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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
VETERANS’ HEALTH CARE - Preliminary Observations on VHA’s Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... existing VA care in the community programs, as required by law, the agency said it will examine strategies for improving the timeliness and accuracy of its payments to community providers.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... existing VA care in the community programs, as required by law, the agency said it will examine strategies for improving the timeliness and accuracy of its payments to community providers.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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General Accountability Office
, issued in 2016
Risk cases: 6
The protection of IT systems and health data in three Danish regions
Security to be improved in IT systems with health data It is Rigsrevisionen’s assessment that the three regions are not protecting the access to IT systems and health data in a satisfactory manner. As a consequence, unauthorised persons might gain access to sensitive and confidential personal data, which could affect there liability and availability of important health data used in the treatment of hospital patients. Based on the results of the study and the current threat scenario, Rigsrevisionen finds that basic security measures against cyber attacks and protection of access to IT systems and health data should be a top priority for Denmark’s five regions. Basic security measures in combination with management and control of user privileges can reduce the risk of compromising the regions’ IT systems and data considerably.
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Security to be improved in IT systems with health data It is Rigsrevisionen’s assessment that the three regions are not protecting the access to IT systems and health data in a satisfactory manner. As a consequence, unauthorised persons might gain access to sensitive and confidential personal data, which could affect there liability and availability of important health data used in the treatment of hospital patients. Based on the results of the study and the current threat scenario, Rigsrevisionen finds that basic security measures against cyber attacks and protection of access to IT systems and health data should be a top priority for Denmark’s five regions. Basic security measures in combination with management and control of user privileges can reduce the risk of compromising the regions’ IT systems and data considerably.
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National Audit Office of Denmark
, issued in 2018
Risk cases: 3
Prevention Activities Against Traffic Accidents
traffic accidents, which are dramatically leading to loss of life and property. Examination and evaluation of the Traffic Information Systems (TIS) under the traffic control headline. TIS' main purpose ... accidents dramatically leading to loss of life and property. ... Performance Audit Studies covering certain IT Issues related to Prevention Activities Against Traffic Accidents. It aims to contribute to the continuous improvement of prevention activities against ... ... ... You need a way more than IT, to make an IT system successful ... SAI of Turkey examined the Traffic Information Systems and found out that not only IT infrastructure determined the audited IT project's outcomes. There were also non-IT issues that decided: low ... quality of driving education, poor technical infrastruture, as well as lack of monitoring and coordination at prioritization stage.
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traffic accidents, which are dramatically leading to loss of life and property. Examination and evaluation of the Traffic Information Systems (TIS) under the traffic control headline. TIS' main purpose ... accidents dramatically leading to loss of life and property. ... Performance Audit Studies covering certain IT Issues related to Prevention Activities Against Traffic Accidents. It aims to contribute to the continuous improvement of prevention activities against ... ... ... You need a way more than IT, to make an IT system successful ... SAI of Turkey examined the Traffic Information Systems and found out that not only IT infrastructure determined the audited IT project's outcomes. There were also non-IT issues that decided: low ... quality of driving education, poor technical infrastruture, as well as lack of monitoring and coordination at prioritization stage.
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Turkish Court of Accounts
, issued in 2008
Risk cases: 4
Homeland Security. Oversight of Neglected Human Resources Information Technology Investment Is Needed
Human resources IT investments get stuck in management's lack of interest Although the Human Resources Information Technology (HRIT) investment was initiated about 12 years ago with the intent to consolidate, integrate, and modernize the department's human resources IT infrastructure, the Department of Homeland Security (DHS) has made very limited progress in achieving these goals. HRIT's minimally involved executive steering committee during a time when significant problems were occurring was a key factor in the lack of progress. This is particularly problematic given that the department's ability to efficiently and effectively carry out its mission is significantly hampered by its fragmented human resources. DHS's ineffective management of HRIT, such as the lack of an updated schedule and a life-cycle cost estimate, also contributed to the neglect this investment has experienced. DHS will be limited in efficiently tracking and reporting accurate, comprehensive performance and learning management data across the organization, and could risk further implementation delays.
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Human resources IT investments get stuck in management's lack of interest Although the Human Resources Information Technology (HRIT) investment was initiated about 12 years ago with the intent to consolidate, integrate, and modernize the department's human resources IT infrastructure, the Department of Homeland Security (DHS) has made very limited progress in achieving these goals. HRIT's minimally involved executive steering committee during a time when significant problems were occurring was a key factor in the lack of progress. This is particularly problematic given that the department's ability to efficiently and effectively carry out its mission is significantly hampered by its fragmented human resources. DHS's ineffective management of HRIT, such as the lack of an updated schedule and a life-cycle cost estimate, also contributed to the neglect this investment has experienced. DHS will be limited in efficiently tracking and reporting accurate, comprehensive performance and learning management data across the organization, and could risk further implementation delays.
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US Government Accountability Office
, issued in 2016
Risk cases: 1
WannaCry Cyber Attack and the NHS
Why the British NHS became a victim of WannaCry The NAO's investigation points at the problem of insufficient powers of the cybersecurity coordinator across the health organisation. As a result no remedial actions were taken, and the cyber attack succeeded thanks to neglected precautions.
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Why the British NHS became a victim of WannaCry The NAO's investigation points at the problem of insufficient powers of the cybersecurity coordinator across the health organisation. As a result no remedial actions were taken, and the cyber attack succeeded thanks to neglected precautions.
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National Audit Office
, issued in 2017
Risk cases: 3
Conflicts of interest
First, recognise the conflicts of interest are a real risk the British NAO gathered a significant amount of intelligence on conflicts, particularly in the health and education sectors. These are areas of government where services are increasingly commissioned and delivered by parties at arm’s-length to departments. Conflicts of interest can occur naturally as a product of the way a system is designed and most often arise from operational situations.
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First, recognise the conflicts of interest are a real risk the British NAO gathered a significant amount of intelligence on conflicts, particularly in the health and education sectors. These are areas of government where services are increasingly commissioned and delivered by parties at arm’s-length to departments. Conflicts of interest can occur naturally as a product of the way a system is designed and most often arise from operational situations.
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National Audit Office
, issued in 2015
Risk cases: 8
Federal Agencies Need to Address Aging Legacy Systems
Be aware of legacy IT risks The US government spends about 75 percent of the total amount budgeted for information technology on operations and maintenance. GAO reviewed Office of Management and Budget and 26 agencies, covering years 2010 through 2017 and recommends to develop a goal for spending measure and finalize guidance to identify and prioritize legacy IT needing to be modernized or replaced.
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Be aware of legacy IT risks The US government spends about 75 percent of the total amount budgeted for information technology on operations and maintenance. GAO reviewed Office of Management and Budget and 26 agencies, covering years 2010 through 2017 and recommends to develop a goal for spending measure and finalize guidance to identify and prioritize legacy IT needing to be modernized or replaced.
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General Accountability Office
, issued in 2016
Risk cases: 3
Australian Taxation Office: Administration of Australian Business Number Registrations
More elligibility and data integrity needed The Australian Business Number (ABN) and Australian Business Register initiatives were implemented as part of theGovernment's comprehensive reform of the taxation system in 2000. Their introduction involved challenging issues of technology and governance , including the imperative to process and register significant numbers of applications in a short time. Overall, the Australian SAI concluded that the ABN registration process is operating effectively. However, matters relating to the eligibility of some ABN applicants need to be reviewed. Further, some data integrity issues remain outstanding.
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More elligibility and data integrity needed The Australian Business Number (ABN) and Australian Business Register initiatives were implemented as part of theGovernment's comprehensive reform of the taxation system in 2000. Their introduction involved challenging issues of technology and governance , including the imperative to process and register significant numbers of applications in a short time. Overall, the Australian SAI concluded that the ABN registration process is operating effectively. However, matters relating to the eligibility of some ABN applicants need to be reviewed. Further, some data integrity issues remain outstanding.
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The Australian National Audit Office
, issued in 2003
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.
Full description
National Audit Office
, issued in 2015
Risk cases: 5