“…Practical obstacles may hinder the implementation of quality monitoring: time, funding, necessary structures, technical requirements may be lacking, or employee compliance may be poor [ 41 ▪▪ , 56 , 93 ▪▪ ]. An important problem is that existing data can be hard to utilize for quality purposes [ 56 , 93 ▪▪ ]. In an Australian study, clinicians had limited access to data exports, which was a significant barrier to the utilization of such data [ 93 ▪▪ ].…”