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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
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 ... 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 ... 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 ... 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 ... 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 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
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
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
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 ... services to the Danish society from unauthorized access, obtained on the basis 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
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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 ... services to the Danish society from unauthorized access, obtained on the basis 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
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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?
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 ... . E-health solutions also save patients time. <br/> The purpose of the audit was to assess whether the objectives set to e-Health – higher quality of the health service and more efficient organisation ... 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 ... ... 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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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 ... . E-health solutions also save patients time. <br/> The purpose of the audit was to assess whether the objectives set to e-Health – higher quality of the health service and more efficient organisation ... 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 ... ... 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
Is the project 'E-health in Latvia' a step towards the right direction?
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 ... 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 ... 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 ... 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 ... , thus the objective of this policy – to promote more effective provision of healthcare services will be attained only partially. ... 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
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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 ... 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 ... 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 ... 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 ... , thus the objective of this policy – to promote more effective provision of healthcare services will be attained only partially. ... 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
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State Audit Office of the Republic of Latvia
, issued in 2015
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
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
Data security and positions with access to confidential information
. The 2007 Civil Service Data Information Security Decree (in Dutch: VIR 2007) is the legal foundation of the first part of this audit (data security). The Security Screening Act (in Dutch: WVO ... ) is the foundation of the second part (positions with access to confidential information). Only four of the organizations we have audited show an acceptible level of compliance with the 2007 Civil Service Data ... Information Security Decree, eight organizations show scope for improvement and nine organizations show an unsatisfactory level of compliance with the 2007 Civil Service Data Information Security Decree. When ... ... Shortcomings in information security and in positions with access to confidential information ... Surprising weaknesses were revealed by the NCA in its Government-wide operational audit performed as part of the 2011 audit into the state of central government accounts: Poor quality of data ... protection policy and poor protection of information systems. Also, non vetted positions with access to confidential information.
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. The 2007 Civil Service Data Information Security Decree (in Dutch: VIR 2007) is the legal foundation of the first part of this audit (data security). The Security Screening Act (in Dutch: WVO ... ) is the foundation of the second part (positions with access to confidential information). Only four of the organizations we have audited show an acceptible level of compliance with the 2007 Civil Service Data ... Information Security Decree, eight organizations show scope for improvement and nine organizations show an unsatisfactory level of compliance with the 2007 Civil Service Data Information Security Decree. When ... ... Shortcomings in information security and in positions with access to confidential information ... Surprising weaknesses were revealed by the NCA in its Government-wide operational audit performed as part of the 2011 audit into the state of central government accounts: Poor quality of data ... protection policy and poor protection of information systems. Also, non vetted positions with access to confidential information.
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Netherlands Court of Audits
, issued in 2012
Risk cases: 3