A. Dwivedi

Merger of knowledge management and information technology in healthcare: opportunities and challenges

In the last 10 years, the Information and Communication Technologies (ICTs) revolution has redefined the structure of the 21st century healthcare organization. It is clear that the 21st century healthcare organization will bring about new healthcare services and that traditional management and technological concepts would not be the appropriate conduit for disseminating these new healthcare services. The fundamental challenge faced by the 21st century clinical practitioner is to acquire proficiency in understanding and interpreting clinical information so as to attain knowledge and wisdom. An additional challenge that must be considered is that clinical practitioners make potentially life-saving decisions whilst attempting to deal with large amounts of clinical data. We focus on the emergence of telehealth as an alternative implementation for transfer of medical information using futuristic Information and Communication Technologies (ICT). We contend that current healthcare applications are being used in a static manner; futuristic applications will need to be dynamic in nature and would call for the transfer of context-based healthcare information. A Knowledge Management (KM) solution would allow healthcare institutions to give clinical data context, so as to allow knowledge derivation for more effective clinical diagnosis. It would also provide a mechanism for effective transfer of the acquired knowledge in order to aid healthcare workers as and when required Using data inputs from our collaborating organization, Applied Network Solutions (ANS), we argue that healthcare institutions that integrate KM and ICT into their main organizational processes are more likely to survive and prosper. These organizations would have a profound understanding of how to use clinical information for creating value in tangible and intangible terms.

Workflow management systems: the healthcare technology of the future?

In recent years, healthcare institutions have had problems accessing and maintaining the large amounts of data they deal with. This paper identifies current approaches and technologies which relate to patient administration systems. It argues that, in the near future, WWW-based multimedia patient administration systems would become the norm for healthcare institutions. The development and acceptance of web-based multimedia patient administration systems is likely to aggravate the problem of healthcare institutions being flooded with large amounts of clinical data. A large amount of clinical procedures relating to patient management are repetitive and Workflow Management Systems (WFMS) can automate these repeated activities. We believe that the introduction of WFMS would enable healthcare institutions to face this challenge of transforming large amounts of medical data into contextually relevant clinical information. The central contention of this paper is that there is a dynamic connection between healthcare, workflow and internet technologies, which is being ignored. This paper further establishes that it is possible to build a virtual electronic health record database based on the client server architecture using current internet and object-oriented (OO) technologies.

Towards a practical healthcare information security model for healthcare institutions

In recent years, a number of countries have introduced plans for national electronic patient record (EPR) systems. This paper argues that, in the near future, both patients and healthcare stakeholders will be able to access medical records from WWW-based EPR systems. We contend that the primary impediment to the successful implementation and widespread uptake of the EPR concept is the fact that current healthcare information security (HIS) applications are not sufficiently robust. This paper identifies two main Information Security technologies: 1) Public key infrastructure (PKI) and 2) Biometrics that hold a lot of promise in a healthcare context. The key contribution of this paper is to propose a novel multi-layered HIS framework based on a combination of PKI, Smartcard and Biometrics technologies. We argue that this new HIS framework could assist healthcare institutions to provide a truly secure infrastructure for the electronic transmission of clinical data in the future. This paper also makes a case for the creation of a new nodal HIS body because existing information security bodies like the Forum of Incident Response and Security Teams are for general-purpose organizations and not specifically suited for the healthcare sector.

Telehealth systems: considering knowledge management and ICT issues

We examine the factors necessary for telehealth implementations in healthcare organisations. We focus on the transfer of medical information using information and communication technologies (ICT). The paper identifies current applications of telehealth and telemedicine. It contends that we are using such applications in a static manner, whilst futuristic systems would be dynamic in nature and would support the transfer of context-based information. This could make web-based multimedia patient administration systems the norm for healthcare institutions. Such a scenario is likely to lead to a situation where healthcare institutions would be flooded with large amounts of clinical data. The introduction of the knowledge management (KM) paradigm would enable healthcare institutions to face the challenge of transforming large amounts of medical data into relevant clinical information. A KM solution would allow healthcare institutions to give clinical data context, so as to allow knowledge derivation for more effective clinical diagnoses. It would also provide a mechanism for the effective transfer of the acquired knowledge so as to aid telecare workers, as and when required.

Clinical knowledge management for healthcare

A quiet transformation has taken place in health related research in the last twenty-five years. This transformation can be traced to the coming of age of new scientific domains like bioinformatics and cybernetics which have evolved thanks to trans-disciplinary research. The success of the human genome project is perhaps the most significant pointer of this silent transformation. We believe that in the future, as a result of synergistic interaction between bioinformatics and other paradigms, healthcare systems would have an increased interest in knowledge recycling of the collaborative learning process acquired from practices. In this context, the knowledge management (KM) paradigm could assist twenty-first century clinical practitioners to acquire proficiency in understanding and interpreting clinical information so as to attain knowledge and wisdom whilst dealing with large amounts of clinical data.

Guest Editorial Introduction to the Special Issue on Advances in Clinical and Health-Care Knowledge Management

Clinical and health-care knowledge management (KM) as a discipline has attracted increasing worldwide attention in recent years. The approach encompasses a plethora of interrelated themes including aspects of clinical informatics, clinical governance, artificial intelligence, privacy and security, data mining, genomic mining, information management, and organizational behavior. This paper introduces key manuscripts which detail health-care and clinical KM cases and applications.

Critical success factors for achieving superior m-health success.

Recent healthcare trends clearly show significant investment by healthcare institutions into various types of wired and wireless technologies to facilitate and support superior healthcare delivery. This trend has been spurred by the shift in the concept and growing importance of the role of health information and the influence of fields such as bio-informatics, biomedical and genetic engineering. The demand is currently for integrated healthcare information systems; however for such initiatives to be successful it is necessary to adopt a macro model and appropriate methodology with respect to wireless initiatives. The key contribution of this paper is the presentation of one such integrative model for mobile health (m-health) known as the Wi-INET Business Model, along with a detailed Adaptive Mapping to Realisation (AMR) methodology. The AMR methodology details how the Wi-INET Business Model can be implemented. Further validation on the concepts detailed in the Wi-INET Business Model and the AMR methodology is offered via a short vignette on a toolkit based on a leading UK-based healthcare information technology solution.

Building New Healthcare Management Paradigms: A Case for Healthcare Knowledge Management

Advances in information technology have made it possible for medical stakeholders to have access to almost all existing health information available. However, as a result of these advances, physicians, and other medical stakeholders are facing an information overload and, in some cases, paradoxical information. This chapter presents evidence that (a) highlights the extent of the information explosion in healthcare and (b) elucidates the extent to which the information explosion in healthcare is adversely affecting the ability of medical stakeholders in the process of medical diagnosis and treatment. This chapter then discusses the concept of knowledge management (KM) as applicable to the healthcare sector (i.e. healthcare KM and clinical KM). Finally, this chapter presents a case for the incorporation of the KM paradigm as the driving force in the healthcare sector.

Organization current knowledge design (OCKD): a knowledge management framework for healthcare institutions

The objective of this paper is to contribute to the existing body of knowledge on the linkages between three multidisciplinary research themes Healthcare management concepts, Information and Communication Technology (ICT) and Knowledge Management (KM). We introduce Organization Current Knowledge Design (OCKD), a KM framework for Healthcare Institutions (His). The OCKD framework is likely to be the first holistic KM framework for His which would assist His to discover and create new knowledge. We review relevant literature on the need for knowledge management in healthcare and develop theoretical propositions, validated by a pilot case study, to build a conceptual KM Health framework. The conceptual KM Health framework is then validated via sub case analysis and two additional cases, and a final version of the KM framework is presented.

How workflow management systems enable the achievement of value driven healthcare delivery

Healthcare institutions globally are currently having major problems accessing and maintaining the large amounts of data that are continuously being generated. Examination of the clinical procedures relating to patient management reveals that many of these activities are repetitive. Workflow Management Systems (WFMS) can automate these repeated activities. Moreover, the introduction of WFMS would enable healthcare institutions to face this challenge of transforming large amounts of medical data into contextually relevant clinical information and knowledge. In order to emphasise the dynamic connection between healthcare, workflow and internet technologies, the intelligence continuum is introduced.