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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Management and development of IT systems in the Ministry of the Environment
not made a decision about the future of this register. ... The purpose of this audit was to assess whether the information systems in the area of government of the Ministry of the Environment (and their development) support the reliable, economical ... and sustainable collection and use of environmental information. On a broader scale the National Audit Office looked at all of the 42 environmental information systems created in the area of government ... ... Estonian environmental information system needs reforms ... Correctness and reliability of the environmental data is guaranteed to a considerable extent. However there is a need for redevelopment of environmental information systems, particularly ... by the Environmental Register.
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Submission of data to national databases in municipalities, towns and cities
The National Audit Office analysed the activities of the database managers following a ruling made by the Supreme Court in 2010, which stated that the public functions assigned to local authorities ... must be clearly financed from the state budget. It was also assessed whether the measures taken by database managers have been sufficient to guarantee that local authorities submit all required data ... and that these data are correct. ... ... Funds as basic factor of data processing ... The NAO of Estonia audited the activities of state agencies in the management of the database selected for the audit, to which local authorities are obliged to submit data. It was found that in most ... cases the state does not compensate the costs of data submission for local governments.
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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 ... 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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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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Auditing the National Rationing System
The audit was to investigate the data quality, validity and reliability of two sub-systems (Ration Card and Ration Distribution) of a National Rationing System (Ration System) with the comparison ... to the rules and regulations in order to make an assessment of soundness of the Ration system and its related operations. ... Unreliable databases trigger all kinds of possible problems ... Ministry responsible for functioning of the National Rationing System developed to automate and optimize the delivery of essential subsidized commodities to eligible beneficiaries and providing state ... with reliable information fails its job.
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Online fraud
Uneven response to online fraud This type of fraud can affect everyone, but yet it is not a strategic priority for local police forces and the response from industry is uneven. UK NAO underlines: For too long, as a low-value but high-volume crime, online fraud has been overlooked by government, law enforcement and industry. It is a crime that can affect everyone. Fraud is now the most commonly experienced crime in England and Wales, is growing rapidly and demands an urgent response. Yet fraud is not a strategic priority for local police forces, and the response from industry is uneven.
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