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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
Use of European Union funds in promoting information society
The National Audit Office audited the use of the aid allocated from the structural funds of the European Union (hereinafter EU aid) in the information technology (IT) area of the state. The National ... Audit Office checked whether the distribution of funds for the development of the information society has been balanced and transparent, and whether the distribution of aid is adequately supervised ... . Balanced distribution of aid means that development of the information society entails paying attention (and ideally providing proportional funding) to information systems aimed at the public sector, private ... Riigikontroll auditeeris Euroopa Liidu struktuurifondidest ehk tõukefondidest eraldatud toetuste (edaspidi ELi toetusraha) kasutamist riigi infotehnoloogia (IT) valdkonnas. Uuriti, kas raha jagamine ... infoühiskonna arendamise eesmärgil on olnud tasakaalustatud ja läbipaistev ning kas toetuste jagamise üle tehakse piisavat järelevalvet. Riigikontrolli hinnangul on riik infoühiskonna arengukava rakendamiseks ... toetuste jagamisel keskendunud liiga riigile suunatud IT-arenduste rahastamisele ning jätnud tagaplaanile ettevõtete konkurentsivõime parandamisele ja kolmandale sektorile suunatud IT arendusprojektide ... Balance needed for success of Information Society Development Plan ... , true suppervision and measurement of progress are listed by the Estonian SAI as next key elements necessary to keep balanced development of strategy for Information Society. ... 50% of aid has been granted primarily for the development of information systems of state agencies, i.e. as much as the other two target groups - business and citizens - put together. Information
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The National Audit Office audited the use of the aid allocated from the structural funds of the European Union (hereinafter EU aid) in the information technology (IT) area of the state. The National ... Audit Office checked whether the distribution of funds for the development of the information society has been balanced and transparent, and whether the distribution of aid is adequately supervised ... . Balanced distribution of aid means that development of the information society entails paying attention (and ideally providing proportional funding) to information systems aimed at the public sector, private ... Riigikontroll auditeeris Euroopa Liidu struktuurifondidest ehk tõukefondidest eraldatud toetuste (edaspidi ELi toetusraha) kasutamist riigi infotehnoloogia (IT) valdkonnas. Uuriti, kas raha jagamine ... infoühiskonna arendamise eesmärgil on olnud tasakaalustatud ja läbipaistev ning kas toetuste jagamise üle tehakse piisavat järelevalvet. Riigikontrolli hinnangul on riik infoühiskonna arengukava rakendamiseks ... toetuste jagamisel keskendunud liiga riigile suunatud IT-arenduste rahastamisele ning jätnud tagaplaanile ettevõtete konkurentsivõime parandamisele ja kolmandale sektorile suunatud IT arendusprojektide ... Balance needed for success of Information Society Development Plan ... , true suppervision and measurement of progress are listed by the Estonian SAI as next key elements necessary to keep balanced development of strategy for Information Society. ... 50% of aid has been granted primarily for the development of information systems of state agencies, i.e. as much as the other two target groups - business and citizens - put together. Information
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National Audit Office of Estonia
, issued in 2012
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
The implementation of national IT projects in social and health care
IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'.
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IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'.
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National Audit Office of Finland
, issued in 2011
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
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
State aid for IT projects in social and health care
In 2000-2009 about 180 million euros in national and European Union funds went to finance information technology projects in social and health care, not including the costs of developing national ... information system services (KanTa project) or the National Project for Social Services IT (Tikesos project). Financing has been provided by the Ministry of Social Affairs and H ealth, the Finnish Funding ... Agency for Technology and Innovation (Tekes), regional councils (previously state provincial offices), and indirectly by the Slot Machine Association under the direction of the Ministry of Social Affairs ... Difficult coordination of IT projects ... Finish Audit Office analyzed results of poor cooperation between authorities on national and local level in social and health care projects: difficult integration of information systems and poor ... coordination of the financing information technology projects, including double financing.
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In 2000-2009 about 180 million euros in national and European Union funds went to finance information technology projects in social and health care, not including the costs of developing national ... information system services (KanTa project) or the National Project for Social Services IT (Tikesos project). Financing has been provided by the Ministry of Social Affairs and H ealth, the Finnish Funding ... Agency for Technology and Innovation (Tekes), regional councils (previously state provincial offices), and indirectly by the Slot Machine Association under the direction of the Ministry of Social Affairs ... Difficult coordination of IT projects ... Finish Audit Office analyzed results of poor cooperation between authorities on national and local level in social and health care projects: difficult integration of information systems and poor ... coordination of the financing information technology projects, including double financing.
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National Audit Office of Finland
, issued in 2011
Risk cases: 3
Digitisation of municipal services
The purpose of digitisation is to increase the quality and efficiency of public services. It is a goal to make online services the norm for public administration's communication with citizens ... and the private sector. The municipal sector is a significant provider of public services, and digitisation of municipal services is therefore essential for achieving this goal.<br/>The audit surveyed the status ... , assessed the significance of and possible obstacles to digitisation of municipal services. The audit examined how the Ministry of Local Government and Modernisation's use of policy instruments contributes ... ... Municipalities have not digitised their services to any extent ... Digitisation increases the quality and efficiency of public services and municipal sector is a significant provider of public services. Report of Riksrevisjonen of Norway shows however ... , that municipalities need a substantial support to execute this demanding task. To provide them with help, the central government has to coordinate own efforts first.
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The purpose of digitisation is to increase the quality and efficiency of public services. It is a goal to make online services the norm for public administration's communication with citizens ... and the private sector. The municipal sector is a significant provider of public services, and digitisation of municipal services is therefore essential for achieving this goal.<br/>The audit surveyed the status ... , assessed the significance of and possible obstacles to digitisation of municipal services. The audit examined how the Ministry of Local Government and Modernisation's use of policy instruments contributes ... ... Municipalities have not digitised their services to any extent ... Digitisation increases the quality and efficiency of public services and municipal sector is a significant provider of public services. Report of Riksrevisjonen of Norway shows however ... , that municipalities need a substantial support to execute this demanding task. To provide them with help, the central government has to coordinate own efforts first.
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Office of the Auditor General of Norway
, issued in 2016
Risk cases: 2
Open Government Data - Are all exceptions to the principle of cost-free access and reuse legitimate?
The United Kingdom, a country seen, like the United States, as a pioneer in open public data, has estimated at £6.8bn (€7,9bn) the revenue in 2010 and 2011 generated for British society by open ... public data, of which £5bn (€5.8bn) is profit. As an example, a start-up has highlighted the existence of areas in which massive savings can be made by analysing prescriptions of patented drugs ... and the corresponding generics.<br/> Such possibilities are not beyond reach for France, which is not only deemed to be among the pioneers but also one of the countries making the most rapid progress in this domain ... ... Open data strategy should decide the costs problem ... French Cour des comptes presents analysis on implementation of the open data practice across the administration. Massive savings are expected, when public access to large amounts of highquality data ... is made easy. France is among the pioneers and countries making the most rapid progress in this domain. Charges for the reuse of the public information has been identified as the main problem.
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The United Kingdom, a country seen, like the United States, as a pioneer in open public data, has estimated at £6.8bn (€7,9bn) the revenue in 2010 and 2011 generated for British society by open ... public data, of which £5bn (€5.8bn) is profit. As an example, a start-up has highlighted the existence of areas in which massive savings can be made by analysing prescriptions of patented drugs ... and the corresponding generics.<br/> Such possibilities are not beyond reach for France, which is not only deemed to be among the pioneers but also one of the countries making the most rapid progress in this domain ... ... Open data strategy should decide the costs problem ... French Cour des comptes presents analysis on implementation of the open data practice across the administration. Massive savings are expected, when public access to large amounts of highquality data ... is made easy. France is among the pioneers and countries making the most rapid progress in this domain. Charges for the reuse of the public information has been identified as the main problem.
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Cour des comptes
, issued in 2013
Risk cases: 1
Peering Point Betriebs GmbH
In 2004 the Peering Point Betriebs GmbH was established to provide an effective and secure IT network for the operation of the e-card (a smart card which replaced health insurance vouchers ... in the course of the introduction of the electronic administration system) and other services in health care. Since its foundation the company has suffered losses. Net losses were covered by the two owners ... – the Main Association of Austrian Social Insurance Institutions and the Austrian Medical Chamber – to 50 % each, and since 2011 in a proportion of 60 to 40. The Main Association failed to give an objective ... ... Safe but expensive ... Network safety of a healthcare e-card system has been provided at a high cost. As the Austrian Court of Audit discovered - there was no concept to reduce the expenditure.
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In 2004 the Peering Point Betriebs GmbH was established to provide an effective and secure IT network for the operation of the e-card (a smart card which replaced health insurance vouchers ... in the course of the introduction of the electronic administration system) and other services in health care. Since its foundation the company has suffered losses. Net losses were covered by the two owners ... – the Main Association of Austrian Social Insurance Institutions and the Austrian Medical Chamber – to 50 % each, and since 2011 in a proportion of 60 to 40. The Main Association failed to give an objective ... ... Safe but expensive ... Network safety of a healthcare e-card system has been provided at a high cost. As the Austrian Court of Audit discovered - there was no concept to reduce the expenditure.
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Austrian Court of Audit
, issued in 2012
Risk cases: 1