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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
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
Good Practice in Annual Reports 2016-17
Reporting: a real skill The Building Public Trust Awards, sponsored by PwC, have been running for 15 years and the British NAO co-sponsors the public sector award. The Good Practices in annual reports 2016-2017 present eye-opening examples of how to make complex reports easily understandable and how to clearly outline goals and achievement of them.
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Reporting: a real skill The Building Public Trust Awards, sponsored by PwC, have been running for 15 years and the British NAO co-sponsors the public sector award. The Good Practices in annual reports 2016-2017 present eye-opening examples of how to make complex reports easily understandable and how to clearly outline goals and achievement of them.
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National Audit Office
, issued in 2018
Risk cases: 4
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
Report on the problems connected with the development and implementation of the digitally based Shared Medication Record
. and relevant health staff and the patients have direct digital access to updated medical data round the clock. The report answers the following questions: 1) Has the Ministry of Health and the NHA provided ... a sufficient framework for carrying through the SMR programme? 2) Has the Ministry of Health and the NHA directed the SMR programme towards delivering within the agreed costs, time and quality parameters ... The purpose of the examination was to assess whether the department of the Danish Ministry of Health, the Danish National eHealth Authority (NHA) and the five regions that are responsible ... ... Involvement of key participants necessary from the very beginning ... Digitally based Shared Medication Record is basis of the complex healthcare system. Rigsrevisionen analysed unsolved issues related to unclear business case, insufficient analysis of work flows ... and processes leading to implementation problems, governance not involving key players, and IT security organisation.
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. and relevant health staff and the patients have direct digital access to updated medical data round the clock. The report answers the following questions: 1) Has the Ministry of Health and the NHA provided ... a sufficient framework for carrying through the SMR programme? 2) Has the Ministry of Health and the NHA directed the SMR programme towards delivering within the agreed costs, time and quality parameters ... The purpose of the examination was to assess whether the department of the Danish Ministry of Health, the Danish National eHealth Authority (NHA) and the five regions that are responsible ... ... Involvement of key participants necessary from the very beginning ... Digitally based Shared Medication Record is basis of the complex healthcare system. Rigsrevisionen analysed unsolved issues related to unclear business case, insufficient analysis of work flows ... and processes leading to implementation problems, governance not involving key players, and IT security organisation.
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National Audit Office of Denmark
, issued in 2014
Risk cases: 2
Extract from the report to the Public Accounts Committee on the access to IT systems that support the provision of essential services to the Danish society
The report is focused on the significant risk that is associated with inadequate management and control of domain administrator privileges, which makes it possible for unauthorized persons to obtain ... access to the IT systems and data of the institutions. Rigsrevisionen has not examined for what specific purposes unauthorized access to the institutions’ systems and data can be used. ... ... Inadequate management and control of domain administrator privileges ... The Danish report concerns the measures - taken by six government institutions of various branches of State activities - to protect IT systems and data that support the provision of essential ... services to the Danish society from unauthorized access, obtained on the basis of domain administrator privileges.
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The report is focused on the significant risk that is associated with inadequate management and control of domain administrator privileges, which makes it possible for unauthorized persons to obtain ... access to the IT systems and data of the institutions. Rigsrevisionen has not examined for what specific purposes unauthorized access to the institutions’ systems and data can be used. ... ... Inadequate management and control of domain administrator privileges ... The Danish report concerns the measures - taken by six government institutions of various branches of State activities - to protect IT systems and data that support the provision of essential ... services to the Danish society from unauthorized access, obtained on the basis of domain administrator privileges.
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National Audit Office of Denmark
, issued in 2015
Risk cases: 4
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
Working of Inland Container Depots and Container Freight Stations
NEW! Online report on audit of SAI India With this first digital audit report of the Comptroller and Auditor General of India, new chapter has been opened in our profession: the online form is primary versus printable pdf. Advantages: high level of readability, live responsive charts, easy browsing and search of what users find interesting. The reported performance audit concerned 'dry ports', or multimodal logistics centres, which play growing role in domestic and international trade. It shows how gaps in concept and lax attitude to internal control can result on capacities, speed of trade, and enviromental safety.
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NEW! Online report on audit of SAI India With this first digital audit report of the Comptroller and Auditor General of India, new chapter has been opened in our profession: the online form is primary versus printable pdf. Advantages: high level of readability, live responsive charts, easy browsing and search of what users find interesting. The reported performance audit concerned 'dry ports', or multimodal logistics centres, which play growing role in domestic and international trade. It shows how gaps in concept and lax attitude to internal control can result on capacities, speed of trade, and enviromental safety.
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Comptroller and Auditor General of India
, issued in 2017
Risk cases: 5
The effectiveness of Official Development Assistance expenditure
Need of more coordination and transparency The audit of the UK's Official Development Assistance revealed among others: fragmented responsibilities and difficulties in review and reporting. These led to difficulties in assessment of effectiveness of the assistance and of progress in implementing the UK Aid Strategy.
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Need of more coordination and transparency The audit of the UK's Official Development Assistance revealed among others: fragmented responsibilities and difficulties in review and reporting. These led to difficulties in assessment of effectiveness of the assistance and of progress in implementing the UK Aid Strategy.
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National Audit Office
, issued in 2019
Risk cases: 4
State aid for IT projects in social and health care
In 2000-2009 about 180 million euros in national and European Union funds went to finance information technology projects in social and health care, not including the costs of developing national ... information system services (KanTa project) or the National Project for Social Services IT (Tikesos project). Financing has been provided by the Ministry of Social Affairs and H ealth, the Finnish Funding ... Agency for Technology and Innovation (Tekes), regional councils (previously state provincial offices), and indirectly by the Slot Machine Association under the direction of the Ministry of Social Affairs ... Difficult coordination of IT projects ... Finish Audit Office analyzed results of poor cooperation between authorities on national and local level in social and health care projects: difficult integration of information systems and poor ... coordination of the financing information technology projects, including double financing.
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In 2000-2009 about 180 million euros in national and European Union funds went to finance information technology projects in social and health care, not including the costs of developing national ... information system services (KanTa project) or the National Project for Social Services IT (Tikesos project). Financing has been provided by the Ministry of Social Affairs and H ealth, the Finnish Funding ... Agency for Technology and Innovation (Tekes), regional councils (previously state provincial offices), and indirectly by the Slot Machine Association under the direction of the Ministry of Social Affairs ... Difficult coordination of IT projects ... Finish Audit Office analyzed results of poor cooperation between authorities on national and local level in social and health care projects: difficult integration of information systems and poor ... coordination of the financing information technology projects, including double financing.
Full description
National Audit Office of Finland
, issued in 2011
Risk cases: 3