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Activities of the state in implementing the e-health system - Do the state, doctors and patients benefit from ehealth?
Estonia’s population is aging and the share of elderly people is increasing, as fewer children are being born and people are living longer. This creates a constantly growing need for health ... and social services and patients are also becoming more and more demanding about the volume and quality of the services provided. The more extensive and systematic implementation of e-health solutions helps ... make the health system more efficient, improves people’s health via more effective prevention, raises the awareness of patients and also contributes to the more reasonable use of health resources ... ... Why state, doctors and patients do not benefit from e-Health as much as they could? ... The report reviews whether the objectives set to the e-Health – ambitious multiyear program of Estonian Government - have been achieved. They are: higher quality of the health service and more ... efficient organisation of health care. As SAI Estonia found out, wide range problems started from two basic points: lack of strategic manager and unrealisitc schedule.
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Estonia’s population is aging and the share of elderly people is increasing, as fewer children are being born and people are living longer. This creates a constantly growing need for health ... and social services and patients are also becoming more and more demanding about the volume and quality of the services provided. The more extensive and systematic implementation of e-health solutions helps ... make the health system more efficient, improves people’s health via more effective prevention, raises the awareness of patients and also contributes to the more reasonable use of health resources ... ... Why state, doctors and patients do not benefit from e-Health as much as they could? ... The report reviews whether the objectives set to the e-Health – ambitious multiyear program of Estonian Government - have been achieved. They are: higher quality of the health service and more ... efficient organisation of health care. As SAI Estonia found out, wide range problems started from two basic points: lack of strategic manager and unrealisitc schedule.
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National Audit Office of Estonia
, issued in 2014
Risk cases: 3
Informatisation of hospitals
The goals of the audit were: 1. Assesment to what degree service providers are prepared to implement the electronic health information system. 2. Assessment of government activities related ... to the construction of the health information system within the framework of the "Healthcare Informatisation Program" ... ... Sometimes it is really not about the money.. ... Informatisation of healthcare is one of the most money-consuming IT activities of the State. Polish NIK shows how a poor concept can delay modernization of hospitals. The new IT system was expected ... to take some burden off doctors, streamline medical care, prevent fraud and improve efficiency. But will it be created at all?
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The goals of the audit were: 1. Assesment to what degree service providers are prepared to implement the electronic health information system. 2. Assessment of government activities related ... to the construction of the health information system within the framework of the "Healthcare Informatisation Program" ... ... Sometimes it is really not about the money.. ... Informatisation of healthcare is one of the most money-consuming IT activities of the State. Polish NIK shows how a poor concept can delay modernization of hospitals. The new IT system was expected ... to take some burden off doctors, streamline medical care, prevent fraud and improve efficiency. But will it be created at all?
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Sumpreme Audit Office
, issued in 2013
Risk cases: 3
Is the project 'E-health in Latvia' a step towards the right direction?
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 ... 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 ... 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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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 ... 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 ... 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
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
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
Federal Human Resources Data
Internal control weaknesses may put mission at risk GAO audited the Enterprise Human Resources Integration payroll data warehose. The American auditors pointed at problems that may impede 'leverage of these data to meet its mission and allow others to make full use' of them. The critical internal contols areas to be improved in this cas are: completeness, accuracy, and validity of information, authorization, documentation, monitoring, results' evaluation.
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Internal control weaknesses may put mission at risk GAO audited the Enterprise Human Resources Integration payroll data warehose. The American auditors pointed at problems that may impede 'leverage of these data to meet its mission and allow others to make full use' of them. The critical internal contols areas to be improved in this cas are: completeness, accuracy, and validity of information, authorization, documentation, monitoring, results' evaluation.
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General Accountability Office
, issued in 2016
Risk cases: 2
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
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
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
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