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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
Incorrect payments in social insurance - Control activities of the Swedish Social Insurance Agency
the social insurance system as a whole. According to the estimates made, about SEK 1.2 billion had been underpaid and the rest was made up of benefits where the person insured had received overpayment.<br ... /> The Swedish NAO audited the work of the Government and the Swedish Social Insurance Agency to prevent incorrect payments in the period 2012–2015. The audit focused on the benefits for which the Swedish Social ... Insurance Agency is responsible. The audited benefits account for half of the insurance expenditure, half of the payments that are incorrect and for more than 70 per cent of the amount the Swedish Social ... Balance of priorities needed to reduce incorrect payments ... Role of social insurance in public finance is so substantial that reduction of incorrect payments' volume is matter of huge savings. The Swedish NAO noted positive initiatives by the Social Insurance ... Agency in this regard. However they found also, that serious problems can stem from giving higher priority to the speed of payment and customers satisfaction. They both are undoubtedly important features ... of each system, still, the prevention of incorrect payments needs strategic support to be really effective.
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the social insurance system as a whole. According to the estimates made, about SEK 1.2 billion had been underpaid and the rest was made up of benefits where the person insured had received overpayment.<br ... /> The Swedish NAO audited the work of the Government and the Swedish Social Insurance Agency to prevent incorrect payments in the period 2012–2015. The audit focused on the benefits for which the Swedish Social ... Insurance Agency is responsible. The audited benefits account for half of the insurance expenditure, half of the payments that are incorrect and for more than 70 per cent of the amount the Swedish Social ... Balance of priorities needed to reduce incorrect payments ... Role of social insurance in public finance is so substantial that reduction of incorrect payments' volume is matter of huge savings. The Swedish NAO noted positive initiatives by the Social Insurance ... Agency in this regard. However they found also, that serious problems can stem from giving higher priority to the speed of payment and customers satisfaction. They both are undoubtedly important features ... of each system, still, the prevention of incorrect payments needs strategic support to be really effective.
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Swedish National Audit Office
, issued in 2016
Risk cases: 3
The National Offender Management Information System (NOMIS)
for project’s cost reduction, the aims of the revised National Offender Management Service (NOMS) and the progress made, the impact of the delays and rescoping on the costs and benefits achieved, and NOMS ... This report examines the reasons for the delays and cost increases to the original integrated information system and, since the moratorium imposed by the Minister of State in order to seek options ... ’ fitness to deliver. The aim of one integrated information system (C-NOMIS i.e. National Offender Management Information System) was to improve information sharing about offenders; address the lack ... Rescoping necessary, but not fully successful ... by poor management leading to a three-year delay, a doubling in project costs and reductions in scope and benefits. ... An initiative to build a single offender management IT system for the prison and probation services has not delivered value for money. The NAO investigation found the project had been hampered
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for project’s cost reduction, the aims of the revised National Offender Management Service (NOMS) and the progress made, the impact of the delays and rescoping on the costs and benefits achieved, and NOMS ... This report examines the reasons for the delays and cost increases to the original integrated information system and, since the moratorium imposed by the Minister of State in order to seek options ... ’ fitness to deliver. The aim of one integrated information system (C-NOMIS i.e. National Offender Management Information System) was to improve information sharing about offenders; address the lack ... Rescoping necessary, but not fully successful ... by poor management leading to a three-year delay, a doubling in project costs and reductions in scope and benefits. ... An initiative to build a single offender management IT system for the prison and probation services has not delivered value for money. The NAO investigation found the project had been hampered
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National Audit Office
, issued in 2009
Risk cases: 4
Coordinated Audit on Information Technology Governance
IT governance needs awareness and SAIs' support The OLACEFS auditors found that the greatest challenge for the SAIs is to raise the awareness of the audit institutions about the importance of IT governance and the benefits that could be obtained by improving its degree of maturity. The audit was conducted by 11 SAIs and coordinated by TCU of Brasil. They concluded: 'It is important, even urgent, to invest resources to implement or enhance: the IT committees; the IT planning process; strategic IT planning; monitoring the IT contracting process; the business continuity plan; the designation of a responsible person or unit to manage security information; a risk management process; an asset inventory process; an information security committee; and a policy for access control.'
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IT governance needs awareness and SAIs' support The OLACEFS auditors found that the greatest challenge for the SAIs is to raise the awareness of the audit institutions about the importance of IT governance and the benefits that could be obtained by improving its degree of maturity. The audit was conducted by 11 SAIs and coordinated by TCU of Brasil. They concluded: 'It is important, even urgent, to invest resources to implement or enhance: the IT committees; the IT planning process; strategic IT planning; monitoring the IT contracting process; the business continuity plan; the designation of a responsible person or unit to manage security information; a risk management process; an asset inventory process; an information security committee; and a policy for access control.'
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Risk cases: 5
Parallel Audit on Biometric Passports - Overall Results (anonymised)
A biometric passport (or ePassport) contains biometric information which serves to authenticate the identity of travellers. Biometric passport management is the process of establishing ... and implementing the regulation on standards for security features and biometrics in passports and travel documents issued by the member states. The aim is to develop and maintain efficient and secure biometric ... passport production procedures (see page 5). ... EUROSAI ITWG: Parallel Audit on Biometric Passports ... deficiencies and weaknesses related to the IS/IT system and the IT management. Medium risks have been identified in the area of laws and regulations, cost-benefit realisation and transparency, as well ... Swiss SAI summed up results of audits concluded in seven countries (Belgium, Latvia, Lithuania, Norway, Portugal, Switzerland). The evaluation of the reported results showed that the overall passport ... process is generally under control while a couple of high-risk findings were identified in the non-process-specific assessments. In the non-process-specific assessments, most of the countries found
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A biometric passport (or ePassport) contains biometric information which serves to authenticate the identity of travellers. Biometric passport management is the process of establishing ... and implementing the regulation on standards for security features and biometrics in passports and travel documents issued by the member states. The aim is to develop and maintain efficient and secure biometric ... passport production procedures (see page 5). ... EUROSAI ITWG: Parallel Audit on Biometric Passports ... deficiencies and weaknesses related to the IS/IT system and the IT management. Medium risks have been identified in the area of laws and regulations, cost-benefit realisation and transparency, as well ... Swiss SAI summed up results of audits concluded in seven countries (Belgium, Latvia, Lithuania, Norway, Portugal, Switzerland). The evaluation of the reported results showed that the overall passport ... process is generally under control while a couple of high-risk findings were identified in the non-process-specific assessments. In the non-process-specific assessments, most of the countries found
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Swiss Federal Audit Office
, issued in 2015
Risk cases: 4
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.
Full description
State Audit Office of the Republic of Latvia
, issued in 2015
Risk cases: 3
Recovery of housing allowance - easy to make mistakes
Avoid mistakes in housing allowance recovery Housing allowance recovery rules are complex and outdated. What more, ad hoc changes can result in unpredicted deficiencies. The Swedish NAO found that monitoring and evaluation based analysis is of critical importance to avoid problems on the administration side - and what much more important: on the side of financialy vulnerable households.
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Avoid mistakes in housing allowance recovery Housing allowance recovery rules are complex and outdated. What more, ad hoc changes can result in unpredicted deficiencies. The Swedish NAO found that monitoring and evaluation based analysis is of critical importance to avoid problems on the administration side - and what much more important: on the side of financialy vulnerable households.
Full description
Swedish National Audit Office
, issued in 2018
Risk cases: 4
Homelessness
Homelessness grows despite increased spendings to reduce it British NAO analyses the root-causes of unsuccessful effort to reduce homelessness in England. They point at a side effect of the Goverment reform of welfare reform and at lack of full impact assessment.
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Homelessness grows despite increased spendings to reduce it British NAO analyses the root-causes of unsuccessful effort to reduce homelessness in England. They point at a side effect of the Goverment reform of welfare reform and at lack of full impact assessment.
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National Audit Office
, issued in 2016
Risk cases: 3
Housing in England: overview
Efforts to support housing Even if housebuilding in England has not kept pace with need and there has been a reduction in social rented homes, significant advantages can be enjoyed: an increase in home ownership and in the number of private rented homes. The quality of housing improved in recent years too. The National Audit Office has reviewed critical elements of the housing being one of the government's key priorities. Looking for risks, they found that a potential conflict of objectives can lead to tensions in delivery.
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Efforts to support housing Even if housebuilding in England has not kept pace with need and there has been a reduction in social rented homes, significant advantages can be enjoyed: an increase in home ownership and in the number of private rented homes. The quality of housing improved in recent years too. The National Audit Office has reviewed critical elements of the housing being one of the government's key priorities. Looking for risks, they found that a potential conflict of objectives can lead to tensions in delivery.
Full description
National Audit Office
, issued in 2017
Risk cases: 2
Information security work at nine agencies
Difficulties in achieving appropriate IT security Together with the Swedish NAO we assume that the picture that emerges at the agencies audited applies also to most of the other agencies in the public administration. The information security work is not given high enough priority in relation to the risks that exist. This applies to both the Government, which should have been clearer in its directions to agencies on this matter, and to agency managements, which did not give priority to the work of information security to the extent required. Much indicates that it is difficult for many agencies to achieve an appropriate level of information security work.
Full description
Difficulties in achieving appropriate IT security Together with the Swedish NAO we assume that the picture that emerges at the agencies audited applies also to most of the other agencies in the public administration. The information security work is not given high enough priority in relation to the risks that exist. This applies to both the Government, which should have been clearer in its directions to agencies on this matter, and to agency managements, which did not give priority to the work of information security to the extent required. Much indicates that it is difficult for many agencies to achieve an appropriate level of information security work.
Full description
Swedish National Audit Office
, issued in 2016
Risk cases: 4