Lewis, ZL and Mello-Thoms, C and Gadabu, OJ and Gillespie, EM and Douglas, GP and Crowley, RS
(2011)
The feasibility of automating audit and feedback for ART guideline adherence in Malawi.
Journal of the American Medical Informatics Association, 18 (6).
868 - 874.
ISSN 1067-5027
![[img]](http://d-scholarship.pitt.edu/style/images/fileicons/text_plain.png) |
Plain Text (licence)
Available under License : See the attached license file.
Download (1kB)
|
Abstract
Objective: To determine the feasibility of using electronic medical record (EMR) data to provide audit and feedback of antiretroviral therapy (ART) clinical guideline adherence to healthcare workers (HCWs) in Malawi. Materials and methods: We evaluated recommendations from Malawi's ART guidelines using GuideLine Implementability Appraisal criteria. Recommendations that passed selected criteria were converted into ratio-based performance measures. We queried representative EMR data to determine the feasibility of generating feedback for each performance measure, summed clinical encounters representing each performance measure's denominator, and then measured the distribution of encounter frequency for individual HCWs across nurse and clinical officer groups. Results: We analyzed 423 831 encounters in the EMR data and generated automated feedback for 21 recommendations (12%) from Malawi's ART guidelines. We identified 11 nurse recommendations and eight clinical officer recommendations. Individual nurses and clinical officers had an average of 45 and 59 encounters per month, per recommendation, respectively. Another 37 recommendations (21%) would support audit and feedback if additional routine EMR data are captured and temporal constraints are modeled. Discussion: It appears feasible to implement automated guideline adherence feedback that could potentially improve HCW performance and supervision. Feedback reports may support workplace learning by increasing HCWs' opportunities to reflect on their performance. Conclusion: A moderate number of recommendations from Malawi's ART guidelines can be used to generate automated guideline adherence feedback using existing EMR data. Further study is needed to determine the receptivity of HCWs to peer comparison feedback and barriers to implementation of automated audit and feedback in low-resource settings.
Share
Citation/Export: |
|
Social Networking: |
|
Details
Item Type: |
Article
|
Status: |
Published |
Creators/Authors: |
Creators | Email | Pitt Username | ORCID  |
---|
Lewis, ZL | | | | Mello-Thoms, C | crm1@pitt.edu | CRM1 | | Gadabu, OJ | | | | Gillespie, EM | | | | Douglas, GP | | | | Crowley, RS | | | |
|
Date: |
17 November 2011 |
Date Type: |
Publication |
Journal or Publication Title: |
Journal of the American Medical Informatics Association |
Volume: |
18 |
Number: |
6 |
Page Range: |
868 - 874 |
DOI or Unique Handle: |
10.1136/amiajnl-2011-000097 |
Schools and Programs: |
School of Medicine > Biomedical Informatics |
Refereed: |
Yes |
ISSN: |
1067-5027 |
MeSH Headings: |
Anti-Retroviral Agents--therapeutic use; Automatic Data Processing; Electronic Health Records; Feasibility Studies; Feedback; Guideline Adherence; Health Personnel; Humans; Malawi; Medical Audit--methods; Practice Guidelines as Topic |
Other ID: |
NLM PMC3197989 |
PubMed Central ID: |
PMC3197989 |
PubMed ID: |
21565857 |
Date Deposited: |
29 Aug 2012 20:59 |
Last Modified: |
02 Feb 2019 16:56 |
URI: |
http://d-scholarship.pitt.edu/id/eprint/13802 |
Metrics
Monthly Views for the past 3 years
Plum Analytics
Altmetric.com
Actions (login required)
 |
View Item |