Knowledge Management In Health Care Organizations

Abstract:

This review article analyzes theories, methods, and technologies that can be effective in building a socio-technical environment within a health care organization that is able to facilitate the collaboration between individuals in the management of patient care and in expanding scientific and professional knowledge. The article is organized as follows. In section 2, I discuss the nature of knowledge in general and with a particular attention to medical knowledge. The future of health information systems (HIS) is discussed in section 3, which provides also an overview of theories for designing and developing such systems. Section 4 describes different types of collaboration, and reviews the methods and information and communication technologies (ICT), which can be exploited for knowledge creation and interaction management. The potential of workflow management technology for building innovative components within HIS is analyzed in section 5. Finally, section 6 presents the conclusions.

• References

• 1 Davenport TH, Prusak L. Working Knowledge: How Organizations Manage What They Know. Cambridge, MA: Harvard Business School Press; 1998
• 2 Institute of Medicine. Crossing the Quality Chasm. Washington, D.C: National Academy Press; 2001
• 3 Hamel G, Prahalad CK. Competing for the Future. Boston, MA: Harvard Business School Press; 1994
• 4 Leonard-Barton D. Well-springs of Knowledge: Building and Sustaining the Sources of Innovation. Boston, MA: Harvard Business School Press; 1995
• 5 Stewart TA. Intellectual Capital: the New Wealth of Organizations. New York, NY: Doubleday; 1997
• 6 Garvin DA. Learning in Action: a Guide to Putting the Learning Organizations to Work. Boston, MA: Harvard Business School Press; 2000
• 7 Institute of Medicine. To Err is Human: Building a Safer Health System. Washington, D.C: National Academy Press; 2000
• 8 Barley V, Neale G, Burns-Cox C, Savage P, Machin S, El Sobky A. et al. Reducing error, improving safety. BMJ 2000; 321 7259 505-14.
• 9 Millenson ML. Demanding Medical Excellence. 2nd ed. Chicago, USA: The University Chicago Press; 1999
• 10 Fieschi M, Dugour J-C, Staccini P, Gouvernet J, Bouhaddou O. Medical decsion support systems: old dilemmas and new paradigms. Methods Inf Med 2003; 42: 190-8.
• 11 Searle JR. The Construction of Social Reality. New York, NY: The Free Press; 1995
• 12 Hutchins E. Cognition in the Wild. Cambridge, MA: The MIT Press; 1995
• 13 Ellingsen G, Monteiro E. Mechanisms for producing a working knowledge: enacting, orchestrating and organizing. Information and Organization 2003; 13: 203-29.
• 14 Wenger E, McDermott R, Snyder W. Cultivating Communities of Practice. Boston, MA: Harvard Business School Press; 2002
• 15 Drucker PF. Knowledge-worker productivity: the biggest challenge. California Management Review 1999; 41 (02) 79-94.
• 16 Cohen SS, Prusak L. In Good Company: How Social Capital Makes Organization Work. Boston, MA: Harvard Business School Press; 2001
• 17 Cappelli P. A market driven approach to retaining talent. Harvard Business Review. 2000. January-February 103-11.
• 18 Dessler G. How to earn your employees. Academy of Management Executive 1999; 13 (02) 58-67.
• 19 Liebowitz J. Knowledge management and its link to artificial intelligence. Expert Systems with Applications 2001; 20 (01) 6.
• 20 Minsky M. Steps Toward Artificial Intelligence. In Feigenbaum EA, Feldman J. editors Computers and Thought. New York, NY: MacGraw Hill; 1963
• 21 Newell A, Simon HA. Human Problem Solving. Englewood Cliffs, NJ: Prentice Hall; 1972
• 22 Simon HA. Models of Man: Social and Rational. New York, NY: John Wiley; 1957
• 23 Kurzweil R. Intelligent Machines. Cambridge, MA: MIT Press; 2003
• 24 Block N. The Computer Model of Mind. In Osherson DH, Smith EE. editors Thinking: An Invitation to Cognitive Science. Cambridge, MA: MIT Press; 1990
• 25 Maturana H, Varela F. The Tree of Knowledge. Boston, MA: New Science Library; 1987
• 26 Varela F, Thompson JE, Rosch E. The Embodied Mind. Cambridge, MA: MIT Press; 1992
• 27 Winograd T, Flores F. Understanding Computers and Cognition. Norwood, NJ: Ablex; 1986
• 28 Varela F, Bourgine P. Towards a Practice of Autonomous Systems. Cambridge, MA: MIT Press; 2003
• 29 McDermott R. Why information technology inspired, but cannot deliver knowledge management. California Management Review 1999; 41 (03) 103-17.
• 30 Smith B. The ecological approach to information processing. In Nyíri JC. editor Mobile Communication: Essays on Philosophy, Psychology and Education. Vienna, A: Passagen Verlag; 2003: 1724-32.
• 31 Gibson JJ. The Ecological Approach to visual Perception. Boston, MA: HoughtonMifflin; 1979
• 32 Donald M. Origins of Modern Mind: Three Stages of Evolution of Culture and Cognition. Cambridge, MA: Harvard University Press; 1991
• 33 Polanyi M. The Tacit Dimension. London, UK: Routledge & Kegan Paul; 1966
• 34 Nonaka I, Takeuchi H. The KnowledgeCreating Company. Oxford, UK: University Press; 1995
• 35 Stefanelli M. The socio-organizational age of artificial intelligence in medicine. Artif Intell Med 2001; 23: 25-47.
• 36 Panzarasa S, Maddè S. Quaglini S, Pistarini C, Stefanelli M. Evidence-based careflow management systems: the case of poststroke rehabilitation. J Biomed Inform 2002; 35: 123-39.
• 37 Stefanelli M. The role of methodologies to improve efficiency and effectiveness of care delivery processes for the year 2013. Methods Inf Med 2002; 66 1-3 39-44.
• 38 Bellazzi R, Zupan B. Intelligent data analysis special issue. Methods Inf Med 2001; 5: 362-4.
• 39 Cook SDN, Brown JS. Bridging epistemologies: the generative dancing between organizational knowledge and organizational learning. Organization Science 1999; 10 (04) 381-400.
• 40 Brown JS, Duguid P. Balancing act: how to capture knowledge without killing it. Harvard Business Review 2000 MayJune. 2000: 73-80.
• 41 Quaglini S, Stefanelli M, Cavallini A, Micieli G, Fassino C, Mossa C. Guidelinebased careflow systems. Artif Intell Med 2000; 20: 5-22.
• 42 Boland RJ, Tenkasi RV. Perspective making and perspective taking in communities of knowing. Organization Science 1995; 6 (04) 350-72.
• 43 Kuhn KA, Giuse DA, Haux R. IMIA working conference on health information systems 2002 Heidelberg practical HIS experiences. Methods Inf Med 2002; 42: VI-VIII.
• 44 Kuhn KA, Giuse DA, Talmon J. The Heidelberg Conference: setting an agenda for the AMIA working group on Health Information Systems. International Journal of Medical Informatics 2003; 69: 77-82.
• 45 Giuse DA, Kuhn KA. Health iformations systems challenges: the Heidelberg conference and the future. International Journal of Information Management 2003; 69: 105-14.
• 46 Hartswood MJ, Procter RN, Rouchy P, Rouncefield M, Slack R, Voss A. Working IT out in medical practice: IT systems design and development as co-production. Methods Inf Med. 2002
• 47 Lorenzi NM, Riley RT. Organizational issues = change. Int J Medical Inf 2003; 69: 197-203.
• 48 Wyatt JC, Wyatt SM. When and how to evaluate health information systems?. Int J Med Inf 2003; 69: 251-9.
• 49 Davidow W, Malone M. The Virtual Corporation, Structuring and Revitalizing the Corporation for the 21st Century. NewYork, NY: Harper Business; 2003
• 50 Wright P, Snell S. Toward a unifying framework for exploring fit and flexibility in strategic resource management. Academy of Management Review 1998; 23: 756-72.
• 51 Ghemawat P, Costa R. The organizational tension between static and dynamic efficiency. Strategic Management Journal 1993; 14: 59-73.
• 52 Thompson J. Organizations in Action. New York, NY: MacGraw-Hill; 1967
• 53 Burns T, Stalker J. The Management of Innovation. London, UK: Tavistock; 2003
• 54 Daft R. Essentials of Organization Theory and Design. Cincinnati, OH: SouthWestern College; 1998
• 55 Tushman M, O’Reilly CA. Winning through Innovation. Boston, MA: Harvard Business School Press; 2003
• 56 Adler P, Goldoftas B, Levine D. Flexibility versus efficiency? A case study of model changeovers in the Toyota production system. Organization Science 1999; 10: 43-68.
• 57 Newell S, Huang JC, Galiers RD, Pan SL. Implementing enterprise resource planning and knowledge management systems in tandem: fostering efficiency and complementarity. Information and Organization 2003; 13: 25-52.
• 58 Lee Z, Lee J. An ERP implementation case study from a knowledge transfer perspective. Jourbal of Information Technology 2000; 15: 281-8.
• 59 Shanks G, Seddon P. Editorial. Journal of Information Technology 2000; 15: 243-4.
• 60 Special Issue on Enterprise Resource Planning (ERP). Communications of the ACM 43[4]. 2000
• 61 Starbuck W. Learning by knowledge intensive firms. Journal of Management Studies 2002; 29: 713-40.
• 62 Von Krogh G, Ichijo K, Nonaka I. Enabling Knowledge Creation. New York, USA: Oxford University Press; 2001
• 63 Wenger E. Communities of Practice. New York, NY: Cambridge University Press; 1998
• 64 Brennan P, Safran C. Report of conference track 3: patient empowerment. Int J Med Inf 2003; 69: 301-4.
• 65 Ash J, Berg M. Report of conference Track 4: socio-technical issues of HIS. Int J Med Inf 2003; 69: 305-6.
• 66 Beyer H, Holtzblatt K. Contestual Design: Defining Customer Centered Systems. San Francisco, CA: Morgan Kaufmann; 1998
• 67 Greenbaum J, Kyng M. Design at Work: Cooperative Design of Computer Systems. Hillsdale, NJ: Lawrence Erlbaum Associates; 1991
• 68 Norman DA, Draper SW. editors User Centered System Design. Hillsdale, NJ: Lawrence Erlbaum Associates;; 2003
• 69 van der Aalst WMP, van Hee K. Workflow Management: Models, Methods, and Systems. Cambridge, MA: The MIT Press; 2002
• 70 Halverson CA. Activity theory and distributed cognition: or what does CSCW need to do with theories?. Computer Supported Cooperative Work 2002; 11: 243-67.
• 71 Redmiles D. Introduction to the special issue on activity theory and the practice of design. Computer Supported Cooperative Work 2002; 11: 1-11.
• 72 Engeström Y. Coordination, Cooperation and Communication in the Courts. Mind, Culture, and Activity. Cambridge, UK: Cambridge University Press; 1997: 369-88.
• 73 Salomon G. editor Distributed Cognitions. Learning in doing: Social, Cognitive, and Computational Perspectives. Cambridge, UK: Cambridge University Press; 1993
• 74 Clark A. Being There: Putting Brain, Body, and World Together Again. Cambridge, MA: MIT Press; 1997
• 75 Simon HA. The Sciences of the Artificial. Cambridge, MA: MIT Press; 1990
• 76 Workflow Management Coalition. Workflow Standards. In Lawrence P. editor Workflow Handbook. Chichester, UK: John Wiley & Sons; 1997: 241-421.
• 77 Kumar A, Smith B. Ontology for taskbased clinical guidelines and the theory of granular partitions. Proceedings of the 9th Conference on Artificial Intelligence in Medicine Europe; 18-22 October 2003 Cyprus. In press. 2003
• 78 Kumar A, van der Aalst WMP, Verbeek E. Dynamic work distribution in workflow management systems: how to balance quality and performance. Journal of Management Information Systems 2002; 18 (03) 157-93.
• 79 Klein M, Dellarocas C. A knowledgebased approach to handling exceptions in workflow systems. Computer Supported Cooperative Work 2000; 9: 399-412.
• 80 Luo Z, Sheth A, Kochut K, Miller J. Exception handling in workflow systems. Applied Intelligence 2000; 13: 125-47.
• 81 Dickson K, Chiu W, Li Q, Karlapalem K. Web interface-driven cooperative exception handling in ADOME workflow management system. Information Systems 2001; 26 (02) 93-120.
• 82 Coiera E. Interaction design theory. Int J Med Inf 2003; 69: 205-22.
• 83 Coiera E. When communication is better than computation. J Am Med Inform Assoc 2000; 7: 277-86.
• 84 Berg M, Toussaint P. The mantra of modeling and the forgotten power of paper: a sociotechnical view on the development of process-oriented ICT in health care. Int J MedInf 2003; 69: 223-34.
• 85 Garrod S. How groups co-ordinate their concepts and terminology: implications for medical informatics. Methods Inf Med 1998; 37: 471-6.
• 86 Atkinson P. Medical Talk and Medical Work. London, UK: Sage; 1995
• 87 Micieli G, Cavallini A, Quaglini S. Guideline compliance improves stroke outcome A preliminary study in 4 districts in the Italian Region of Lombardia. Stroke 2002; 33: 1341-7.
• 88 Fox MS, Gruninger M. Enterprise modeling. AI Magazine. 1998. Fall 109-21.
• 89 Smith B, Searle JR. The construction of social reality: an exchange. American Journal of Economics and Sociology 2003; 62 (02) 285-309.
• 90 Zhuge H. Component-based workflow systems development. Decision Support Systems 2003; 35: 517-36.
• 91 van der Aalst WMP. Three good reasons for using a Petri-net-based Workflow Management System. In: Wakayama T, Kannapan T, Khoong CM, Navathe S, Yates J. editors Information and Process Integration in Enterprises: Rethinking Documents. Boston, MA: Kluwer Academic Publishers; 1998: 161-82.
• 92 Liu D, Wang J, Chan S, Sun J, Zhang L. Modeling worflow process with colored Petri nets. Comuperts in Industry 2002; 49: 267-81.
• 93 Zhuge H. Workflowand agent-based cognitive flow management for distributed team cooperation. Information & Management 2003; 40: 419-29.
• 94 Mentzas G, Halaris C, Kavadias S. Modelling business processes with workflow systems: an evaluation of alternative approaches. International Journal of Information Management 2001; 21: 123-35.
• 95 Chung PWH, Cheung L, Stader J, Jarvis P, Moore J, Macintosh A. Knowledge-based process management an approach to handling adaptive workflow. KnowldgeBased Systems 2003; 16: 149.
• 96 Weigand H, van den Heuvel W. Crossorganizational workflow integration using contracts. Decision Support Systems 2002; 33: 247-65.
• 97 Lechleitner G, Pfeiffer K-P, Wilhelmy I, Ball M. Cerner Millennium TM: the Innsbruck experience. Methods of Information in Medicine 2003; 42: 8-15.
• 98 Gell G, Schmücker P, Pedevilla M, Leitner H, Naumann J, Fuchs H. SAP and Partners: IS-H TM and IS-H*MED. Methods Inf Med 2003; 42: 16-24.
• 99 Haux R, Seggeweis C, Baldauf-Sobez W, Kullmann P, Reichert H, Luedecke L. et al. Soarian^TM: workflow management applied for health care. Methods of Information in Medicine 2003; 42: 25-36.
• 100 Degoulet P, Marin L, Lavril M, Le Bozec C, Delbecke E, Meaux JJ et al. The HEGP component-based clinical information system. Int J Med Inf 2003; 69: 115-26.
• 101 Kuhn KA, Lenz R, Elstner T, Siegele H, Moll R. Experiences with a generator tool for building clinical application modules. Methods Inf Med 2003; 42: 37-44.
• 102 Giuse D. Provider order entry with integrated decision support: from academia to industry. Methods Inf Med 2003; 42: 45-50.