The health care industry is increasingly becoming a knowledge-based community that depends critically on knowledge management (KM) activities to improve the quality of care. Utilizing knowledge management systems (KMS) to manage medical information and health care knowledge to support the full spectrum of knowledge needs in the nursing process has become an important issue for nursing professionals.
Over the past decade, with the rapid advance in information technology (IT), the health care industry has increasingly embraced new IT and net-enabled applications in the search for opportunities for higher-quality care (Wu, Hung, Hisa, & Tsai, in press). Recently, a growing interest in the electronic health (e-health) concept is causing significant changes in the healthcare environment (Lin & Umoh, 2002). As health care industry moves into the e-health age, health care organizations are becoming knowledge-based communities connected to hospitals, clinics, pharmacies, and customers for sharing knowledge, reducing costs, and improving the quality of care. Thus, the success of e-health depends critically on the collection, analysis and seamless sex change of clinical and medical information or knowledge within and across the above organizational boundaries (Bose, 2003). Consequently, as e-health has become the norm, the barriers to transparent and accessible information are dissolving. Medical information and clinical knowledge management issues are beginning to emerge. The key challenges in these issues are: (1) how to integrate several disparate and standalone information repositories into a knowledge-based repository to create a single version for healthcare professionals, and (2) how to effectively manage this disparate knowledge using available IT facilities.
Over the past decade, with the rapid advance in information technology (IT), the health care industry has increasingly embraced new IT and net-enabled applications in the search for opportunities for higher-quality care (Wu, Hung, Hisa, & Tsai, in press). Recently, a growing interest in the electronic health (e-health) concept is causing significant changes in the healthcare environment (Lin & Umoh, 2002). As health care industry moves into the e-health age, health care organizations are becoming knowledge-based communities connected to hospitals, clinics, pharmacies, and customers for sharing knowledge, reducing costs, and improving the quality of care. Thus, the success of e-health depends critically on the collection, analysis and seamless sex change of clinical and medical information or knowledge within and across the above organizational boundaries (Bose, 2003). Consequently, as e-health has become the norm, the barriers to transparent and accessible information are dissolving. Medical information and clinical knowledge management issues are beginning to emerge. The key challenges in these issues are: (1) how to integrate several disparate and standalone information repositories into a knowledge-based repository to create a single version for healthcare professionals, and (2) how to effectively manage this disparate knowledge using available IT facilities.
Managing knowledge of medical professionals within health care organizations is critical to prosper in competitive e-health environments (O’Dell & Grayson, 1998). Nurses are knowledge intensive and primary professional in health care organizations. They are required to take new nursing knowledge and experience that can be acquired through various net-enabled applications or Internet. Nursing professionals are being asked to do more with less in such context. While their nursing care responsibilities have increased, the IT support of nursing practices appears to lag far behind. This lack of IT support for nursing professionals has become an issue of significant importance. E-health requires better access to IT applications to analyze hospital-wide nursing care information and knowledge in the nursing process. As IT capabilities are extended to support a knowledge-centric view rather than simply a data-centric view, nursing practices must begin to take advantage of these new capabilities. A well-designed IT-based knowledge management system (KMS) has become an ever more central force in improving the quality of care in competitive e-health environments.
There is a general consensus that IT-based technologies could be applied to the development of healthcare KMS (Heathfield & Louw, 1999; Ryu, Ho, & Han, 2003). For instance, Kerwin (2002) indicated the importance of the Internet and related technologies in improving healthcare quality and medical KM. Selsy, Eisenberg, Hersh, & Buitendijk (2001) reported that the electronic portal(e-portal) enables hospitals to integrate the medical knowledge into clinical workflow. Bose(2003) argued that a well-designed healthcare KMS infrastructure should incorporate necessary healthcare processes, tools, and techniques. However, very little is actually known about how to effectively integrate the technologies, knowledge management activities and the enabling IT in facilitating nursing knowledge management practices. To address this problem, a comprehensive framework that guides the design of a nursing KMS is necessary.
Knowledge management systems refer to a class of information systems applied to manage organizational knowledge (Alavi & Leidner, 2001). That is, they are IT-based systems developed to support and enhance the organizational processes of knowledge creation, storage, transfer, and application (Barnes, 2002). Many knowledge management initiatives rely on IT as an important enabler. Recently, progress in IT provides KM capabilities that were not possible before. Examples include finding an expert of recorded source of knowledge using online directories and searching databases; sharing knowledge and working together via Internet or Intranet; accessing to information on past projects; and learning about customers’ needs by mining transaction data.
In light of the extant literature, three main KMS functions are included: (1) the codifying and sharing of internal best practices (O’Dell & Grayson, 1998); (2) the creation of corporate knowledge directories (Ruggles, 1997), and (3) the creation of knowledge networks (Robey, Boudreau, & Rose, 2000). In fact, many new IT applications have been continually implemented to supportorganization knowledge management. Liao (2003) classified such KM technologies and applicationsinto six categories: knowledge-based systems (KBS), data mining (DM), information and communication technology (ICT), artificial intelligence (AI) / expert systems (ES), database technology (DT), and modeling. Healthcare organizations should design and develop a nursing KMS that facilitate the integration and sharing of the collective experience and knowledge for nurses (Forgionne, Gangopadhyay, Klein, & Eckhardt, 1999). A well-designed nursing KMS should provide nurses clinical information and knowledge where, when, and how they want it. Further, it can help eliminate the traditional separations of time and space, for example, physician office, rehabilitation, patient home, and chronic care office.
Nursing practices are increasingly being encoded in the form of nursing guidelines and protocols that drive health care service delivery. Nurses especially use the health care knowledge combined with their know-how and experience to deliver health care services. Today, this work can be enhanced by enabling technologies such as a KMS.The nursing KMS designers should decide on which practice(s) of the nursing process will focus on and link it to and employ enabling IT facilities as necessary. For example, if the intent is to provide nurses with the ability to search for detailed medical information to assist in assessment tasks, then a nursing KMS with detailed structured information and personalized healthcare records must be provided. Moreover, a nurse can also use knowledge directories (such as e-portal), search engines, and visualization (such as PACIS) to view other patient information sources.
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Barnes, S. (2002). Knowledge management systems: theory and practice. Thomson Learning Press.
Bose, R. (2003). Knowledge management-enabled health care management systems: Capabilities, infrastructure, and decision-support. Expert Systems with Applications, 24, 59-71
Davenport, T. H. & Prusak, L. (1998). Working knowledge. Harvard Business School Press.
Englebardt, S. P. & Nelson, R. (2002). Health care informatics: An interdisciplinary approach. Mosby Press.
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