Knowledge management for a special class of professional practices. Learning from ehealth

Resum

This work postulates that an eHealth initiative is comparable in many respects to a technology-facilitated Knowledge Management (KM) initiative. eHealth experience provides rich evidence to explore KM policy-making for leveraging professional intellect. Implementing eHealth implies caring for patients with codified knowledge to some extent. With appropriate application of KM strategy, technology can accommodate wiser use of professional intellect to deliver medicine more effectively and efficiently. A simple and quantifiable model has been derived to help determine the optimal KM strategy. This policy device may be tested in further research. A more imperative task is to achieve that ideal state of adopting technology into medical practice. An assessment model has been developed to help in achieving this goal through identifying the causal factors. Methodological triangulation is applied to formulate, operationalise and test a seven-dimensional Computerised Clinical Decision Support System (CDSS) Use model. It involves (i) a multi-stage literature review of different disciplines and (ii) applications of R programming skills and various statistical/psychometric techniques including bootstrapping. VBA programmes have been developed to quicken the sampling process that requires compiling incomplete information from various sources. A multi-stage Factor Analysis process has validated the CDSS Use model. It includes testing the dimensions that have been under-studied or not yet operationalised. The results suggest that Knowledge Quality of a system and medical decision factors are crucial to judiciously adopting HIT into medical practice. They also support integrating the contexts of a profession and the type of system under study into system assessment. This work shows a convincing approach to formulation of a KM model even if the KM process cannot be modelled directly. It offers an objective base to better understand medical/clinical decision-making. This will help govern medical practice to deliver better care under the eHealth (or soon to be KM) climate.