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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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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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 ... . 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 ... a sufficient framework for carrying through the SMR programme? 2) Has the Ministry of Health and the NHA directed the SMR programme towards delivering within the agreed costs, time and quality parameters ... ... 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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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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