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Correct information at the right time in healthcare and nursing – collaboration without effect?
The Swedish National Audit Office has conducted an audit to determine whether Government initiatives have contributed to the objective that authorised healthcare staff shall have access to the right ... patient information at the right time by means of direct electronic access. ... ... Information share is crucial for competitive health care ... the Government and the municipalities must improve if the investments in better access to common patient information shall get impact in practice. ... Health and social care staff has very limited access to patient information from other care-giving institutions, which may lead to health damage and wrong-treatment. The cooperation between
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The Swedish National Audit Office has conducted an audit to determine whether Government initiatives have contributed to the objective that authorised healthcare staff shall have access to the right ... patient information at the right time by means of direct electronic access. ... ... Information share is crucial for competitive health care ... the Government and the municipalities must improve if the investments in better access to common patient information shall get impact in practice. ... Health and social care staff has very limited access to patient information from other care-giving institutions, which may lead to health damage and wrong-treatment. The cooperation between
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Riksrevisionen (Swedish National Audit Office)
, issued in 2011
Risk cases: 3
Coordinated Audit on Information Technology Governance
IT governance needs awareness and SAIs' support The OLACEFS auditors found that the greatest challenge for the SAIs is to raise the awareness of the audit institutions about the importance of IT governance and the benefits that could be obtained by improving its degree of maturity. The audit was conducted by 11 SAIs and coordinated by TCU of Brasil. They concluded: 'It is important, even urgent, to invest resources to implement or enhance: the IT committees; the IT planning process; strategic IT planning; monitoring the IT contracting process; the business continuity plan; the designation of a responsible person or unit to manage security information; a risk management process; an asset inventory process; an information security committee; and a policy for access control.'
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IT governance needs awareness and SAIs' support The OLACEFS auditors found that the greatest challenge for the SAIs is to raise the awareness of the audit institutions about the importance of IT governance and the benefits that could be obtained by improving its degree of maturity. The audit was conducted by 11 SAIs and coordinated by TCU of Brasil. They concluded: 'It is important, even urgent, to invest resources to implement or enhance: the IT committees; the IT planning process; strategic IT planning; monitoring the IT contracting process; the business continuity plan; the designation of a responsible person or unit to manage security information; a risk management process; an asset inventory process; an information security committee; and a policy for access control.'
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Risk cases: 5
The protection of IT systems and health data in three Danish regions
Security to be improved in IT systems with health data It is Rigsrevisionen’s assessment that the three regions are not protecting the access to IT systems and health data in a satisfactory manner. As a consequence, unauthorised persons might gain access to sensitive and confidential personal data, which could affect there liability and availability of important health data used in the treatment of hospital patients. Based on the results of the study and the current threat scenario, Rigsrevisionen finds that basic security measures against cyber attacks and protection of access to IT systems and health data should be a top priority for Denmark’s five regions. Basic security measures in combination with management and control of user privileges can reduce the risk of compromising the regions’ IT systems and data considerably.
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Security to be improved in IT systems with health data It is Rigsrevisionen’s assessment that the three regions are not protecting the access to IT systems and health data in a satisfactory manner. As a consequence, unauthorised persons might gain access to sensitive and confidential personal data, which could affect there liability and availability of important health data used in the treatment of hospital patients. Based on the results of the study and the current threat scenario, Rigsrevisionen finds that basic security measures against cyber attacks and protection of access to IT systems and health data should be a top priority for Denmark’s five regions. Basic security measures in combination with management and control of user privileges can reduce the risk of compromising the regions’ IT systems and data considerably.
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National Audit Office of Denmark
, issued in 2018
Risk cases: 3
Use of consultants and temporary staff
New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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National Audit Office
, issued in 2016
Risk cases: 7
Coordination of Infrastructure Works by Metropolitan Municipalities
of Interior, as administrative trusteeship, improves policies and legal arrangements relating to coordination of infrastructure works to bring in necessary measures with a view to leveraging effectiveness ... 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 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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of Interior, as administrative trusteeship, improves policies and legal arrangements relating to coordination of infrastructure works to bring in necessary measures with a view to leveraging effectiveness ... 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 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
The Shared Services Centre
The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The Australian National Audit Office
, issued in 2016
Risk cases: 2
The National Offender Management Information System (NOMIS)
with offenders (end-to-end services). ... ’ fitness to deliver. The aim of one integrated information system (C-NOMIS i.e. National Offender Management Information System) was to improve information sharing about offenders; address the lack ... This report examines the reasons for the delays and cost increases to the original integrated information system and, since the moratorium imposed by the Minister of State in order to seek options ... Rescoping necessary, but not fully successful ... An initiative to build a single offender management IT system for the prison and probation services has not delivered value for money. The NAO investigation found the project had been hampered ... by poor management leading to a three-year delay, a doubling in project costs and reductions in scope and benefits.
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with offenders (end-to-end services). ... ’ fitness to deliver. The aim of one integrated information system (C-NOMIS i.e. National Offender Management Information System) was to improve information sharing about offenders; address the lack ... This report examines the reasons for the delays and cost increases to the original integrated information system and, since the moratorium imposed by the Minister of State in order to seek options ... Rescoping necessary, but not fully successful ... An initiative to build a single offender management IT system for the prison and probation services has not delivered value for money. The NAO investigation found the project had been hampered ... by poor management leading to a three-year delay, a doubling in project costs and reductions in scope and benefits.
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National Audit Office
, issued in 2009
Risk cases: 4
Management of State Information Resources
model; rationality of the use of the State Budget funds when managing information resources; use of the possibilities of the state information resources to improve the performance of the public sector ... The objective of the audit was to assess effectiveness of the management of the state information resources and of the use of their possibilities: suitability of the chosen state resources management ... . Audit procedures were performed in all major institutions which form and implement the policy of information resources: Ministry of Transport and Communications, Ministry of the Interior, Ministry ... Well targeted requirements, interconnected information resources and broad use - why so difficult to be gained? ... The leading idea of the 'Approach to Management of State Information Resources' programme was to entrench a comprehensive management of data resources. After five years preparations, the desired ... momentum was still not the case. SAI Lithuania analysed roots of the problems: concept, poor use of funds, lack of interconnections, unsatified users.
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model; rationality of the use of the State Budget funds when managing information resources; use of the possibilities of the state information resources to improve the performance of the public sector ... The objective of the audit was to assess effectiveness of the management of the state information resources and of the use of their possibilities: suitability of the chosen state resources management ... . Audit procedures were performed in all major institutions which form and implement the policy of information resources: Ministry of Transport and Communications, Ministry of the Interior, Ministry ... Well targeted requirements, interconnected information resources and broad use - why so difficult to be gained? ... The leading idea of the 'Approach to Management of State Information Resources' programme was to entrench a comprehensive management of data resources. After five years preparations, the desired ... momentum was still not the case. SAI Lithuania analysed roots of the problems: concept, poor use of funds, lack of interconnections, unsatified users.
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National Audit Office of the Republic of Lithuania
, issued in 2013
Risk cases: 3
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
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 ... 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 ... ... Shaky coordination of investments in important systems ... 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 ... of the project, involving additional spendings, delays and errors in data processing.
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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 ... 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 ... ... Shaky coordination of investments in important systems ... 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 ... of the project, involving additional spendings, delays and errors in data processing.
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Court of Audit of the Republic of Slovenia
, issued in 2014
Risk cases: 7
Activities of the state in implementing the e-health system - Do the state, doctors and patients benefit from ehealth?
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 ... 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 ... ... 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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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 ... 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 ... ... 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