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Electronic Health Records - VA Needs to Identify and Report Existing System Costs
Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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Difficulties after 30 years of decentralized development The US Department of Veterans Affairs provides health care services to approximately 9 million veterans and their families. However, the IT system they use is more than 30 years old, is costly to maintain, and does not fully support exchanging health data. The US GAO, analyzed the system's modenization plans and found serious problems with definition and cost estimation.
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US Government Accountability Office
, issued in 2019
Risk cases: 3
Australian Taxation Office: Administration of Australian Business Number Registrations
More elligibility and data integrity needed The Australian Business Number (ABN) and Australian Business Register initiatives were implemented as part of theGovernment's comprehensive reform of the taxation system in 2000. Their introduction involved challenging issues of technology and governance , including the imperative to process and register significant numbers of applications in a short time. Overall, the Australian SAI concluded that the ABN registration process is operating effectively. However, matters relating to the eligibility of some ABN applicants need to be reviewed. Further, some data integrity issues remain outstanding.
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More elligibility and data integrity needed The Australian Business Number (ABN) and Australian Business Register initiatives were implemented as part of theGovernment's comprehensive reform of the taxation system in 2000. Their introduction involved challenging issues of technology and governance , including the imperative to process and register significant numbers of applications in a short time. Overall, the Australian SAI concluded that the ABN registration process is operating effectively. However, matters relating to the eligibility of some ABN applicants need to be reviewed. Further, some data integrity issues remain outstanding.
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The Australian National Audit Office
, issued in 2003
Risk cases: 3
Maintenance efficiency in the rail network
The primary objective of railway politics is to contribute to ensure that users of the transport service have good railway options. The Norwegian National Rail Administration is organised under ... the Ministry of Transport and Communications, and its responsibilities include operation, maintenance and development of the State's railway infrastructure. The maintenance activities must safeguard safety ... , fixed assets and operational stability of the railway system. The most important objective for the maintenance is to reduce the scope of operational interruptions, and to facilitate better punctuality ... ... Rail network maintenance - negative balance of costs and results ... SAI Norway evaluated efficiency of the railway maintenance and found that its costs increased nearly 110 per cent in years 2006–2014. Negative development in uptime and regularity dominated the first ... part of the examined period, from 2006 to 2011. It turned positive from 2011, but in 2014 results were still worse than in 2006. The results have lagged behind the Ministry's target figures for most ... of the period.
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The primary objective of railway politics is to contribute to ensure that users of the transport service have good railway options. The Norwegian National Rail Administration is organised under ... the Ministry of Transport and Communications, and its responsibilities include operation, maintenance and development of the State's railway infrastructure. The maintenance activities must safeguard safety ... , fixed assets and operational stability of the railway system. The most important objective for the maintenance is to reduce the scope of operational interruptions, and to facilitate better punctuality ... ... Rail network maintenance - negative balance of costs and results ... SAI Norway evaluated efficiency of the railway maintenance and found that its costs increased nearly 110 per cent in years 2006–2014. Negative development in uptime and regularity dominated the first ... part of the examined period, from 2006 to 2011. It turned positive from 2011, but in 2014 results were still worse than in 2006. The results have lagged behind the Ministry's target figures for most ... of the period.
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Office of the Auditor General of Norway
, issued in 2016
Risk cases: 2
Opportunities Exist for FAA to Improve Airport Terminal Area Safety Efforts
Inefficient use of data The US GAO examined various issues related to runway safety and to update its prior work on airport terminal areas. Their findings point at inefficient use of data, which may lead to more risk and to inefficient targeting their limited resources.
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Inefficient use of data The US GAO examined various issues related to runway safety and to update its prior work on airport terminal areas. Their findings point at inefficient use of data, which may lead to more risk and to inefficient targeting their limited resources.
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US Government Accountability Office
, issued in 2019
Risk cases: 3
Central government staff costs
Results of staff reductions The British NAO found that departments had significantly reduced numbers of their civil servants and of course salary costs at the same time. But they reduced staff numbers mainly by minimising recruitment, and the age profile of the civil service has changed. NAO pays a lot attention to what effect this has had on the future pipeline of talent and skills. It reminds also that the departments need long-term operating models to work efficiently with the staff reduced.
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Results of staff reductions The British NAO found that departments had significantly reduced numbers of their civil servants and of course salary costs at the same time. But they reduced staff numbers mainly by minimising recruitment, and the age profile of the civil service has changed. NAO pays a lot attention to what effect this has had on the future pipeline of talent and skills. It reminds also that the departments need long-term operating models to work efficiently with the staff reduced.
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National Audit Office
, issued in 2015
Risk cases: 5
Centralisation of support services of state authorities
Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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Most goals of centralisation of support services were achived Centralisation of support services of state authorities has generally been successful, the quality of accounting has improved, and accounting has become more effective. The objective of saving on costs was not achieved. It would be beneficial to analyse the implementation of a similar model in local governments, i.e. concentrating the accounting services to central units in order to improve the quality of accounting and make work more effective. It would allow saving working time on doing routine accounting procedures and use this time more for financial management, which helps to use public funds better and more expediently.
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National Audit Office of Estonia
, issued in 2018
Risk cases: 2
WannaCry Cyber Attack and the NHS
Why the British NHS became a victim of WannaCry The NAO's investigation points at the problem of insufficient powers of the cybersecurity coordinator across the health organisation. As a result no remedial actions were taken, and the cyber attack succeeded thanks to neglected precautions.
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Why the British NHS became a victim of WannaCry The NAO's investigation points at the problem of insufficient powers of the cybersecurity coordinator across the health organisation. As a result no remedial actions were taken, and the cyber attack succeeded thanks to neglected precautions.
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National Audit Office
, issued in 2017
Risk cases: 3
Identifying and meeting central government's skills requirements
Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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Start with well managed responsibilities UK Departments have invested heavily in skills development. Government estimates that expenditure on formal training, including salary costs of departmental learning and development staff, was £275 million in 2009-10. NAO identified weaknesses of the system which start with devolved responsibilities, lead to: weak data, mis-profiled trainings, doubtful personal decisions, lack of well-targeted evaluation - and finish at more expensive buying-in and retaining key skills...
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National Audit Office
, issued in 2011
Risk cases: 6
VA ACQUISITION MANAGEMENT: Supply Chain Management and COVID-19 Response
Pandemic points up weaknesses of procurement solutions US Department of Veterans Affairs acquires hundreds of millions of dollars-worth of medical supplies each year. The Medical-Surgical Prime Vendor-Next Generation (MSPV-NG) is one of its key initiatives to modrnize its processes. GAO auditor pointed in their previous audits that the approach lacked an effective medical supply procurement strategy, clinician involvement, and reliable data systems. In time of the pandemic, the problem seems even more difficult to deal with.
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Pandemic points up weaknesses of procurement solutions US Department of Veterans Affairs acquires hundreds of millions of dollars-worth of medical supplies each year. The Medical-Surgical Prime Vendor-Next Generation (MSPV-NG) is one of its key initiatives to modrnize its processes. GAO auditor pointed in their previous audits that the approach lacked an effective medical supply procurement strategy, clinician involvement, and reliable data systems. In time of the pandemic, the problem seems even more difficult to deal with.
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US Government Accountability Office
, issued in 2019
Risk cases: 4
The implementation of national IT projects in social and health care
IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'.
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IT management expenditure in public administration totalled about 2.1 billion euros in 2009. IT management expenditure by local authorities and federations of municipalities in the field of health ... care totalled about 270 million euros ino 2009. Health care's share of IT management expenditure in public administration thus amounted to about 13 per cent in 2009. ... ... IT-centred manner of project implementation can harm IT investments' results ... SAI Finland perfomed a vast review of IT projects in health and social protection. Many interesting findings cover structural problems, as 'Many separate systems with no future' and characteristics ... of poor governance, as 'No cost monitoring - unclear objectives - arguable usefulness'.
Full description
National Audit Office of Finland
, issued in 2011
Risk cases: 3