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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.
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State Audit Office of the Republic of Latvia
, issued in 2015
Risk cases: 3
The Board of Audit and Inspection (BAI) conducted an audit on the information systems in the area of service delivery to improve the system’s efficiency and convenience.
Korea was recognized as an Information Technology (IT) powerhouse by the international community of the UN in 2010. Such an achievement is attributable to the significant investments that the Korean ... government has commissioned toward improving the country’s information infrastructure within a short period of time.<br/> The government is investing 1 trillion won every year in an e-government project ... for citizens in the welfare and employment sectors by utilizing the renewed information infrastructure.<br/> However, the information system of some government ministries proved to have overlapping functions ... Enormous IT investments require tremendous coordination ... Korean government is investing 1 trillion won in e-government projectsevery year. Thus, the country has earned a reputation for the IT powerhouse. Apart from undeniable advantages, the huge scale ... and the speed, the information technologies are implemented with, cause some problems to be tackled. The SAI Korea turns special atention to two of them: overlapping functionalities and interconnectivity issues.
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Korea was recognized as an Information Technology (IT) powerhouse by the international community of the UN in 2010. Such an achievement is attributable to the significant investments that the Korean ... government has commissioned toward improving the country’s information infrastructure within a short period of time.<br/> The government is investing 1 trillion won every year in an e-government project ... for citizens in the welfare and employment sectors by utilizing the renewed information infrastructure.<br/> However, the information system of some government ministries proved to have overlapping functions ... Enormous IT investments require tremendous coordination ... Korean government is investing 1 trillion won in e-government projectsevery year. Thus, the country has earned a reputation for the IT powerhouse. Apart from undeniable advantages, the huge scale ... and the speed, the information technologies are implemented with, cause some problems to be tackled. The SAI Korea turns special atention to two of them: overlapping functionalities and interconnectivity issues.
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Board of Audit and Inspection of Korea
, issued in 2011
Risk cases: 3
Improved Planning and Performance Measures Are Needed to Help Ensure Successful Technology Modernization
Massive modernization effort needs coordination Social security issues can touch lives of many. Information technology in this area are increasingly costly and difficult to maintain. GAO is recommending to develop comprehensive metrics to effectively gauge modernization progress; complete comprehensive strategic planning, including its enterprise architecture; and define the new roles and responsibilities to help ensure effective oversight.
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Massive modernization effort needs coordination Social security issues can touch lives of many. Information technology in this area are increasingly costly and difficult to maintain. GAO is recommending to develop comprehensive metrics to effectively gauge modernization progress; complete comprehensive strategic planning, including its enterprise architecture; and define the new roles and responsibilities to help ensure effective oversight.
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General Accountability Office
, issued in 2012
Risk cases: 3
Whether Disclosure of the Public Sector Data Is Ensured
Strategy more important than declarations Why open data are so dificult to become reality? Lithuania possesses the elements required to disclose data but lacks a strategic approach. The report by SAI Lithuania reviews all critical elements of this problem. Most of them look like a pattern reproduced by other countries. And one important thing: the SAI Lithuania opened their own data - exactly on the day of publication of the audit report!
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Strategy more important than declarations Why open data are so dificult to become reality? Lithuania possesses the elements required to disclose data but lacks a strategic approach. The report by SAI Lithuania reviews all critical elements of this problem. Most of them look like a pattern reproduced by other countries. And one important thing: the SAI Lithuania opened their own data - exactly on the day of publication of the audit report!
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National Audit Office of the Republic of Lithuania
, issued in 2016
Risk cases: 9
Report on the problems connected with the development and implementation of the digitally based Shared Medication Record
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 ... 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 ... . 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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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 ... 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 ... . 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