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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
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.
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National Audit Office of Denmark
, issued in 2015
Risk cases: 5
Audit to the Social Security Systems of Collection of Contributions and Quotes and Relationship with Banking and other Entities Engaged in Collection Initiatives
The audit aims to evaluate the effectiveness and efficiency of the processes implemented in respect of the processing schemes of contributions/quotas, whose Wages Statements (WS) entered ... into the system in the first quarter of 2007, test the reliability, stability and confidence level of the application systems developed and the respective values processed in the entire collection circuit ... and respective accounting, and also check compliance with the contracts celebrated with banking entities. ... ... Application level of Social Security IS analyzed ... Processes maturity and automation of controls appeared to be main problems in the system which reliability, stability and confidence level were tested.
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The audit aims to evaluate the effectiveness and efficiency of the processes implemented in respect of the processing schemes of contributions/quotas, whose Wages Statements (WS) entered ... into the system in the first quarter of 2007, test the reliability, stability and confidence level of the application systems developed and the respective values processed in the entire collection circuit ... and respective accounting, and also check compliance with the contracts celebrated with banking entities. ... ... Application level of Social Security IS analyzed ... Processes maturity and automation of controls appeared to be main problems in the system which reliability, stability and confidence level were tested.
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TRIBUNAL DE CONTAS DE PORTUGAL
, issued in 2008
Risk cases: 2
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
Centralisation of support services of state authorities
Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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National Audit Office of Estonia
, issued in 2018
Risk cases: 2
Protection of automatically processed personal data
resolved,the National Audit Office conducted an audit to assess the efficiency of the protection and supervision of automatically processed personal data and to check whether: - the regulation of personal data ... Over the past few years, a number of legal, management, supervision, information, and methodological issues related to the protection of personal data have piled up. As they have not been fully ... protection conforms to the data processing practices; - personal data is properly processed at public sector bodies; - the State Data Protection Inspectorate (SDPI) performs sufficient supervision ... ... Data protection needs a long term strategy ... Rapid development of information and communication technology continuously brings about issues of personal data protection. Due to lack of long-term vision in this area they are frequently ... not addressed by the existing legislation. Moreover, SAI of Lithuania revealed failures in organization and control of personal data protection by public sector.
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resolved,the National Audit Office conducted an audit to assess the efficiency of the protection and supervision of automatically processed personal data and to check whether: - the regulation of personal data ... Over the past few years, a number of legal, management, supervision, information, and methodological issues related to the protection of personal data have piled up. As they have not been fully ... protection conforms to the data processing practices; - personal data is properly processed at public sector bodies; - the State Data Protection Inspectorate (SDPI) performs sufficient supervision ... ... Data protection needs a long term strategy ... Rapid development of information and communication technology continuously brings about issues of personal data protection. Due to lack of long-term vision in this area they are frequently ... not addressed by the existing legislation. Moreover, SAI of Lithuania revealed failures in organization and control of personal data protection by public sector.
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National Audit Office of the Republic of Lithuania
, issued in 2013
Risk cases: 2
Is the project 'E-health in Latvia' a step towards the right direction?
Objective of the audit was to verify efficiency and productivity of the actions by the institutions in charge for implementation of the e-health, as well as to audit economy and productivity of use ... of funds invested in the project for achievement of set objectives and gaining the planned benefits. Audit covered such main questions: 1) Will the e-health policy be able to solve problems and achieve ... the objective? 2) Are the actual activities performed by the National Health Service justified for achievement of the set objectives? 3) Will necessary information security and personal data protection be ensured ... E-health is a step forward in right direction, but not all objectives will be reached! ... Project “E-health in Latvia” supports healthy lifestyle, it will provide valuable and accessible information and will promote more efficient provision of services to patients. It is undoubtedly ... a step towards the right direction then. However, as found the Latvian SAI, the e-health policy will not be implemented within the initially planned scope and deadline and within set data security levels ... , thus the objective of this policy – to promote more effective provision of healthcare services will be attained only partially.
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Objective of the audit was to verify efficiency and productivity of the actions by the institutions in charge for implementation of the e-health, as well as to audit economy and productivity of use ... of funds invested in the project for achievement of set objectives and gaining the planned benefits. Audit covered such main questions: 1) Will the e-health policy be able to solve problems and achieve ... the objective? 2) Are the actual activities performed by the National Health Service justified for achievement of the set objectives? 3) Will necessary information security and personal data protection be ensured ... E-health is a step forward in right direction, but not all objectives will be reached! ... Project “E-health in Latvia” supports healthy lifestyle, it will provide valuable and accessible information and will promote more efficient provision of services to patients. It is undoubtedly ... a step towards the right direction then. However, as found the Latvian SAI, the e-health policy will not be implemented within the initially planned scope and deadline and within set data security levels ... , thus the objective of this policy – to promote more effective provision of healthcare services will be attained only partially.
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State Audit Office of the Republic of Latvia
, issued in 2015
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
Audit of the procurement of ICT products with the potential to be standard products
ICT procurement system reviewed SFAO points out what is critical in ICT procurement. Requirements management is extremely important, as well as procurement strategies for relevant product groups. Legal rules should protect investments and support competition, but they can still be insufficient without appropriate reporting - if you want your system to adapt to changes.
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ICT procurement system reviewed SFAO points out what is critical in ICT procurement. Requirements management is extremely important, as well as procurement strategies for relevant product groups. Legal rules should protect investments and support competition, but they can still be insufficient without appropriate reporting - if you want your system to adapt to changes.
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Swiss Federal Audit Office
, issued in 2015
Risk cases: 4
Improved Planning and Performance Measures Are Needed to Help Ensure Successful Technology Modernization
Massive modernization effort needs coordination Social security issues can touch lives of many. Information technology in this area are increasingly costly and difficult to maintain. GAO is recommending to develop comprehensive metrics to effectively gauge modernization progress; complete comprehensive strategic planning, including its enterprise architecture; and define the new roles and responsibilities to help ensure effective oversight.
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Massive modernization effort needs coordination Social security issues can touch lives of many. Information technology in this area are increasingly costly and difficult to maintain. GAO is recommending to develop comprehensive metrics to effectively gauge modernization progress; complete comprehensive strategic planning, including its enterprise architecture; and define the new roles and responsibilities to help ensure effective oversight.
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General Accountability Office
, issued in 2012
Risk cases: 3