Medical Audit — Quality and Compliance in Healthcare

What Is Medical Audit?

Medical Audit is a systematic review process of clinical records, care processes, and health outcomes to assess quality of care and regulatory compliance in healthcare institutions. It encompasses three dimensions: clinical audit (evaluation of medical practice), administrative audit (documentation completeness), and financial audit (billing accuracy).

In Peru, MINSA requires periodic audits as part of quality supervision and improvement mechanisms. WHO and PAHO promote medical audit as a fundamental tool for continuous quality improvement, recommending audit cycles that include gap identification, improvement implementation, and re-evaluation.

Digitizing the audit process through a HIS and business intelligence tools transforms a traditionally manual process into a data-driven one. Clinical dashboards and health KPIs provide the visibility needed to identify improvement opportunities and document compliance.

Why It Matters in Healthcare

• Quality of care: identifies gaps between current clinical practice and evidence-based best practices.
• Regulatory compliance: documents adherence to regulatory requirements from authorities such as MINSA, SUSALUD, and accreditation bodies.
• Billing accuracy: financial auditing verifies that coding and billing reflect the services actually delivered.
• Documentation completeness: evaluates the quality and completeness of records in the electronic health record.
• Continuous improvement: audit cycles generate data for implementing measurable improvement plans.
• Risk management: identifies patterns that may represent risks to patient safety.

How Davix Relates to Medical Audit

• Davix Inteligencia Comercial provides audit-ready reports, dashboards, and KPIs that support clinical and administrative auditing processes.
• It facilitates the generation of quality indicators aligned with MINSA, SUSALUD, and international standards.
• It enables documentation completeness analysis of medical records for administrative auditing.
• Interactive dashboards allow identifying trends, gaps, and improvement opportunities in real time.
• It integrates with the Davix HIS to access the clinical and operational data required for auditing.

Discover how Davix Inteligencia Comercial empowers audit processes at your institution.