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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
Report on the problems connected with the development and implementation of the digitally based Shared Medication Record
for the hospitals have made an adequate effort to develop and implement the Shared Medication Record (SMR). With the SMR, data on the citizens’ medication can be shared across hospitals, general practitioners, etc ... The purpose of the examination was to assess whether the department of the Danish Ministry of Health, the Danish National eHealth Authority (NHA) and the five regions that are responsible ... . and relevant health staff and the patients have direct digital access to updated medical data round the clock. The report answers the following questions: 1) Has the Ministry of Health and the NHA provided ... ... Involvement of key participants necessary from the very beginning ... Digitally based Shared Medication Record is basis of the complex healthcare system. Rigsrevisionen analysed unsolved issues related to unclear business case, insufficient analysis of work flows ... and processes leading to implementation problems, governance not involving key players, and IT security organisation.
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for the hospitals have made an adequate effort to develop and implement the Shared Medication Record (SMR). With the SMR, data on the citizens’ medication can be shared across hospitals, general practitioners, etc ... The purpose of the examination was to assess whether the department of the Danish Ministry of Health, the Danish National eHealth Authority (NHA) and the five regions that are responsible ... . and relevant health staff and the patients have direct digital access to updated medical data round the clock. The report answers the following questions: 1) Has the Ministry of Health and the NHA provided ... ... Involvement of key participants necessary from the very beginning ... Digitally based Shared Medication Record is basis of the complex healthcare system. Rigsrevisionen analysed unsolved issues related to unclear business case, insufficient analysis of work flows ... and processes leading to implementation problems, governance not involving key players, and IT security organisation.
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National Audit Office of Denmark
, issued in 2014
Risk cases: 2
Activities of the state in implementing the e-health system - Do the state, doctors and patients benefit from ehealth?
of health care – have been achieved. The four main e-health projects were reviewed in the audit: Electronic Health Record, Digital Prescription, Digital Registration and Digital Image. The problems ... 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? ... 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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of health care – have been achieved. The four main e-health projects were reviewed in the audit: Electronic Health Record, Digital Prescription, Digital Registration and Digital Image. The problems ... 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? ... 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
The implementation of national IT projects in social and health care
IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'.
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IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'.
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National Audit Office of Finland
, issued in 2011
Risk cases: 3
Effectiveness of the execution of the eHealth project
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 ... management of the health and health related data. The Ministry had planned to finish the project by December 2015 with estimated implementation and operational costs of 133 million euro by December 2023 ... 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 ... ... Clear concept, good planning and financial control are indispensable conditions for a successful IT project ... data. The Court has pointed at a long list of project management fundamentals to be corrected. ... 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
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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 ... management of the health and health related data. The Ministry had planned to finish the project by December 2015 with estimated implementation and operational costs of 133 million euro by December 2023 ... 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 ... ... Clear concept, good planning and financial control are indispensable conditions for a successful IT project ... data. The Court has pointed at a long list of project management fundamentals to be corrected. ... 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
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Court of Audit of the Republic of Slovenia
, issued in 2013
Risk cases: 5
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
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 ... 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. ... ... 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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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 ... 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. ... ... 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
VETERANS’ HEALTH CARE - Preliminary Observations on VHA’s Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
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 ... 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 ... 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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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 ... 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 ... 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
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
Protection of automatically processed 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 ... of the Interior, Information Society Development Committee under the Ministry of Transport and Communications, and public establishment Central Project Management Agency. ... 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 ... ... 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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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 ... of the Interior, Information Society Development Committee under the Ministry of Transport and Communications, and public establishment Central Project Management Agency. ... 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 ... ... 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
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