Vikraman Baskaran

Towards Total Knowledge Management for Healthcare: Clinical and Organizational Considerations

Knowledge Management (KM) has made a significant impact on the global healthcare sector. However, it is important to address the link between knowledge, information and engineering. Knowledge Engineering (KE) is often only a small part of a KM-based project, yet some KM practitioners favour wholly KE-biased Knowledge Management projects, disregarding a more necessary holistic stance. This paper analyses some current achievements in the KM field and provides a benchmark from which academics and practitioners can attempt to attain “Total Knowledge Management for Healthcare” (TKMh).

Managing information and knowledge within maternity services: Privacy and consent issues

Objective Electronic Patient Records have improved vastly the quality and efficiency of care delivered. However, the formation of single demographic database and the ease of electronic information sharing give rise to many concerns including issues of consent, by whom and how data are accessed and used. This paper examines the organizational and socio-technical issues related to privacy, confidentiality and security when employing electronic records within a maternity service hospital in England. Methods A preliminary questionnaire was administered (n  =  52), in total, 24 responses were received. Sixteen responses were from personnel in the information technology department, 5 from health information department and 3 from midwifery managers. This was followed by a semi-structured interview with representatives from the clinical and technological side. Results A number of issues related to information governance (IG) have been identified, especially breaches on sharing personal information without consent from the patients have been identified as one immediate challenge that needs to be fixed. Conclusion There is an immediate need for more robust, realistic, built-in accountability both locally and nationally on data sharing. A culture of ownership and strict adherence to IG principles is paramount. Focused training in the area of data, information and knowledge sharing will bring in a balance of legitimate usage against the individuals rights to confidentiality and privacy.

Knowledge management as a holistic tool for superior project management

The challenges encountered in project-based organisations have been addressed by many strategies. This paper intends to provide an empirical insight of knowledge and its application within project environs. This would instigate learning and innovation within Knowledge Management (KM) in project-based organisations. Based on two case studies, a simple understanding of knowledge, Knowledge Creation (KC) and its management are proposed. It further underlines the humanistic core of KM and a framework that can be utilised to align knowledge paths. Finally, the paper concludes with suggestions and recommendations for future research on KM in the realm of project management.

Predicting Breast Screening Attendance Using Machine Learning Techniques

Machine learning-based prediction has been effectively applied for many healthcare applications. Predicting breast screening attendance using machine learning (prior to the actual mammogram) is a new field. This paper presents new predictor attributes for such an algorithm. It describes a new hybrid algorithm that relies on back-propagation and radial basis function-based neural networks for prediction. The algorithm has been developed in an open source-based environment. The algorithm was tested on a 13-year dataset (1995-2008). This paper compares the algorithm and validates its accuracy and efficiency with different platforms. Nearly 80% accuracy and 88% positive predictive value and sensitivity were recorded for the algorithm. The results were encouraging; 40-50% of negative predictive value and specificity warrant further work. Preliminary results were promising and provided ample amount of reasons for testing the algorithm on a larger scale.

A knowledge-based primary care approach to increase breast screening attendance

The static rate of breast screening attendance in the UK has been of concern in the fight against breast cancer mortality. This paper highlights how primary care can play a vital role in addressing this issue. Knowledge created through prediction mechanisms and sharing them with care deliverers forms the core of this discussion. Knowledge-based alerts are employed to initiate interventions to increase the breast screening attendance. This paper highlights the various factors that are to be considered while deploying such initiatives in primary care setting and validates them through a questionnaire-based survey.

A smartphone-based cloud computing tool for managing type 1 diabetes in Ontarians.

Diabetes caused by hyperglycemia has been classified as a pandemic chronic disease by the World Health Organization (1), has been reported in more than 180 million cases worldwide (1), and may continue to increase in the next 15 years (2,3). Diabetesrelated conditions in Ontario, Canada, are not being monitored or managed as expected, which may result in major complications for 1 in 20 patients with diabetes within a year (4). Patients with diabetes in Ontario have been found to have reduced life expectancies by nearly 13 years when compared to those of people without diabetes (5). There are 3 types of diabetes: type 1, type 2 and gestational diabetes. Although there have been a number of studies that have tried to address type 2 diabetes mellitus (6e11), type 1 diabetes has been studied relatively less from the perspective of personal disease management. However, compared to type 2 diabetes, type 1 has to be more thoroughly managed to avoid longterm complications in the eyes, the kidneys and the cardiovascular and cognitive systems. The effective management of type 1 diabetes is challenging because patients with type 1 diabetes are normally young children, adolescents and young adults who, despite their lack of knowledge about the disease and the medical implications of the disease, are responsible for handling complex treatments, such as insulin pumps and maintaining proper glycemic levels and required physical activities. Although there is an abundance of information, and it is easy to access information about type 1 diabetes, self-management of this disease in adolescents is strongly associated with peer support (6). A lack of peer support effectively results in lower-than-optimal levels of management of type 1 diabetes (6). Daneman reports that in Canada, type 1 diabetes accounts for 5% to 10% of all cases of the disease (7). The self-management of type 1 diabetes has to incorporate 2 kinds of situations: 1) crisis situations caused by hypoglycemia and 2) managing proper glycemic levels. A crisis situation due to hypoglycemia often is associated with loss of consciousness and seizures, commonly referred to as diabetic coma (diabetic ketoacidosis) and, eventually, a fall in many cases (8,9). If

HIV/AIDS behavioural challenges in Lagos state schools: an empirical study

This paper evaluates the extent of the behavioural challenges concerning HIV/AIDS among senior secondary school and tertiary institution students in Lagos, Nigeria. The study was carried out in collaboration with the Lagos State Ministry of Education. Questionnaires (n = 958 copies) were administered to selected senior secondary schools in the Lagos State administrative divisions (urban and rural) and the Lagos State University (LASU). The study aimed to record information about students’ behaviour related to HIV/AIDS as this would provide information relating to the factors responsible for its transmission. The results show that the behaviour of the respondents with regard to HIV/AIDS puts them at risk of contracting the virus. We conclude by suggesting the use of Knowledge Management (KM) techniques as an appropriate modern approach to tackling the problem and the availability of Behavioural Change Communication (BCC) materials in all Lagos State schools should be increased.

Physician intervention via knowledge management: using HL7 messaging to increase breast-screening uptake

Healthcare strategists have realised the relevance and importance of Knowledge Management (KM) for clinical and healthcare environments. There has been a huge thrust in Information Technology (IT) driven KM projects in healthcare. Projects related to Electronic Patient Record (EPR) have been the focus of many of the healthcare projects being carried out around the world. The synergy between overlapping technologies and the need for semantic interoperability of disparate systems have revolutionised how knowledge, information and data is being exchanged across the healthcare realm. This project addresses the issues of KM by leveraging the available IT tools and technologies within approved and dedicated standards (for example, HL7) to increase breast-screening attendance in a regional setting in the UK.

Tracking the healthcare management landscape: implications for integrated healthcare management and practice

The objective of this paper is to examine the feasibility of incorporating the Knowledge Management (KM) paradigm in healthcare. We discuss whether it would be beneficial for healthcare organisations to adopt the KM paradigm so as to facilitate effective decision-making in the context of healthcare delivery. Alternative healthcare management concepts with respect to their ability in providing a solution to the above mentioned issue are reviewed. This paper concludes that the KM paradigm can transform the healthcare sector. Based on empirical data and a long-term healthcare case study, a preliminary conceptual analysis of alternative healthcare management concepts is presented. The results reveal that KM can assist healthcare institutions (His) in making healthcare processes more effective.

E-Health: Focusing on People-Centric Dimensions

This chapter highlights the essential issue of people skills and knowledge for E-Health based initiatives. People-based issues have Knowledge Management (KM) at their core and the best KM implementations rely heavily on skilfully integrating technology with human requirements. The chapter features three short E-Health cases and discusses the human dimensions of each of these. Finally, we call for increased use of Populomics (a comprehensive way of studying health issues and providing focused solutions) when implementing E-Health as this produces a powerful solution taking into account multiple factors.