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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
Report to the Public AccountsCommittee on mitigation of cyber attacks
This report concerns the action taken by Danish government bodies to prevent cyber attacks. Behaving sensibly in cyberspace to avoid attacks is important, but should be supplemented by technical ... security controls that can increase security and mitigate cyber attacks. International studies have concluded that three central security controls can prevent the majority of the currently known types ... of attacks: - technical restriction of download of programmes; - limited use of local administrators; - systematic software updates. Rigsrevisionen has assessed whether the government bodies in the study ... Three basic security measures are often neglected ... Government agencies are open for cyber attacks because they often forget to respect three basic IT security measures. The three measures are: 1. technical restriction on programs downloading; 2 ... . limited use of local administrators rights; 3. systematic software updates.
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This report concerns the action taken by Danish government bodies to prevent cyber attacks. Behaving sensibly in cyberspace to avoid attacks is important, but should be supplemented by technical ... security controls that can increase security and mitigate cyber attacks. International studies have concluded that three central security controls can prevent the majority of the currently known types ... of attacks: - technical restriction of download of programmes; - limited use of local administrators; - systematic software updates. Rigsrevisionen has assessed whether the government bodies in the study ... Three basic security measures are often neglected ... Government agencies are open for cyber attacks because they often forget to respect three basic IT security measures. The three measures are: 1. technical restriction on programs downloading; 2 ... . limited use of local administrators rights; 3. systematic software updates.
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National Audit Office of Denmark
, issued in 2013
Risk cases: 3
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
Report to on the user-friendliness and user involvement in the development of e-government services in Denmark
is to provide an assessment of the authorities’ efforts to ensure that e-government services are user-friendly. The report answers the following questions: - Have the authorities involved the users ... The e-government user-friendliness requirements are divided into five overall categories: language, design and flow, data and functionality, and accessibility. 1) The objective of the study ... in the development of the e-government services? - Have the authorities conducted post-launch assessments of the user-friendliness of the e-government services, and do the contracts with the suppliers of the solutions ... ... User-friendliness of public services should be consistenty required and tested ... The Danish Rigsrevisionen is of the opinion that the user-friendliness of the services can be improved if the authorities meet all the requirements of the Danish Agency for Digitisation concerning ... the matter. The audit covered user-friendliness related problems in case of five systems, before and after the launch. The systems take-up was also considered, as well as communicating with citizens who ... are unable to use digital services.
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is to provide an assessment of the authorities’ efforts to ensure that e-government services are user-friendly. The report answers the following questions: - Have the authorities involved the users ... The e-government user-friendliness requirements are divided into five overall categories: language, design and flow, data and functionality, and accessibility. 1) The objective of the study ... in the development of the e-government services? - Have the authorities conducted post-launch assessments of the user-friendliness of the e-government services, and do the contracts with the suppliers of the solutions ... ... User-friendliness of public services should be consistenty required and tested ... The Danish Rigsrevisionen is of the opinion that the user-friendliness of the services can be improved if the authorities meet all the requirements of the Danish Agency for Digitisation concerning ... the matter. The audit covered user-friendliness related problems in case of five systems, before and after the launch. The systems take-up was also considered, as well as communicating with citizens who ... are unable to use digital services.
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National Audit Office of Denmark
, issued in 2013
Risk cases: 2
The National Offender Management Information System (NOMIS)
This report examines the reasons for the delays and cost increases to the original integrated information system and, since the moratorium imposed by the Minister of State in order to seek options ... for project’s cost reduction, the aims of the revised National Offender Management Service (NOMS) and the progress made, the impact of the delays and rescoping on the costs and benefits achieved, and NOMS ... ’ fitness to deliver. The aim of one integrated information system (C-NOMIS i.e. National Offender Management Information System) was to improve information sharing about offenders; address the lack ... Rescoping necessary, but not fully successful ... by poor management leading to a three-year delay, a doubling in project costs and reductions in scope and benefits. ... An initiative to build a single offender management IT system for the prison and probation services has not delivered value for money. The NAO investigation found the project had been hampered
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This report examines the reasons for the delays and cost increases to the original integrated information system and, since the moratorium imposed by the Minister of State in order to seek options ... for project’s cost reduction, the aims of the revised National Offender Management Service (NOMS) and the progress made, the impact of the delays and rescoping on the costs and benefits achieved, and NOMS ... ’ fitness to deliver. The aim of one integrated information system (C-NOMIS i.e. National Offender Management Information System) was to improve information sharing about offenders; address the lack ... Rescoping necessary, but not fully successful ... by poor management leading to a three-year delay, a doubling in project costs and reductions in scope and benefits. ... An initiative to build a single offender management IT system for the prison and probation services has not delivered value for money. The NAO investigation found the project had been hampered
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National Audit Office
, issued in 2009
Risk cases: 4
Higher education institutions' provision of premises- room for improvement
How to pay for higher education institutions' premises Higher education institutions' rental costs constitute a significant part of central government rental expenses. Swedish NAO analysed results of reform, which aimed at more effective use of resources at central government agencies and more effective management of real property and assets for the State as a whole. Apart from the positive results as a whole, substantial room for improvement still exists: especially in identifying targets of costs, looking for incentives and in mitigating commercial approach to education institutions.
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How to pay for higher education institutions' premises Higher education institutions' rental costs constitute a significant part of central government rental expenses. Swedish NAO analysed results of reform, which aimed at more effective use of resources at central government agencies and more effective management of real property and assets for the State as a whole. Apart from the positive results as a whole, substantial room for improvement still exists: especially in identifying targets of costs, looking for incentives and in mitigating commercial approach to education institutions.
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Swedish National Audit Office
, issued in 2018
Risk cases: 2
Staff scheduling in government institutions
Scheduling irregular hours work Danish Rigsrevisionen shows in their study problems with staff scheduling in government institutions where employees are required to work irregular hours. Optimized staff scheduling contributed to reducing payroll costs. On the other hand, problems with rearrangement of work, recording working hours, optimisation of staffing levels and analysis of overtime triggers - add up to high costs of workforce. IT is not always used as ally either.
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Scheduling irregular hours work Danish Rigsrevisionen shows in their study problems with staff scheduling in government institutions where employees are required to work irregular hours. Optimized staff scheduling contributed to reducing payroll costs. On the other hand, problems with rearrangement of work, recording working hours, optimisation of staffing levels and analysis of overtime triggers - add up to high costs of workforce. IT is not always used as ally either.
Full description
National Audit Office of Denmark
, issued in 2015
Risk cases: 5