Audit Report on the Development and Implementation of the Medical Assistance Tracking Information System by the Human Resources Administration

AUDIT REPORT IN BRIEF

Our office performed an audit of the development and implementation of the Medical Assistance Tracking Information System by the Human Resources Administration (HRA). The mission of the HRA is to enhance the quality of life for all City residents by providing temporary assistance to eligible individuals and families to help them lead independent and productive lives. The Home Care Service Program (HCSP) of the HRA Medical Assistance Program is responsible for Medicaid-funded, non-institutional, long-term care programs. The HCSP uses the Home Attendant Line Operating (HALO) system and nine stand-alone personal computer applications to manage its business functions.

In April 1999, HRA undertook a project to implement a new system to replace HCSP’s existing systems and to provide improved efficiency at HCSP. The first step in the project was the replacement of HALO system, which was designed in the early 1970s and by 1998 had become obsolete. A replacement system known as the Medical Assistance Tracking Information System (MATIS) was designed and developed by Computer Horizons Corporation in conjunction with HRA employees. The objective of the MATIS system was to fully automate the business processes carried out by the HCSP staff. HRA is planning to integrate MATIS and the other subsystems into a new system, Long Term Care Web, which is scheduled to be completed in May 2008.

Audit Findings and Conclusions

We could not ascertain whether MATIS met the overall goals as stated in the original system justification, although the system is operational and the system design allowed for future enhancements and upgrades. Specifically, we found issues when we performed sample testing and created test cases to review and analyze the data stored in the system. Based on the test results, MATIS contains inaccurate, outdated, and unreliable data. There are also security weaknesses in MATIS. MATIS does not require that users change their passwords on regular basis, and MATIS is not equipped with an automatic lockout feature. Moreover, HRA does not have procedures in place to ensure that security violations are recorded, documented, and reviewed.

The results of our user satisfaction survey revealed that 75 percent of the respondents stated that they would like to see changes made to MATIS. Of those surveyed, 71 percent of the respondents stated that the data in the system was occasionally incorrect, and 52 percent of the respondents stated that MATIS is not user friendly. Further, the respondents of the survey noted concerns, which included the entering of repetitive data, problems with generating reports, inaccurate data on the system, and difficulty in navigating through MATIS.

There was not a formal approval signifying that the system was fully reviewed by an independent quality assurance (QA) unit prior to MATIS being released into production. HRA also did not have an acceptance-testing certificate for each of the deliverables for the initial business and system requirements. Finally, HRA did not incorporate MATIS into its agency-wide disaster-recovery plan.