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Medical
Knowledge Management Solutions - Revolutionizing the Delivery of
Medical Information to the Point of Need .
Author: William M. Detmer, MD, MSc
President and CEO
Unbound Medicine, Inc.
A Knowledge Problem Threatens Healthcare
Medical science is advancing at an unprecedented rate, yet clinicians
still cannot get the knowledge they need at the point of care. Traditional
information resources are available but usually fail to provide
answers where and when they are needed. As a result, nearly two-thirds
of questions that arise in clinical practice remain unanswered (1,2).
Despite recent technological and scientific advances, medical errors
are still common and costly. In 2000 the Institute of Medicine reported
that medical errors cost the healthcare industry more than $37 billion
each year and that nearly 100,000 people die annually in the U.S.
due to these mistakes (3,4).
Total Knowledge Management Solutions
Advances in technology and information science have prompted more
and more clinicians to adopt the use of the Internet and handheld
devices to glean new knowledge. As a result, a new category of healthcare
solution is emerging to provide clinicians with the right answers
in the right form at the right place at the right time. A confluence
of factors is now enabling complete knowledge management solutions,
employing handheld and web-enabled technologies, to meet the needs
of healthcare professionals.
These new knowledge management solutions are ideal because they
take into account not only the unique needs of clinicians but also
the way they work. The solutions recognize that clinician's are
mobile and thus, provide knowledge that is architected to fit their
needs - both portable and available in "nuggets." Additionally,
because each clinician has a unique set of information needs, both
content and technology are customized and coordinated to deliver
accurate knowledge across time, devices, and settings.
By tightly integrating sophisticated information architectures,
current and authoritative content, and personalized technologies,
new knowledge management solutions will transform how clinical answers
are delivered to the point of need.
Content—The Right Answer
Healthcare professionals need access to accurate information quickly.
Unfortunately, the medical information made available to clinicians
today is often out of date, poorly organized and difficult to locate.
Knowledge management companies are taking a new approach to content
development by:
- Establishing digital networks of expert contributors who collaborate
using Internet-based communication tools to create current, authoritative,
and evidence-based content
- Employing template-driven, Web-based authoring systems to create
content that is structured in a consistent fashion and in ways
known to be useful for end-user clinicians; and
- Employing digital editing processes that facilitate rapid review
and publication.
Information Architecture—The
Right Form
When faced with clinical questions, clinicians typically
ask and give advice using a knowledge structure that they learned
in the first years of professional school. "What is the prognosis
for Disease X?" or "How effective is Therapy Y for treating Disease
Z?" are examples of typical questions that are posed every day using
a shared knowledge structure.
If content is not architected in ways that healthcare
professionals find intuitive, it will not meet their needs. To address
this problem, companies are creating and applying new information
architectures that are derived from the fundamental attributes of
medical knowledge communication. Products that use these architectures
help users ask and answer questions more quickly and effectively.
Technology—Delivery to the Right Place
at the Right Time
Because during a typical day healthcare professionals take on a
variety of roles, perform myriad of tasks and are constantly on
the move, they require specialized tools to manage knowledge. Although
generic technologies exist for delivering content, they often miss
the mark because they do not realize the complexity of the knowledge
being delivered and the coordination that is required between mobile-,
Internet-, and medical records-based knowledge environments.
Complete knowledge management solutions require customized technologies
that take into account the nomadic, need-to-know nature of the medical
practice. Of paramount importance are handheld technologies that
place needed information directly into the hands of mobile users.
New technologies need to support a coordination of content, making
available quick reference material on mobile devices as well as
in-depth versions via a web browser on a desktop. With this knowledge
coordination feature clinicians can get the level of answer appropriate
to the particular task and setting.
The Future
Never before have content, information science, and technology converged
to create such powerful solutions for medical practitioners. With
these new solutions, clinicians will gain access to everything from
up-to-date information on drugs, diagnostics tests and disease management
as well as institutional policies and procedures. Healthcare organizations
will reap the benefits as well. Access to such critical information,
delivered where and when it is needed, will reduce opportunities
for costly mistakes and medical errors, and thus improve patient
care. The future of medical knowledge management is being scripted
now; it is time to take advantage of the revolution.
# # #
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Covell DG, Uman GC, Manning PR. Information
Needs in Office Practice: Are They Being Met Ann Intern Med
1985, Oct; 103(4):596-9.
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Ely JW, Osheroff JA, Ebell MH, Bergus GR, Levy
BT, Chambliss ML, et al Analysis of questions asked by family
doctors regarding patient care. BMJ 1999;319:358-61.
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Medical Errors: The Scope of the Problem: Fact
sheet, Publication No. AHRQ 00-P037. Agency for Healthcare
Research and Quality, Rockville, MD.
-
To Err Is Human: Building a Safer Health System,
Kohn LT et al., Editors; Committee on Quality of Health Care
in America, Institute of Medicine, 2000.
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