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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 ... 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 ... 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 ... 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 ... 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
Operation of the Record Systems Applied in the Eligibility Scheme of Benefits and Services Provided from the Social Security Funds
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. ... 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 ... ... 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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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. ... 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 ... ... 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
Activities of the state in implementing the e-health system - Do the state, doctors and patients benefit from ehealth?
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 ... . E-health solutions also save patients time. <br/> The purpose of the audit was to assess whether the objectives set to e-Health – higher quality of the health service and more efficient organisation ... 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 ... ... 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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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 ... . E-health solutions also save patients time. <br/> The purpose of the audit was to assess whether the objectives set to e-Health – higher quality of the health service and more efficient organisation ... 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 ... ... 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
Coordination of Infrastructure Works by Metropolitan Municipalities
Rapid population growth at metropoles as well as dense and planless structuring, especially in İstanbul and Ankara, have lead to an increase in demand for utilities services and consequently ... in coordination of infrastructure services at MMs and preventing resource waste. ... , in the resources used for the construction and maintenance of utilities. Moreover, in cities with dense population, damages to roads and sidewalks during the construction and maintenance of utilities cause problems ... ... ... Start geographic information system with cooperation rules and digital maps ... Organization of geographic and infrastructure information systems is an especially difficult task when bacause vast and intense coordination is necessary. The Turkisch Court of Accounts lists ... problems that reduce use and rise costs of this fundamental task.
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Rapid population growth at metropoles as well as dense and planless structuring, especially in İstanbul and Ankara, have lead to an increase in demand for utilities services and consequently ... in coordination of infrastructure services at MMs and preventing resource waste. ... , in the resources used for the construction and maintenance of utilities. Moreover, in cities with dense population, damages to roads and sidewalks during the construction and maintenance of utilities cause problems ... ... ... Start geographic information system with cooperation rules and digital maps ... Organization of geographic and infrastructure information systems is an especially difficult task when bacause vast and intense coordination is necessary. The Turkisch Court of Accounts lists ... problems that reduce use and rise costs of this fundamental task.
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Turkish Court of Accounts
, issued in 2008
Risk cases: 2
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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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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National Audit Office
, issued in 2017
Risk cases: 6
Management and development of IT systems in the Ministry of the Environment
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 ... of the Ministry of Environment, but focused in greater detail on four of them: the Environmental Register, the Estonian Nature Information System, the Environmental Permits Information System and the Land Cadastre ... ... 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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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 ... of the Ministry of Environment, but focused in greater detail on four of them: the Environmental Register, the Estonian Nature Information System, the Environmental Permits Information System and the Land Cadastre ... ... 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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National Audit Office of Estonia
, issued in 2013
Risk cases: 2
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
The Ministry of the Environment lacks a compact information system and still uses 125 separate information systems and databases
The objective of the audit was to scrutinise the management of funds earmarked for the purchase and administration of ICT within the MoE and selected organisations which come under the management ... of the MoE. The audit identified the following risks: (1) non-existence of the Integrated environmental information system (IEIS) as an independent information system; (2) purchase of ICT, within the budget ... chapter of the MoE, through a state co-funded organisation CENIA which comes under the management of the MoE; (3) utilisation of the information systems. The audited period was 2010 to 2013; where relevant ... ... Ministry of the Environment manages 125 information systems and databases ... The Ministry of the Environment (MoE) has for more than 20 years a legal obligation to administer and manage an Integrated Environmental Information System (IEIS). In spite of this fact, the existing ... systems (more than 125 information systems and databases) are designed, implemented and managed as individual information systems without a direct integration into a joint point of reference.
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The objective of the audit was to scrutinise the management of funds earmarked for the purchase and administration of ICT within the MoE and selected organisations which come under the management ... of the MoE. The audit identified the following risks: (1) non-existence of the Integrated environmental information system (IEIS) as an independent information system; (2) purchase of ICT, within the budget ... chapter of the MoE, through a state co-funded organisation CENIA which comes under the management of the MoE; (3) utilisation of the information systems. The audited period was 2010 to 2013; where relevant ... ... Ministry of the Environment manages 125 information systems and databases ... The Ministry of the Environment (MoE) has for more than 20 years a legal obligation to administer and manage an Integrated Environmental Information System (IEIS). In spite of this fact, the existing ... systems (more than 125 information systems and databases) are designed, implemented and managed as individual information systems without a direct integration into a joint point of reference.
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Supreme Audit Office of Czech Republic
, issued in 2015
Risk cases: 7
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