State auditors warn ministry of expensive mistakes in planned electronic health archive
Ministry rejects criticism
The National Audit Office says that efforts to put prescriptions and patients’ medical reports into electronic form so that they can be passed on easily from health clinics to hospitals, or doctors to pharmacies has amounted to a waste of half a billion euros. The aim of the project has been to allow patients to members of the public to check their patient data and prescriptions on line.
The Audit Office says that the Ministry of Social Affairs and Health has failed to in its management and oversight duties. Both Minister of Social Affairs and Health Paula Risikko (Nat. Coalition Party) and the ministry’s Chief of Staff Kari Välimäki reject the criticism.
The electronic health archive was originally scheduled to come on line from next year, but because of delays, Parliament passed a measure last month allowing a.
Power and money have been passed on to organisations, research institutes, and consultants. Services have been ordered without competition for tenders, in blatant violation of applicable law, and possibly the Finnish constitution, the auditors say.
A draft report acquired by Helsingin Sanomat calls on ministries to suspend current eligibility inspections of pharmacies and other participants, saying that the requirements have not been prepared in accordance with paragraph 21 of the constitution, the rule of law, or good governance.
“The Ministry of Social Affairs and Health has exceeded its authority”, the draft report states.
The ministry is faulted for self-inflicted haste, which has led to “panicky decisions”. Legislative proposals for switching to electronic systems have had to be fixed numerous times because of hasty preparation.
The draft report also criticises the schedules set by the ministry to be unrealistic, noting that they have failed time and time again, eroding the confidence that the health care establishment has had in the reform.
The proposed system of electronic prescriptions is seen as perhaps most blatant example of inefficiency. Although the reform has been 21 years in the making, it has only been implemented in Turku this year on an experimental basis. Electronic prescriptions have been in use in Denmark since 1990.
The draft report does not place much hope in the final outcome.
Electronic patient information would not necessarily be sufficiently up to date in light of the fast pace at medical clinics today.
New national systems also cannot replace the present antiquated patient data systems that are now in use at health clinics and hospitals.
According to Päivi Sillanaukee, a leading civil servant at the Ministry of Social Affairs and Health, the ministry has fixed, or is starting to fix the problems raised by the National Audit Office.
Efforts are being made to employ a task force of about ten people at the National Institute for Health and Welfare (THL) to take responsibility for operative leadership – to see where the ministry has failed most seriously.
Sillanaukee is not taking a stand on claims of violations of the law on public acquisitions.
Minister Risikko says that the criticism is “unreasonable in light of what has been done”.
She says that took the reins in the matter in 2008 and that “the architecture has been changed” since then.
“There is a clear plan. It has been agreed upon with the Ministry of Finance.”
Meanwhile, Chief of Staff Kari Välimäki says that the inspector of the National Audit Office has drawn hasty conclusions, and that the draft report contains factual errors which will be corrected.