ArticleInternational journal of medical informatics2015
Barriers to using eHealth data for clinical performance feedback in Malawi: A case study.
Article in International journal of medical informatics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Digital Health Data Quality Issues: Systematic Review.Journal of medical Internet research · 2023Pooled it
- Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review.Implementation science : IS · 2020Pooled it
- Missed opportunities for digital health data use in healthcare decision-making: A cross-sectional digital health landscape assessment in Homa Bay county, Kenya.PLOS digital health · 2025Article
- Dementia prevalence and risk factors in people with and without HIV in Malawi: A medical record review.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Facilitator and Barrier to Health Information System Use from Health Professionals Perspective: A Scoping Review.Journal of multidisciplinary healthcare · 2025Review
- Adopting Data to Care to Identify and Address Gaps in Services for Children and Adolescents Living With HIV in Mozambique.Global health, science and practice · 2024Article
- Scoping review of health information technology usability methods leveraged in Africa.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Routine Healthcare Facility- and Antenatal Care-Based Malaria Surveillance: Challenges and Opportunities.The American journal of tropical medicine and hygiene · 2023Article
- Professional Competence and Its Effect on the Implementation of Healthcare 4.0 Technologies: Scoping Review and Future Research Directions.International journal of environmental research and public health · 2022Article
- An mHealth-Based Health Management Information System Among Health Workers in Volta and Eastern Regions of Ghana: Pre-Post Comparison Analysis.JMIR medical informatics · 2022Article
- Electronic Data Capture System (REDCap) for Health Care Research and Training in a Resource-Constrained Environment: Technology Adoption Case Study.JMIR medical informatics · 2022Article
- Perceptions on Data Quality, Use, and Management Following the Adoption of Tablet-Based Electronic Health Records: Results from a Pre-Post Survey with District Health Officers in Ghana.Journal of multidisciplinary healthcare · 2022Article
- Users' perception on factors contributing to electronic medical records systems use: a focus group discussion study in healthcare facilities setting in Kenya.BMC medical informatics and decision making · 2021Article
- Development of standard indicators to assess use of electronic health record systems implemented in low-and medium-income countries.PloS one · 2021Article
- Improving quality and use of routine health information system data in low- and middle-income countries: A scoping review.PloS one · 2020Article
- Implementing eHealth Technology to Address Gaps in Early Infant Diagnosis Services: Qualitative Assessment of Kenyan Provider Experiences.JMIR mHealth and uHealth · 2018Article
- Rubber stamp templates for improving clinical documentation: A paper-based, m-Health approach for quality improvement in low-resource settings.International journal of medical informatics · 2018Article
- Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.BMC research notes · 2018Article
- Patterns of computer and Internet use and its association with HIV knowledge in selected countries in sub-Saharan Africa.PloS one · 2018Article
- Effectiveness of Implementation of Electronic Malaria Information System as the National Malaria Surveillance System in Thailand.JMIR public health and surveillanceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
introductionSub-optimal performance of healthcare providers in low-income countries is a critical and persistent global problem. The use of electronic health information technology (eHealth) in these settings is creating large-scale opportunities to automate performance measurement and provision of feedback to individual healthcare providers, to support clinical learning and behavior change. An electronic medical record system (EMR) deployed in 66 antiretroviral therapy clinics in Malawi collects data that supervisors use to provide quarterly, clinic-level performance feedback. Understanding barriers to provision of eHealth-based performance feedback for individual healthcare providers in this setting could present a relatively low-cost opportunity to significantly improve the quality of care.
objectiveThe aims of this study were to identify and describe barriers to using EMR data for individualized audit and feedback for healthcare providers in Malawi and to consider how to design technology to overcome these barriers.
methodsWe conducted a qualitative study using interviews, observations, and informant feedback in eight public hospitals in Malawi where an EMR system is used. We interviewed 32 healthcare providers and conducted seven hours of observation of system use.
resultsWe identified four key barriers to the use of EMR data for clinical performance feedback: provider rotations, disruptions to care processes, user acceptance of eHealth, and performance indicator lifespan. Each of these factors varied across sites and affected the quality of EMR data that could be used for the purpose of generating performance feedback for individual healthcare providers.
conclusionUsing routinely collected eHealth data to generate individualized performance feedback shows potential at large-scale for improving clinical performance in low-resource settings. However, technology used for this purpose must accommodate ongoing changes in barriers to eHealth data use. Understanding the clinical setting as a complex adaptive system (CAS) may enable designers of technology to effectively model change processes to mitigate these barriers.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.