JMIR Publications

ABSTRACT

Background:

Antibiotic resistance is a worldwide public health problem that is accelerated by misuse and overuse of antibiotics. Studies have shown that audit and feedback enabling clinicians to compare their clinical performance with their peers is effective in reducing inappropriate prescribing of antibiotics. However, privacy concerns make the audit and feedback hard to implement in clinical settings. Therefore, we have developed a privacy-preserving audit and feedback (A&F).

Objective:

The paper aims to evaluate the privacy-preserving audit and feedback (A&F) system in clinical settings.

Methods:

A privacy-preserving A&F system was deployed in three primary care practices in Norway to generate feedback to twenty 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, and we analysed the data.

Results:

Fourteen GPs responded to the questionnaire, representing a 70% (14/20) response rate. The participants were generally satisfied with usefulness of the feedback and the comparison with peers, as well as protection of privacy. The majority of the GPs value the protection of their own privacy, as well as that of their patients.

Conclusions:

The system overcomes important privacy and scaling challenges commonly associated with secondary use of electronic health record (EHR) data, and has a potential to improve antibiotic prescribing behaviour; however, further study is required to assess its actual effect.