Pandemic IT solutions: The state was not prepared. Subsequent building of IT systems was burdened by chaos and improvisation
Press release on Audit No 21/35 – 25 April 2022
The Supreme Audit Office focused on how the state spent funds on IT support for anti-epidemic activities between the years 2017 and 2021. The auditors focused on how the Ministry of Health proceeded when acquiring IT technologies and solutions to manage outbreaks of infectious diseases. These included purchases of IT equipment, software, services, building specific IT systems, etc. For IT support, the Ministry of Health (MoH) and the Institute of Health Information and Statistics (IHIS) spent a total of CZK 495 million in the years under review. The audit revealed that the Ministry of Health had neither prepared, nor used counter-epidemic IT support, which significantly affected the way in which the Ministry managed the COVID-19 outbreak. After the launch of the IT support, the subsequent building of IT systems was burdened by chaos and a high degree of improvisation, which caused a number of problems.
The Ministry of Health failed to prepare IT support for the management of epidemics. In practice, this meant that the Regional Hygiene Stations (RHS) were not ready to cope with epidemic situations in terms of ICT support. Up to the second half of the year 2020, they were lacking over 900 workstations and laptops. The MoH was aware of the lack of IT equipment on the part of RHS since at least mid-2017.
In addition, there was also a lack of a system that would integrate communication within the MoH — i.e. one of the foundations for successful management and monitoring of the epidemic. The Integrated User System for RHS was meant to fulfil this task. This system was initially due to be completed in 2019, but the MoH postponed the completion date three times. As a result, the above described integrated communication platform was not ready when the state of pandemic was declared.
Following the announcement of the epidemic, the MoH did not react according to the current Pandemic Plan for the Czech Republic. It was last updated in 2011, as shown by an earlier SAO audit. Instead, the MoH created new bodies for the management of the fight against the pandemic. However, their responsibilities and competences were not clearly defined. In some cases, their activities were even duplicated — as in the case of a newly created central management team which duplicated the work of the already existing Central Epidemiological Commission. In addition, the MoH did not use the IT system envisaged by the Pandemic Plan for the Czech Republic — the Pandemic Information System.
The subsequent emergence and development of information systems to manage the COVID-19 epidemic was not managed by the MoH. The Smart quarantine system of services, which became the new IT support for the management of the epidemic and on which the MoH spent CZK 387 million, was affected by a high degree of improvisation and chaotic development during the construction phase. In practice, the contacts of persons who tested positive for COVID-19 failed to be successfully traced as the number of infections was increasing. In some periods, tracing success fell well below 50% and, in extreme cases, to around 20%. The MoH’s lack of preparedness and inadequate management was to some extent compensated for by the Czech Army, which had developed, inter alia, an application for the collection of data on COVID-19, but also by the staff of the IHIS and the National Agency for Communication and Information Technologies.
The actual use of certain parts of the Smart Quarantine was also problematic. Within this system, the application called eRouška (“eMask”) was developed. The general public had shown little interest in this application, with a total of 1.6 million downloads, only half a million of accounts was actually active as of September 2021. Between October 2020 and June 2021, 1.6 million cases of COVID-19 were recorded, but only five percent of the cases reported COVID-19 positivity within this app. In the end, the MoH did not work with the data obtained from the eMask app. However, the MoH paid CZK 20 million for the development and operation of this app.
From the point of view of expenditure, the Ministry of Health also failed to monitor and evaluate expenditure for IT support. In the case of the Smart quarantine, for example, the reimbursement of call centres was problematic, where the average cost per outgoing call ranged between CZK 66 and CZK 435 in the period under review. Expenditure on the operation of call centres represented the most significant part of invoiced costs within the Smart quarantine system of services, accounting for 40% of the total CZK 387 million spent.
The SAO also pointed out that the MoH did not incorporate the newly created IT support into the Pandemic Plan for the Czech Republic or into the MoH’s IT concept. Thus, the probability, that the Smart quarantine system of services – despite all the money spent – will not be used during future pandemics, is high.
“We must now focus on ensuring that the money spent is not wasted and that the infrastructure already created will be further developed. It would be a great mistake if in the future the state were to find itself in a situation similar to the one we are experiencing, and we would realise that things were once again underprepared and that we were at the beginning once more," said President Miloslav Kala.
Supreme Audit Office
- Audit report No. 21/35 (pdf, 898 kB)