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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 ... /> 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 ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... 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 ... /> 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 ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... 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
Information Technology Cost Estimation Agencies Need to Address Significant Weakness in Policies and Practices
To estimate reliable cost for the sucess of an IT program by providing the basis for the informed decision making and realistic budget information. To assess the extent to which selected departments ... and agencies have appropriately implement costestimating policies an procedures(four caracteristics of a reliable cost estimation: comprehensive, well-documented, accurate, credible). ... IT cost estimation ... Check out what may go wrong with the information technology cost estimation. Results of the US GAO audit can help to identify high risk areas: comprehensiveness of estimations, their documentation ... , lack of adequacy and inadequate implementation.
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To estimate reliable cost for the sucess of an IT program by providing the basis for the informed decision making and realistic budget information. To assess the extent to which selected departments ... and agencies have appropriately implement costestimating policies an procedures(four caracteristics of a reliable cost estimation: comprehensive, well-documented, accurate, credible). ... IT cost estimation ... Check out what may go wrong with the information technology cost estimation. Results of the US GAO audit can help to identify high risk areas: comprehensiveness of estimations, their documentation ... , lack of adequacy and inadequate implementation.
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General Accountability Office
, issued in 2012
Risk cases: 4
Audit to the Social Security Systems of Collection of Contributions and Quotes and Relationship with Banking and other Entities Engaged in Collection Initiatives
The audit aims to evaluate the effectiveness and efficiency of the processes implemented in respect of the processing schemes of contributions/quotas, whose Wages Statements (WS) entered ... into the system in the first quarter of 2007, test the reliability, stability and confidence level of the application systems developed and the respective values processed in the entire collection circuit ... and respective accounting, and also check compliance with the contracts celebrated with banking entities. ... ... Application level of Social Security IS analyzed ... Processes maturity and automation of controls appeared to be main problems in the system which reliability, stability and confidence level were tested.
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The audit aims to evaluate the effectiveness and efficiency of the processes implemented in respect of the processing schemes of contributions/quotas, whose Wages Statements (WS) entered ... into the system in the first quarter of 2007, test the reliability, stability and confidence level of the application systems developed and the respective values processed in the entire collection circuit ... and respective accounting, and also check compliance with the contracts celebrated with banking entities. ... ... Application level of Social Security IS analyzed ... Processes maturity and automation of controls appeared to be main problems in the system which reliability, stability and confidence level were tested.
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TRIBUNAL DE CONTAS DE PORTUGAL
, issued in 2008
Risk cases: 2
Management of Information Resources of the Ministry of Agriculture
The Ministry of Agriculture of the Republic of Lithuania has managed 32 information systems and registers. Of these, 24 ones are managed, developed and upgraded by a state enterprise subordinate ... to the Ministry of Agriculture, the Agricultural Information and Rural Business Centre. The annual amount allocated by the Ministry for the maintenance of the Centre totals LTL 17.5 million on average ... . The objective of the audit was to assess the general and development controls of the information resources of the Ministry of Agriculture. The audit was conducted at the Ministry of Agriculture and the state ... ... Without appropiate IT management it is hard to achieve reliable, consistent and secure systems for agriculture ... Since 1996 the Ministry has been using information systems of varying complexity for collecting and processing data, including personal data. The Ministry of Agriculture of the Republic of Lithuania ... has managed 32 information systems and registers. SAI of Lithuania revealed that systems were not well mantained what affected use of funds devoted to the systemsand also their legality and security.
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The Ministry of Agriculture of the Republic of Lithuania has managed 32 information systems and registers. Of these, 24 ones are managed, developed and upgraded by a state enterprise subordinate ... to the Ministry of Agriculture, the Agricultural Information and Rural Business Centre. The annual amount allocated by the Ministry for the maintenance of the Centre totals LTL 17.5 million on average ... . The objective of the audit was to assess the general and development controls of the information resources of the Ministry of Agriculture. The audit was conducted at the Ministry of Agriculture and the state ... ... Without appropiate IT management it is hard to achieve reliable, consistent and secure systems for agriculture ... Since 1996 the Ministry has been using information systems of varying complexity for collecting and processing data, including personal data. The Ministry of Agriculture of the Republic of Lithuania ... has managed 32 information systems and registers. SAI of Lithuania revealed that systems were not well mantained what affected use of funds devoted to the systemsand also their legality and security.
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National Audit Office of the Republic of Lithuania
, issued in 2013
Risk cases: 2
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
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 ... and processes leading to implementation problems, governance not involving key players, and IT security organisation. ... 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
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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 ... and processes leading to implementation problems, governance not involving key players, and IT security organisation. ... 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
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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
Lessons learned from government ICT-projects
This audit has been performed on request of the Dutch parliament. Some newspapers mentioned government losses of four to five billion euro's on a yearly bases. These news items caused the parliament ... to request this audit. The audit has been performed in only 5 months time and consisted of the re-use of earlier performed audits. We have 'recycled' earlier findings about ICT-projects. ... 'Expensive' does not always mean 'High Quality', so... do not feed the spiral ... Excellent analysis of systemic errors commited when designing Government IT projects. The report aims at the essence of problems which are encountered far from information technologies - in: politics ... , business, psychology... Do not be mislead by date of report, it is evergreen for all who really want to know why IT projects fail.
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This audit has been performed on request of the Dutch parliament. Some newspapers mentioned government losses of four to five billion euro's on a yearly bases. These news items caused the parliament ... to request this audit. The audit has been performed in only 5 months time and consisted of the re-use of earlier performed audits. We have 'recycled' earlier findings about ICT-projects. ... 'Expensive' does not always mean 'High Quality', so... do not feed the spiral ... Excellent analysis of systemic errors commited when designing Government IT projects. The report aims at the essence of problems which are encountered far from information technologies - in: politics ... , business, psychology... Do not be mislead by date of report, it is evergreen for all who really want to know why IT projects fail.
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Netherlands Court of Audits
, issued in 2007
Risk cases: 3
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
State funds spent on development, operation and using of data centres services
The aim of the audit was to scrutinise the management of funds spent on building and operating the national data centre (hereinafter “STC1 data centre”), including the expenditure of selected ... organisational units of the state on buying hosting, server-housing and other related services. The audited period was between 2010 and 2014; where relevant, the preceding period was also scrutinised. Audited ... entities: Ministry of the Interior (“MoI”); Ministry of Finance (“MoF”); STÁTNÍ TISKÁRNA CENIN, state firm (state banknote printing firm, hereinafter “STC” or “the state firm”). The audit was conducted ... ... Risks steming from uncoordinated strategy ... SAI of Czech Republic analysed consequences of failures in strategic IT management at the state level. Lack of coordination and implementation rules reduced practical role of the ministry whose task ... was to guard high quality standards for all crucial IT systems in the state administration. Next consecquences were (among others) risk of uneconomical results of large IT investment and risk of inefficient ... supply of services, as well as opposite results of workforce reduction.
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The aim of the audit was to scrutinise the management of funds spent on building and operating the national data centre (hereinafter “STC1 data centre”), including the expenditure of selected ... organisational units of the state on buying hosting, server-housing and other related services. The audited period was between 2010 and 2014; where relevant, the preceding period was also scrutinised. Audited ... entities: Ministry of the Interior (“MoI”); Ministry of Finance (“MoF”); STÁTNÍ TISKÁRNA CENIN, state firm (state banknote printing firm, hereinafter “STC” or “the state firm”). The audit was conducted ... ... Risks steming from uncoordinated strategy ... SAI of Czech Republic analysed consequences of failures in strategic IT management at the state level. Lack of coordination and implementation rules reduced practical role of the ministry whose task ... was to guard high quality standards for all crucial IT systems in the state administration. Next consecquences were (among others) risk of uneconomical results of large IT investment and risk of inefficient ... supply of services, as well as opposite results of workforce reduction.
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Supreme Audit Office of Czech Republic
, issued in 2015
Risk cases: 7