Yigzaw Kassaye Yitbarek, Chomutare Taridzo, Wynn Rolf, Berntsen Gro Karine Rosvold, Bellika Johan Gustav
Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
JMIR Form Res. 2022 Jul 13;6(7):e31650. doi: 10.2196/31650.
Antibiotic resistance is a worldwide public health problem that is accelerated by the misuse and overuse of antibiotics. Studies have shown that audits and feedback enable clinicians to compare their personal clinical performance with that of their peers and are effective in reducing the inappropriate prescribing of antibiotics. However, privacy concerns make audits and feedback hard to implement in clinical settings. To solve this problem, we developed a privacy-preserving audit and feedback (A&F) system.
This study aims to evaluate a privacy-preserving A&F system in clinical settings.
A privacy-preserving A&F system was deployed at three primary care practices in Norway to generate feedback for 20 general practitioners (GPs) on their prescribing of antibiotics for selected respiratory tract infections. The GPs were asked to participate in a survey shortly after using the system.
A total of 14 GPs responded to the questionnaire, representing a 70% (14/20) response rate. The participants were generally satisfied with the usefulness of the feedback and the comparisons with peers, as well as the protection of privacy. The majority of the GPs (9/14, 64%) valued the protection of their own privacy as well as that of their patients.
The system overcomes important privacy and scaling challenges that are commonly associated with the secondary use of electronic health record data and has the potential to improve antibiotic prescribing behavior; however, further study is required to assess its actual effect.
抗生素耐药性是一个全球性的公共卫生问题，抗生素的滥用和过度使用加剧了这一问题。研究表明，审核与反馈能使临床医生将自己的个人临床绩效与同行进行比较，并且在减少抗生素的不恰当处方方面有效。然而，隐私问题使得审核与反馈在临床环境中难以实施。为解决这一问题，我们开发了一种保护隐私的审核与反馈（A&F）系统。
本研究旨在评估一种保护隐私的A&F系统在临床环境中的效果。
在挪威的三家基层医疗诊所部署了一种保护隐私的A&F系统，以针对20名全科医生（GP）对选定呼吸道感染的抗生素处方生成反馈。要求这些全科医生在使用该系统后不久参与一项调查。
共有14名全科医生回复了问卷，回复率为70%（14/20）。参与者总体上对反馈的有用性、与同行的比较以及隐私保护感到满意。大多数全科医生（9/14，64%）重视对自己以及患者隐私的保护。
该系统克服了与电子健康记录数据二次使用通常相关的重要隐私和规模挑战，并且有改善抗生素处方行为的潜力；然而，需要进一步研究以评估其实际效果。
