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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
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.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... 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.<br ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... 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 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
Performance Audit of Public Debt Management Information Systems
The usage and development of the information technologies in public financial management is an important priority of the country at the phase of intensive implementation of electronic governance ... (E-Governance). The fact that information systems play crucial role in the business processes of the Ministry of Finance affects the state and the public in general. <br/> Bearing in mind the role and importance ... of information systems in the public debt management process and having considered legal requirements to information security, State Audit Office of Georgia conducted Performance Audit of Public Debt Management ... ... More effective IT governance needed ... Importance of effective performance of public debt management e-systems may be explained by the world’s increased dependence on such systems. In parallel with the performance audit of debt management ... information systems of the Ministry Of Finance of Georgia, Supreme Audit Institutions of 11 countries also studied this topic, both in terms of systems’ performance and their practical application by local ... financial institutions. Audit conducted by the State Audit Office of Georgia has revealed security and governance shortcomings related to management and usage of these systems.
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The usage and development of the information technologies in public financial management is an important priority of the country at the phase of intensive implementation of electronic governance ... (E-Governance). The fact that information systems play crucial role in the business processes of the Ministry of Finance affects the state and the public in general. <br/> Bearing in mind the role and importance ... of information systems in the public debt management process and having considered legal requirements to information security, State Audit Office of Georgia conducted Performance Audit of Public Debt Management ... ... More effective IT governance needed ... Importance of effective performance of public debt management e-systems may be explained by the world’s increased dependence on such systems. In parallel with the performance audit of debt management ... information systems of the Ministry Of Finance of Georgia, Supreme Audit Institutions of 11 countries also studied this topic, both in terms of systems’ performance and their practical application by local ... financial institutions. Audit conducted by the State Audit Office of Georgia has revealed security and governance shortcomings related to management and usage of these systems.
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State Audit Office Of Georgia
, issued in 2014
Risk cases: 5
Usability of public digital services directed at businesses
G2B - in search of user friendliness Danish Rigsrevisionen finds that the digital services directed at businesses, examined during this audit, are not sufficiently user-friendly from start to finish, and the authorities need to focus more on ensuring that relevant solutions are interlinked in a userfriendly manner.
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G2B - in search of user friendliness Danish Rigsrevisionen finds that the digital services directed at businesses, examined during this audit, are not sufficiently user-friendly from start to finish, and the authorities need to focus more on ensuring that relevant solutions are interlinked in a userfriendly manner.
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National Audit Office of Denmark
, issued in 2015
Risk cases: 3
Good Practice in Annual Reports 2016-17
Reporting: a real skill The Building Public Trust Awards, sponsored by PwC, have been running for 15 years and the British NAO co-sponsors the public sector award. The Good Practices in annual reports 2016-2017 present eye-opening examples of how to make complex reports easily understandable and how to clearly outline goals and achievement of them.
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Reporting: a real skill The Building Public Trust Awards, sponsored by PwC, have been running for 15 years and the British NAO co-sponsors the public sector award. The Good Practices in annual reports 2016-2017 present eye-opening examples of how to make complex reports easily understandable and how to clearly outline goals and achievement of them.
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National Audit Office
, issued in 2018
Risk cases: 4
Performance measurement by regulators
Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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National Audit Office
, issued in 2016
Risk cases: 2
Has Public Administration Used All Opportunities for Efficient Management of ICT Infrastructure?
Efficient Management of ICT Infrastructure Centralised management of ICT services and infrastructure would allow the institutions to optimise in long run their resources – financial, human, material and technical. However, we observed during the audit that the move towards ICT centralisation and single data centres has ceased. The different ministries and even the institutions subordinated to the same ministry do not cooperate sufficiently with each other regarding the ICT management, maintenance, and infrastructure placement. They rather choose to maintain their own, sometimes even several, data centres.
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Efficient Management of ICT Infrastructure Centralised management of ICT services and infrastructure would allow the institutions to optimise in long run their resources – financial, human, material and technical. However, we observed during the audit that the move towards ICT centralisation and single data centres has ceased. The different ministries and even the institutions subordinated to the same ministry do not cooperate sufficiently with each other regarding the ICT management, maintenance, and infrastructure placement. They rather choose to maintain their own, sometimes even several, data centres.
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State Audit Office of the Republic of Latvia
, issued in 2019
Risk cases: 3
WannaCry Cyber Attack and the NHS
Why the British NHS became a victim of WannaCry The NAO's investigation points at the problem of insufficient powers of the cybersecurity coordinator across the health organisation. As a result no remedial actions were taken, and the cyber attack succeeded thanks to neglected precautions.
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Why the British NHS became a victim of WannaCry The NAO's investigation points at the problem of insufficient powers of the cybersecurity coordinator across the health organisation. As a result no remedial actions were taken, and the cyber attack succeeded thanks to neglected precautions.
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National Audit Office
, issued in 2017
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