easily resolved with Googleresolved with Google

Other auditors = great resourceCannot join tablesEasy manipulation (be careful!)Cost: all auditors should have access at no additional cost to department

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Pros and Cons – Access

Access

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AccessPowerful tool – able to view and importAllows for easier table joinsAllows for easier table joinsNo “live support” but relatively easy to resolve with GoogleUses its own unique syntax for queries (not SQL)Still can’t handle massive databasesCost: most auditors can obtain with little or no additional cost to department

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ACL – Scriptingp g

P-Card analysis

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yWeekendRestaurantsCo ntr codeCountry codeAirline, hotel, rental carDuplicate (same name, merchant, date, amt)Split payment (same name, merchant, date, total amt > $2,000)Even dollar amounts ($50, $100)Unique MCC (drug pharmacy dentist theatre grocery)Unique MCC (drug, pharmacy, dentist, theatre, grocery)Level 3 data (gift, amex, visa, gift card)Accidental purchases (oops, mistake, accident, sorry)

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Pros and Cons – ACL

ACL

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Built-in functionality: duplicate, gap, Benford’s, stratify, classifyV t bl h dl illi f d ith Very stable – handles millions of records with easeExcellent support – if you pay for itJoining tables is very difficultg yScripting offers powerful, automated functionality for continuous auditingH iti t fi ld tHypersensitive to field typesUses proprietary syntax for queries Cost: around $1,500 license fee,

Pros and Cons - Picalo

Very similar to ACL / IDEA

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Very similar to ACL / IDEABuilt-in functions are uniqueLittle support other than user manualLittle support other than user manualCost: free download (at least for now)

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Pros and Cons – Toad

Toad (Oracle / Data Analysts)

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The “Cadillac” of query toolsClaims it “can query any database platform (Oracle, DB2, SQL Server)Easily explore data prior to queryingVery stable – handles millions of records with easeSubstandard product support – “ToadWorld” offers basic user forums

Because SQL is universal query language, less support needed – easily resolve issues with Google or SQL manualresolve issues with Google or SQL manual

Allows for more complex queries, table joinsUses standard SQL syntax“Drag-and-drop” allows beginners to build queries, then modifyDrag and drop allows beginners to build queries, then modifyCost: ~$450 for a single license (TDA)

Quest Software recently purchased by Dell

Summary – Tools y

Tool comparison:

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Tool comparison: http://www.informationactive.com/data/attachments/fraudsoftware.PDF/

Summary – Toad y

Toad not usually classified as “fraud software”

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Toad not usually classified as fraud softwareToad is best way to obtain complete data sets, while Excel and ACL provide best analysisExcel and ACL provide best analysis

http://www.toadworld.com/Portals/0/ToadTechPapers/TDA%20TipsNTricks25.pdf/

Why use data?y

Option to inspect 100% transactions

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Option to inspect 100% transactions 

Ability to focus on high risk areas Difficult to always test 100%Difficult to always test 100%Identify outliers immediatelyIdentify statistical trendsIdentify statistical trends

Ability to automate

Why use data? Examplesy p

Employees paying themselves

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Employees paying themselves

Employees adjusting timecards excessively or irregular hour patternsg p

Lost revenue, missing charges (bundle charges)

Duplicate billingDuplicate billing

Analyze statistical patterns in physician billing

Add value increase efficiency of departmentsAdd value, increase efficiency of departmentsP‐Card analysis

How are audit and data related?30

Planning Risk Samples

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Questions & Contact Info33

Questions?

trevor.jones@imail.org

Save the Date: August 25-28 2013August 25-28, 2013

32nd Annual Conference Chi ILChicago, IL

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