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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
Products sold on the European market: unravelling the system of CE marking
Problems with general picture The Netherlands National Court of Audit was interested in finding out whether anyone keeps track of all the actors involved in the process of system of European Union product markings. The interest was aroused by an observation that the vast majority of the questions raised about the system were prompted by incidents and that the questioners did not generally appear to be interested in the operation of the system as a whole...
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Problems with general picture The Netherlands National Court of Audit was interested in finding out whether anyone keeps track of all the actors involved in the process of system of European Union product markings. The interest was aroused by an observation that the vast majority of the questions raised about the system were prompted by incidents and that the questioners did not generally appear to be interested in the operation of the system as a whole...
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The Netherlands Court of Audit
, issued in 2017
Risk cases: 5
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
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
Extract from the report to the Public Accounts Committee on the access to IT systems that support the provision of essential services to the Danish society
access to the IT systems and data of the institutions. Rigsrevisionen has not examined for what specific purposes unauthorized access to the institutions’ systems and data can be used. ... The report is focused on the significant risk that is associated with inadequate management and control of domain administrator privileges, which makes it possible for unauthorized persons to obtain ... ... Inadequate management and control of domain administrator privileges ... The Danish report concerns the measures - taken by six government institutions of various branches of State activities - to protect IT systems and data that support the provision of essential ... services to the Danish society from unauthorized access, obtained on the basis of domain administrator privileges.
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access to the IT systems and data of the institutions. Rigsrevisionen has not examined for what specific purposes unauthorized access to the institutions’ systems and data can be used. ... The report is focused on the significant risk that is associated with inadequate management and control of domain administrator privileges, which makes it possible for unauthorized persons to obtain ... ... Inadequate management and control of domain administrator privileges ... The Danish report concerns the measures - taken by six government institutions of various branches of State activities - to protect IT systems and data that support the provision of essential ... services to the Danish society from unauthorized access, obtained on the basis of domain administrator privileges.
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National Audit Office of Denmark
, issued in 2015
Risk cases: 4
Activities of the state in implementing the e-health system - Do the state, doctors and patients benefit from ehealth?
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 ... 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 ... ... Why state, doctors and patients do not benefit from e-Health as much as they could? ... 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. ... 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
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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 ... 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 ... ... Why state, doctors and patients do not benefit from e-Health as much as they could? ... 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. ... 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
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National Audit Office of Estonia
, issued in 2014
Risk cases: 3
State aid for IT projects in social and health care
information system services (KanTa project) or the National Project for Social Services IT (Tikesos project). Financing has been provided by the Ministry of Social Affairs and H ealth, the Finnish Funding ... and Health. All in all approximately 250 million euros was tied to development projects carried out as national measures in 2000-2010, not including the self-funded portion of aid or loans granted ... In 2000-2009 about 180 million euros in national and European Union funds went to finance information technology projects in social and health care, not including the costs of developing national ... Difficult coordination of IT projects ... Finish Audit Office analyzed results of poor cooperation between authorities on national and local level in social and health care projects: difficult integration of information systems and poor ... coordination of the financing information technology projects, including double financing.
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information system services (KanTa project) or the National Project for Social Services IT (Tikesos project). Financing has been provided by the Ministry of Social Affairs and H ealth, the Finnish Funding ... and Health. All in all approximately 250 million euros was tied to development projects carried out as national measures in 2000-2010, not including the self-funded portion of aid or loans granted ... In 2000-2009 about 180 million euros in national and European Union funds went to finance information technology projects in social and health care, not including the costs of developing national ... Difficult coordination of IT projects ... Finish Audit Office analyzed results of poor cooperation between authorities on national and local level in social and health care projects: difficult integration of information systems and poor ... coordination of the financing information technology projects, including double financing.
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National Audit Office of Finland
, issued in 2011
Risk cases: 3
The development and use of identification services in public administration
The audit examined the implementation and coordination of projects aimed at developing identification services in public administration, cooperation among authorities in this area and compliance ... with legislation in procuring services. The audit also examined development, control and monitoring structures regarding identification services. The audit focused on electronic identification services that are used ... in public administration's electronic transactions. ... ... Unhealthy competition linked with lack of coordinatnion and with procurement irregularities ... See what may go wrong with the IT public procurement. Check out what is the basis to avoid irregularities or omissions in complying with public procurement legislation. National Audit Office ... of Finland identified also risks resulting from lack of horizontal coordination.
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The audit examined the implementation and coordination of projects aimed at developing identification services in public administration, cooperation among authorities in this area and compliance ... with legislation in procuring services. The audit also examined development, control and monitoring structures regarding identification services. The audit focused on electronic identification services that are used ... in public administration's electronic transactions. ... ... Unhealthy competition linked with lack of coordinatnion and with procurement irregularities ... See what may go wrong with the IT public procurement. Check out what is the basis to avoid irregularities or omissions in complying with public procurement legislation. National Audit Office ... of Finland identified also risks resulting from lack of horizontal coordination.
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National Audit Office of Finland
, issued in 2008
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
Supply of food and medicinal products
Supply of food and medicinal products Deficiencies in emergency preparedness and weaknesses in governance are still found by the Swedish NAO in the system of safeguarding supply of food and medicinal products. The system is complex and NAO appreciates efforts made by responsible agencies. However, they found also insufficient clarity in division of responsibilities and weaknesses in coordinantion.
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Supply of food and medicinal products Deficiencies in emergency preparedness and weaknesses in governance are still found by the Swedish NAO in the system of safeguarding supply of food and medicinal products. The system is complex and NAO appreciates efforts made by responsible agencies. However, they found also insufficient clarity in division of responsibilities and weaknesses in coordinantion.
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Swedish National Audit Office
, issued in 2018
Risk cases: 2