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VETERANS’ HEALTH CARE - Preliminary Observations on VHA’s Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
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 ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... in geographic location, performance, and workload); reviewed VHA documents and 156 claims from those 4 locations; and interviewed officials from VHA, Medicare, TRICARE, and selected community providers and state ... 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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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 ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... in geographic location, performance, and workload); reviewed VHA documents and 156 claims from those 4 locations; and interviewed officials from VHA, Medicare, TRICARE, and selected community providers and state ... 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
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
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
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
Effectiveness of the execution of the eHealth project
The Court of Audit of the Republic of Slovenia has audited how effectively the Ministry of Health had managed the project eHealth - the national plan for developing information system support ... to the national public health system in the period between 1st of January 2004 and 26th of September 2013. The audit has focused on the effectiveness of the Ministry in achieving the project’s goals, time ... management, management of the human resources and financial oversight. The goal of the Ministry was to implement a modern information system, which would support secure eHealth operations and effective ... ... Clear concept, good planning and financial control are indispensable conditions for a successful IT project ... The Court of Audit of the Republic of Slovenia analysed a Government eHealth project. Its goal was to implement a modern information system, which would support the health services and health related ... data. The Court has pointed at a long list of project management fundamentals to be corrected.
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The Court of Audit of the Republic of Slovenia has audited how effectively the Ministry of Health had managed the project eHealth - the national plan for developing information system support ... to the national public health system in the period between 1st of January 2004 and 26th of September 2013. The audit has focused on the effectiveness of the Ministry in achieving the project’s goals, time ... management, management of the human resources and financial oversight. The goal of the Ministry was to implement a modern information system, which would support secure eHealth operations and effective ... ... Clear concept, good planning and financial control are indispensable conditions for a successful IT project ... The Court of Audit of the Republic of Slovenia analysed a Government eHealth project. Its goal was to implement a modern information system, which would support the health services and health related ... data. The Court has pointed at a long list of project management fundamentals to be corrected.
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Court of Audit of the Republic of Slovenia
, issued in 2013
Risk cases: 5
Correct information at the right time in healthcare and nursing – collaboration without effect?
The Swedish National Audit Office has conducted an audit to determine whether Government initiatives have contributed to the objective that authorised healthcare staff shall have access to the right ... patient information at the right time by means of direct electronic access. ... ... Information share is crucial for competitive health care ... Health and social care staff has very limited access to patient information from other care-giving institutions, which may lead to health damage and wrong-treatment. The cooperation between ... the Government and the municipalities must improve if the investments in better access to common patient information shall get impact in practice.
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The Swedish National Audit Office has conducted an audit to determine whether Government initiatives have contributed to the objective that authorised healthcare staff shall have access to the right ... patient information at the right time by means of direct electronic access. ... ... Information share is crucial for competitive health care ... Health and social care staff has very limited access to patient information from other care-giving institutions, which may lead to health damage and wrong-treatment. The cooperation between ... the Government and the municipalities must improve if the investments in better access to common patient information shall get impact in practice.
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Riksrevisionen (Swedish National Audit Office)
, issued in 2011
Risk cases: 3
The Shared Services Centre
The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The Australian National Audit Office
, issued in 2016
Risk cases: 2
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
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