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Electronic Health Records - VA Needs to Identify and Report Existing System Costs
Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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US Government Accountability Office
, issued in 2019
Risk cases: 3
OMB and Agencies Need to Focus Continued Attention on Implementing Reform Law
How to invest efficiently in IT IT investments are large and growing position in annual budgets. Historically, they have frequently failed, incurred cost overruns and schedule slippages, or contributed little to mission-related outcomes. GAO recommendations focus on the oversight and execution of the data center consolidation initiative, the accuracy and reliability of the IT Dashboard, and incremental development policies.
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How to invest efficiently in IT IT investments are large and growing position in annual budgets. Historically, they have frequently failed, incurred cost overruns and schedule slippages, or contributed little to mission-related outcomes. GAO recommendations focus on the oversight and execution of the data center consolidation initiative, the accuracy and reliability of the IT Dashboard, and incremental development policies.
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General Accountability Office
, issued in 2016
Risk cases: 3
Peering Point Betriebs GmbH
In 2004 the Peering Point Betriebs GmbH was established to provide an effective and secure IT network for the operation of the e-card (a smart card which replaced health insurance vouchers ... in the course of the introduction of the electronic administration system) and other services in health care. Since its foundation the company has suffered losses. Net losses were covered by the two owners ... – the Main Association of Austrian Social Insurance Institutions and the Austrian Medical Chamber – to 50 % each, and since 2011 in a proportion of 60 to 40. The Main Association failed to give an objective ... ... Safe but expensive ... Network safety of a healthcare e-card system has been provided at a high cost. As the Austrian Court of Audit discovered - there was no concept to reduce the expenditure.
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In 2004 the Peering Point Betriebs GmbH was established to provide an effective and secure IT network for the operation of the e-card (a smart card which replaced health insurance vouchers ... in the course of the introduction of the electronic administration system) and other services in health care. Since its foundation the company has suffered losses. Net losses were covered by the two owners ... – the Main Association of Austrian Social Insurance Institutions and the Austrian Medical Chamber – to 50 % each, and since 2011 in a proportion of 60 to 40. The Main Association failed to give an objective ... ... Safe but expensive ... Network safety of a healthcare e-card system has been provided at a high cost. As the Austrian Court of Audit discovered - there was no concept to reduce the expenditure.
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Austrian Court of Audit
, issued in 2012
Risk cases: 1
The implementation of national IT projects in social and health care
IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'. ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics
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IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'. ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics
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National Audit Office of Finland
, issued in 2011
Risk cases: 3
The Shared Services Centre
The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The Australian National Audit Office
, issued in 2016
Risk cases: 2
Central government staff costs
Results of staff reductions The British NAO found that departments had significantly reduced numbers of their civil servants and of course salary costs at the same time. But they reduced staff numbers mainly by minimising recruitment, and the age profile of the civil service has changed. NAO pays a lot attention to what effect this has had on the future pipeline of talent and skills. It reminds also that the departments need long-term operating models to work efficiently with the staff reduced.
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Results of staff reductions The British NAO found that departments had significantly reduced numbers of their civil servants and of course salary costs at the same time. But they reduced staff numbers mainly by minimising recruitment, and the age profile of the civil service has changed. NAO pays a lot attention to what effect this has had on the future pipeline of talent and skills. It reminds also that the departments need long-term operating models to work efficiently with the staff reduced.
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National Audit Office
, issued in 2015
Risk cases: 5
Identifying and meeting central government's skills requirements
Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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National Audit Office
, issued in 2011
Risk cases: 6
Open Data Trend Report 2015
How to activate the open data policy The Dutch SAI looks for ways to improve open data practice in the Netherlands. They point at experience of two leading countries: UK and US, and advise to: prepare a concrete action plan, to increase number of mandatory published data, to develop government-wide data inventory and to put open data to work.
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How to activate the open data policy The Dutch SAI looks for ways to improve open data practice in the Netherlands. They point at experience of two leading countries: UK and US, and advise to: prepare a concrete action plan, to increase number of mandatory published data, to develop government-wide data inventory and to put open data to work.
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Netherlands Court of Audits
, issued in 2015
Risk cases: 4
Homelessness
Homelessness grows despite increased spendings to reduce it British NAO analyses the root-causes of unsuccessful effort to reduce homelessness in England. They point at a side effect of the Goverment reform of welfare reform and at lack of full impact assessment.
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Homelessness grows despite increased spendings to reduce it British NAO analyses the root-causes of unsuccessful effort to reduce homelessness in England. They point at a side effect of the Goverment reform of welfare reform and at lack of full impact assessment.
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National Audit Office
, issued in 2016
Risk cases: 3
Performance measurement by regulators
Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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National Audit Office
, issued in 2016
Risk cases: 2