As for set up, you may need an advanced user to establish the mapping functions and for general maintenance. From a user's perspective (simplified explanation), there are checklists or audit programs with the attributes to test. Next to the attribute a drop down box to check - 'exception, ok, na. Next to that, a field for your comments. After that, push the reports button and all items marked 'exception' are mapped to the report module which will show the attribute, exception comments and a field for management response dates. The response dates can then be mapped to another module for aging purposes. All exception are also mapped to a matrix by exception type for trend analysis. As for report set up, say for example you are auditing loan files and one exception would be lack of a recorded mortgage. The report would show that exception, your comments, department of responsibility (originations, operations, etc., department manager, whether a response is required, date response due, etc. From that data, I write a management letter with the trends. Very effective.
I was not involved in the set-up so I don't know how difficult it would be.