The feasibility of automating audit and feedback for ART guideline adherence in Malawi.

Journal of the American Medical Informatics Association : JAMIA
Zach Landis LewisRebecca S Crowley

Abstract

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. 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. 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. It appears feasible...Continue Reading

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Citations

Aug 22, 2003·BMC Public Health·Lucinda EnglandJohn Clemens
Dec 5, 2013·Journal of the American Medical Informatics Association : JAMIA·Jyotishman PathakJoshua C Denny
Dec 8, 2011·Methods of Information in Medicine·A GeissbuhlerR Haux
Dec 18, 2013·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Atsushi SoritaLatha Sivaprasad
Aug 5, 2015·International Journal of Medical Informatics·Zach Landis-LewisRebecca S Jacobson
May 11, 2015··Yamiko Joseph MsosaC. Maria Keet

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Software Mentioned

GEM Cutter
GEM
GuideLine Implementability Appraisal ( GLIA )

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