Implementation of the eHealth Project in Latvia


Project audit perspective

By Emīls Pūlmanis

State Audit Office of the Republic of Latvia

Riga, Latvia


In order to improve effectiveness of provision of healthcare service, the project implemented by the Ministry of Health- ”E-health in Latvia” is a step towards the right direction. It will provide the possibility for patients to ensure a greater control over their health issues, by maintaining healthy habits, lifestyle, increase substantiation of adoption of decisions and speed of service in the healthcare industry, ensuring quality and accessible information; patients will receive more quality services and in a shorter period of time for issuance of prescription drugs.

Nevertheless, the policy prepared by the Ministry of Health in the area of e-Health will not be implemented in the planned scope and the planned term; therefore the target-to improve the effectiveness of the provision of healthcare services will only be partially achieved.

The project „e-Health in Latvia” is necessary and important for the society, but already from the very beginning there have been substantial deficiencies (errors) – the professionals of industry are not involved in the project, multiple changes of institutions implementing the project, ineffective project management and finally, there has not been sufficient supervision of the project.

This Paper analyzes the implementation of the e-Health Project in Latvia from the audit perspective, showing results from the performance-compliance audit carried out by the supreme audit institution – State Audit Office of the Republic of Latvia.


Consider as an example a country where the Information and communication technology (ICT) environment and enabling environment for eHealth are both in their early stages. Within this national context, eHealth is project-based, featuring a few small initiatives that are seldom connected to each other. Projects tend to be time-limited, proof-of-concept pilots, where ICT is introduced (or imported) to demonstrate a technology in a limited context. The ICT applications used may themselves be innovative, but the projects are rarely sustainable. They fail because of a lack of infrastructure and skills, a narrow focus on one particular aspect of eHealth that disregards other concerns and impacts, and a lack of ownership by the health entities involved. The use of ICT in the general population in this country is limited to not much more than mobile phones. The commercial ICT market is fragmented, with little local expertise available. The government has no role in funding and technical support for eHealth. This comes instead from aid agencies, donors, nongovernmental organizations (NGOs) and consultants. In this constrained environment, the country cannot consistently meet its international obligations for public health reporting.

Countries can focus on a range of structured activities that lead to the progressive development of a national eHealth strategy. These include:

  • involving the key health and non-health stakeholders in creating a national eHealth vision and plan and its subsequent implementation.
  • establishing governance mechanisms to provide improved visibility, coordination and control of eHealth activities that occur across the country’s health sector.
  • establishing the strategic context for eHealth to provide the foundation for the eHealth vision and plan, and to enable the government to make informed decisions on whether to pursue opportunities that present themselves from the ICT industry and other stakeholders.
  • forming an understanding of the current eHealth environment in terms of the programmes, projects and eHealth components that already exist.

e-Health policy and project background

The Ministry of Health prepared the planning documents for the development of the e-health on a timely basis, as the use of information and communication technologies rapidly penetrated the health care industry. However, healthcare industry professionals were not involved in the development of planning documents, no feasibility studies, research and analysis of the health care were performed.


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About the Author

pmwj36-Jul2015-Pulmanis-AUTHOR PHOTO
Emīls Pūlmanis

Riga, Latvia



Emīls Pūlmanis
is a member of the board of the Professional Association of Project Managers in Latvia and development project manager at State Audit Office of the Republic of Latvia. He has gained a BSc. in engineer economics, a professional master’s degree in project management (MSc.proj.mgmt) and currently is a PhD candidate with a specialization in project management. He has elaborated and directed a number of domestic and foreign financial instruments co-financed projects. He was a National coordinator for a European Commission-funded program – the European Union’s financial instruments PHARE program in Latvia. Over the past seven years he has worked in the public administration project control and monitoring field. He was a financial instrument expert for the Ministry of Welfare and the European Economic Area and Norwegian Financial Mechanism implementation authority as well as an expert for the Swiss – Latvian cooperation program as a NGO grant scheme project evaluation expert. He has gained international and professional project management experience in Germany, the United States and Taiwan. In addition to his professional work, he is also a lecturer at the University of Latvia for the professional master study program in Project management. He has authored more than 35 scientific publications and is actively involved in social activities as a member of various NGO’s.

Emils can be contacted at [email protected].

To view other works by Emils Pulmanis, visit his author showcase in the PM World Library at http://pmworldlibrary.net/authors/emils-pulmanis/