Clinical Knowledge Management: Opportunities and Challenges

359 Pages·2005·4.409 MB·English

by  Bali R.K.

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Rajeev K. Bali
Coventry University, UK
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Library of Congress Cataloging-in-Publication Data
E-learning and virtual science centers / Leo Tan and R. Subramaniam, editors.
p. cm.
Summary: "The book provides an overview of the state-of-the-art developments in the new and
emerging field of science education, called virtual science centers"--Provided by publisher.
Includes bibliographical references and index.
ISBN 1-59140-591-2 (hardcover) -- ISBN 1-59140-592-0 (softcover) -- ISBN 1-59140-593-9
(ebook)
1. Science--Study and teaching--Computer network resources. 2. Internet in education. I. Leo
Tan, 1944- II. R. Subramaniam, 1952-
Q182.7.E18 2005
025.06'5--dc22
2005004518
British Cataloguing in Publication Data
A Cataloguing in Publication record for this book is available from the British Library.
All work contributed to this book is new, previously-unpublished material. The views expressed in
this book are those of the authors, but not necessarily of the publisher.
For my family
Ipsa Scientia Potestas Est
(Knowledge itself is power)
SIR FRANCIS BACON
MEDITATIONES SACRÆ. DE HÆRESIBUS (1597)
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Foreword....................................................................................................................... viii
Swamy Laxminarayan, Idaho State University, USA
Preface ........................................................................................................................... xi
Rajeev K. Bali, Coventry University, UK
Section I: Key Opportunities and Challenges in Clinical Knowledge Management
Chapter I
Issues in Clinical Knowledge Management: Revisiting Healthcare Management....... 1
Rajeev K. Bali, Coventry University, UK
Ashish Dwivedi, University of Hull, UK
Raouf Naguib, Coventry University, UK
Chapter II
It’s High Time for Application Frameworks for Healthcare........................................11
Efstathios Marinos, National Technical University of Athens, Greece
George Marinos, National Technical University of Athens, Greece
Antonios Kordatzakis, National Technical University of Athens, Greece
Maria Pragmatefteli, National Technical University of Athens, Greece
Aggelos Georgoulas, National Technical University of Athens, Greece
Dimitris Koutsouris, National Technical University of Athens, Greece
Chapter III
Management and Analysis of Time-Related Data in Internet-Based Healthcare
Delivery .........................................................................................................................33
Chris D. Nugent, University of Ulster at Jordanstown, Northern Ireland
Juan C. Augusto, University of Ulster at Jordanstown, Northern Ireland
Chapter IV
Interactive Information Retrieval as a Step Towards Effective Knowledge
Management in Healthcare...........................................................................................52
Jörg Ontrup, Bielefeld University, Germany
Helge Ritter, Bielefeld University, Germany
Chapter V
The Challenge of Privacy and Security and the Implementation of Health
Knowledge Management Systems.................................................................................72
Martin Orr, Waitemata District Health Board, New Zealand
Section II: Organisational, Cultural and Regulatory Aspects of
Clinical Knowledge Management
Chapter VI
Knowledge Cycles and Sharing: Considerations for Healthcare Management...........96
Maurice Yolles, Liverpool John Moores University, UK
Chapter VII
Key Performance Indicators and Information Flow: The Cornerstones of Effective
Knowledge Management for Managed Care...............................................................116
Alexander Berler, National Technical University of Athens, Greece
Sotiris Pavlopoulos, National Technical University of Athens, Greece
Dimitris Koutsouris, National Technical University of Athens, Greece
Chapter VIII
Multimedia Capture, Collaboration and Knowledge Management.............................139
Subramanyam Vdaygiri, Siemens Corporate Research Inc., USA
Stuart Goose, Siemens Corporate Research Inc., USA
Chapter IX
Biomedical Image Registration for Diagnostic Decision Making and
Treatment Monitoring ................................................................................................159
Xiu Ying Wang, The University of Sydney, Australia and Heilongjiang
University, China
David Dagan Feng, The University of Sydney, Australia and Hong Kong
Polytechnic University, Hong Kong, China
Chapter X
Clinical Knowledge Management: The Role of an Integrated Drug Delivery
System.........................................................................................................................182
Sheila Price, Loughborough University, UK
Ron Summers, Loughborough University, UK
Chapter XI
Medical Decision Support Systems and Knowledge Sharing Standards ...................196
Srinivasa Raghavan, Krea Corporation, USA
Section III: Knowledge Management in Action:
Clinical Cases and Application
Chapter XII
Feasibility of Joint Working in the Exchange and Sharing of Caller Information
Between Ambulance, Fire and Police Services of Barfordshire................................219
Steve Clarke, The University of Hull, UK
Brian Lehaney, Coventry University, UK
Huw Evans, University of Hull, UK
Chapter XIII
Organizing for Knowledge Management: The Cancer Information Service as
an Exemplar.................................................................................................................234
J. David Johnson, University of Kentucky, USA
Chapter XIV
Clinical Decision Support Systems: Basic Principles and Applications in
Diagnosis and Therapy................................................................................................251
Spyretta Golemati, National Technical University of Athens, Greece
Stavroula G. Mougiakakou, National Technical University of Athens,
Greece
John Stoitsis, National Technical University of Athens, Greece
Ioannis Valavanis, National Technical University of Athens, Greece
Konstantina S. Nikita, National Technical University of Athens, Greece
Chapter XV
Towards Knowledge Intensive Inter-Organizational Systems in Healthcare............271
Teemu Paavola, LifeIT Plc, Finland and Helsinki University of Technology,
Finland
Pekka Turunen, University of Kuopio, Finland
Jari Vuori, University of Kuopio, Finland
Chapter XVI
An Overview of Efforts to Bring Clinical Knowledge to the Point of Care.................285
Dean F. Sittig, Medical Informatics Department, Kaiser Permanente
Northwest, USA, Care Management Institute, Kaiser Permanente, USA
and Oregon Health & Sciences University, USA
Chapter XVII
Social Capital, An Important Ingredient to Effective Knowledge Sharing:
Meditute, A Case Study...............................................................................................297
Jay Whittaker, University of Ballarat, Australia
John Van Beveren, University of Ballarat, Australia
Glossary ......................................................................................................................315
About the Authors.......................................................................................................322
Index ..........................................................................................................................332
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I am honored to be invited by the editor, Dr. Raj Bali, to write the foreword for this book.
In today’s information technology world, we are facing daunting challenges in realizing
an all aspiring and an all-encompassing paradigm of “data-information-knowledge-
intelligence-wisdom”. In the early nineties, under the aegis of the United States Na-
tional Information Infrastructure, the Internet facilitated the creation of an “informa-
tion-for-all” environment. Despite the unstructured nature of its existence, the Internet
has seen an unprecedented global growth in its role as a promoter of information
solutions to the citizens of the world. In contrast to the developments we witnessed in
the past decade, the features of the next generation Internet have shifted emphasis
from the “information-for-all” environment to a “knowledge-for all” paradigm. Some
have even called it the Internet 3. Healthcare is undoubtedly one of the major areas in
which we are beginning to see revolutionary changes that are attributable to the emer-
gence of the knowledge engineering concepts. Bali and his eminent authors have done
great justice to the book’s contents, by pooling together many different dimensions of
knowledge management into this book.
“Knowledge” is the key phraseology that has become the guiding mantra of future
systems. As aptly stated by the National Library of Medicine’s report on the next
generation of their program on the Integrated Advanced Information Management Sys-
tems (IAIMS), “if the challenges of the 20th century IAIMS was tying together all of
the heterogeneous systems that an organization owned, the principle challenge of the
next generation of IAIMS efforts is effective integration of information, data, and knowl-
edge residing in systems owned and operated by other organizations.” There is no
doubt that, in recent times, we are beginning to see that knowledge revolution. Ad-
vances in the field of medical informatics are a clear testimony of newer technology
developments facilitating the storage, retrieval, sharing, and optimal use of biomedical
information, data, and knowledge for problem solving. These are reflected in the design
and implementation of comprehensive knowledge-based networks of interoperable
health record systems. They provide information and knowledge for making sound
decisions about health, when and where needed.
ix
This book delves into the technologies of knowledge management beginning from the
concepts of knowledge creation and extending to the abstraction and discovery tools,
as well as integration, knowledge sharing and structural influences that need to be
considered for successful decision making and global coordination.
There are three major and somewhat overlapping areas of knowledge engineering appli-
cations, which have dominated the healthcare sector: education, patient care, and re-
search. Knowledge stimulates creation of new knowledge and the management and
dissemination of such new knowledge is the key to the building of modern educational
infrastructure in medicine and healthcare. Whether it is the utility of the electronic
cadaver in anatomy education, or the capturing of evidence-based medical content, or
the design of a rule-based expert system in disease diagnosis, technology develop-
ments have stayed focused on creating the knowledge discovery tools, with insights
mainly borrowed from the Artificial Intelligence methodologies. These include machine
learning, case-based reasoning, genetic algorithms, neural nets, intelligent agents, and
stochastic models of natural language understanding, as well as the emerging compu-
tation and artificial life. The central dogma in healthcare research is to ensure the
patient to be the principle focus, from diagnosis and early intervention to treatment and
care. Especially with the advent of the Internet, clinical knowledge management is a
topic of paramount importance. As Bali et al. have pointed out in the opening chapter of
this book, “future healthcare institutions will face the challenge of transforming large
amounts of medical data into clinically-relevant information for diagnosis, to make
recognition of it by deriving knowledge and to effectively transfer the knowledge ac-
quired to the caregiver as and when required.”
Creation of new knowledge from existing knowledge is what makes the field grow. Bali
and his authors present in the book a number of discussions of the available technolo-
gies to stimulate the future expansion. Knowledge repositories are increasingly getting
larger in size and complex in structure, as seen for example, in the hospital information
systems. Such massive data explosions require efficient knowledge management strat-
egies, including the critical need to develop knowledge retrieval and data mining tools.
The latter mostly consist of appropriate software-based techniques to find difficult-to-
see patterns in large groups of data. The effective analysis and interpretation of such
large amounts of data collected are being enhanced by applying machine vision tech-
niques while at the same time we are looking at machine learning mechanisms to pro-
vide self-learning instructions between processes. These are all some of the modern
day innovations that are providing the capabilities to extract new knowledge from the
existing knowledge. Healthcare is benefitting immensely from these applications, mak-
ing it possible for healthcare professionals to access medical expert knowledge where
and when needed.
Medical knowledge stems from scores of multiple sources. The design principles for
the management of knowledge sharing and its global impact are a complex mix of issues
characterized by varying cultural, legal, regulatory, and sociological determinants. What
is especially important is to improve the overall health of the population by improving
the quality of healthcare services, as well as by controlling the cost-effectiveness of
medical examinations and treatment (Golemati et al.). Technology’s answer to this lies
in the vast emergence of clinical decision support systems in which knowledge man-
agement strategies are vital to the overall design. I am very pleased that the authors
have done an excellent job by taking a succinct view of what the issues are and the