Factors Affecting Automated Audit and Feedback Implementation in Malaw
Objective To identify antiretroviral therapy (ART) providers' perceptions and contextual factors affecting implementation of EMR-based clinical audit and feedback in Malawi.
Methods We interviewed and observed ART providers who use an electronic medical record (EMR) in ART clinics, recording interviews and field notes, and conducted a qualitative analysis.
Results We identified barriers, facilitators, and contextual factors that may impact audit and feedback implementation. Barriers were resource shortages, EMR technical problems, and EMR usability challenges. Facilitators included ART providers' perceived needs for feedback and reliance on the EMR data and treatment guidelines. Contextual factors included low continuity of care, and a lack of feedback.
Conclusion We demonstrate a novel approach to understanding healthcare providers' perceptions of the feedback environment. The analysis revealed insights that will inform the design of EMR-based audit and feedback in a low-resource setting.