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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
Operation of the Record Systems Applied in the Eligibility Scheme of Benefits and Services Provided from the Social Security Funds
Hungarian SAI evaluated the set-up and operation of the basic registries of managing bodies (National Health Insurance Fund, Central Administration of National Pension Insurance, National Tax ... and Customs Administration), as well as the dataflow amongst them. In addition, the control system of fulfilling the data provision obligation was evaluated, as well as the IT support activities and whether ... the records had proven reliable in supporting services in compliance with eligibilities and in filtering unjustified services. The audited period covered the years 2007-2010. ... ... Well considered regulations are essential for good quality data ... State Audit Office of Hungary.has proved that date safety may depend on quality of regulations. The report on record systems of social security services casted light on risk connected with huge data ... bases managed by different entities, in a changing legal environment.
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Hungarian SAI evaluated the set-up and operation of the basic registries of managing bodies (National Health Insurance Fund, Central Administration of National Pension Insurance, National Tax ... and Customs Administration), as well as the dataflow amongst them. In addition, the control system of fulfilling the data provision obligation was evaluated, as well as the IT support activities and whether ... the records had proven reliable in supporting services in compliance with eligibilities and in filtering unjustified services. The audited period covered the years 2007-2010. ... ... Well considered regulations are essential for good quality data ... State Audit Office of Hungary.has proved that date safety may depend on quality of regulations. The report on record systems of social security services casted light on risk connected with huge data ... bases managed by different entities, in a changing legal environment.
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State Audit Office of Hungary
, issued in 2012
Risk cases: 2
The protection of research data at the Danish universities
The protection of research data at the Danish universities It is Rigsrevisionen’s assessment that the five largest universities are not adequately protecting their research data against unknown IT equipment. As a result, foreign actors may relatively easy gain unauthorized access to the universities’ research data.This is not considered satisfactory by Rigsrevisionen. The study shows that the five largest universities have defined guidelines for researchers’ use of software and hardware centrally, but that they have failed to centralise efforts to maintain a satisfactory level of security for research data. This is due mainly to the fact that, at some universities, researchers are allowed to bring their own devices,and at all the universities, researchers are allowed to have local administrator privileges, which gives them access to install software. Additionally, all five universities know of incidents where unknown hardware has been connected to their network.
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The protection of research data at the Danish universities It is Rigsrevisionen’s assessment that the five largest universities are not adequately protecting their research data against unknown IT equipment. As a result, foreign actors may relatively easy gain unauthorized access to the universities’ research data.This is not considered satisfactory by Rigsrevisionen. The study shows that the five largest universities have defined guidelines for researchers’ use of software and hardware centrally, but that they have failed to centralise efforts to maintain a satisfactory level of security for research data. This is due mainly to the fact that, at some universities, researchers are allowed to bring their own devices,and at all the universities, researchers are allowed to have local administrator privileges, which gives them access to install software. Additionally, all five universities know of incidents where unknown hardware has been connected to their network.
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National Audit Office of Denmark
, issued in 2018
Risk cases: 3
Staff scheduling in government institutions
Scheduling irregular hours work Danish Rigsrevisionen shows in their study problems with staff scheduling in government institutions where employees are required to work irregular hours. Optimized staff scheduling contributed to reducing payroll costs. On the other hand, problems with rearrangement of work, recording working hours, optimisation of staffing levels and analysis of overtime triggers - add up to high costs of workforce. IT is not always used as ally either.
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Scheduling irregular hours work Danish Rigsrevisionen shows in their study problems with staff scheduling in government institutions where employees are required to work irregular hours. Optimized staff scheduling contributed to reducing payroll costs. On the other hand, problems with rearrangement of work, recording working hours, optimisation of staffing levels and analysis of overtime triggers - add up to high costs of workforce. IT is not always used as ally either.
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National Audit Office of Denmark
, issued in 2015
Risk cases: 5
Effectiveness of the Tax Administration of the Republic of Slovenia in the execution of modernisation projects of the Slovenian duty information system and decreasing the number of duty sub-accounts
The Tax Administration of the Republic of Slovenia (hereinafter: the Tax Administration) is responsible for collecting taxes, fees and other compulsory levies (hereinafter: duties ... ). These are the revenue of the state budget, municipal budgets, the Health Insurance Institute of Slovenia, the Institute for Pension and Disability Insurance of Slovenia (hereinafter: duties recipients) and indirectly ... of the European Union budget. In order to improve its operations, the Tax Authority decided to modernise the Slovenian duties’ collection information system. It used this opportunity to implement also a second ... ... Shaky coordination of investments in important systems ... of the project, involving additional spendings, delays and errors in data processing. ... Slovenian SAI traced a series of problems in management of crucial IT investments in tax administration. Apart from promising goals, unclear business case gave a start to many problems at next stages
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The Tax Administration of the Republic of Slovenia (hereinafter: the Tax Administration) is responsible for collecting taxes, fees and other compulsory levies (hereinafter: duties ... ). These are the revenue of the state budget, municipal budgets, the Health Insurance Institute of Slovenia, the Institute for Pension and Disability Insurance of Slovenia (hereinafter: duties recipients) and indirectly ... of the European Union budget. In order to improve its operations, the Tax Authority decided to modernise the Slovenian duties’ collection information system. It used this opportunity to implement also a second ... ... Shaky coordination of investments in important systems ... of the project, involving additional spendings, delays and errors in data processing. ... Slovenian SAI traced a series of problems in management of crucial IT investments in tax administration. Apart from promising goals, unclear business case gave a start to many problems at next stages
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Court of Audit of the Republic of Slovenia
, issued in 2014
Risk cases: 7
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
Identifying and meeting central government's skills requirements
Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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National Audit Office
, issued in 2011
Risk cases: 6
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
Centralisation of support services of state authorities
Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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National Audit Office of Estonia
, issued in 2018
Risk cases: 2
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