Implications of transforming the Patient Record into a Knowledge Management System

In this paper I theorize about how transforming the interpretative scheme for what a patient record is might restructure a health care setting. The observations presented here were obtained when I during three years followed implications of constructing and computerizing a patient record at three different hospitals. The results were then analyzed and interpreted within a framework combining theories about knowledge management with concepts from structuration theory and cognitive theories about schema-use, representations and sense-making. The findings indicate that thinking about the patient record as a knowledge management system might start a horizontal and vertical movement, a movement of coordination and enhancement. I propose that what the employees want to achieve with the knowledge management system depends on what strategy they have for it.interpretative schemes; anesthesia patient record; knowledge management system; knowledge management; structuration theory

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

Knowledge structuring-Knowledge domination. Two interrelated concepts

“Sociology for me is not only about the big institutions, such as governments, organizations, business firms or societies as a whole. It is very much about the individual and our individual experiences. We come to understand ourselves much better through grasping the wider social forces that influence our lives.” ( Anthony Giddens, published at www.polity.co.uk, a leading social science and humanities publisher. ) This quotation helps identify one reason for integrating ideas about knowledge management with concepts from Anthony Giddens structuration theory in the theoretical framework that I use as an analytical tool in this research. Structuration theory concerns itself with the “social forces that influence our lives” and these forces interest me. In the same article Giddens continuous: ”We live in a world of quite dramatic change…There are three major sets of changes happening in contemporary societies and it is the task of sociology to analyze what they mean for our lives today. First there is globalisation….The second big influence is that of technological change. Information technology is altering many of the ways in which we work and in which we live. The nature of the jobs people do, for example, has been transformed….The third fundamental set of changes is in our everyday lives. Our lives are structured less by the past than by our anticipated future”. In this paper I agure that there is a continous structuring going on in society. I therefore concern myself with a pair of twin concepts that are interrelated. The first one is knowledge structuring; the second is knowledge domination. These two concepts are of vital importance when trying to understand, assess and monitor implications of transformations of work processes and tools at work.Knowledge structuring; knowledge domination; knowledge management; structuration theory; cognitive theories; transformations; information technology; globalisation.

Hadron therapy information sharing prototype

The European PARTNER project developed a prototypical system for sharing hadron therapy data. This system allows doctors and patients to record and report treatment-related events during and after hadron therapy. It presents doctors and statisticians with an integrated view of adverse events across institutions, using open-source components for data federation, semantics, and analysis. There is a particular emphasis upon semantic consistency, achieved through intelligent, annotated form designs. The system as presented is ready for use in a clinical setting, and amenable to further customization. The essential contribution of the work reported here lies in the novel data integration and reporting methods, as well as the approach to software sustainability achieved through the use of community-supported open-source components

Challenges and Opportunities for Computerizing the Anesthesia Record

journal articleBiomedical Informatic

MS

thesisHealth information systems are networks of computers employed by health care enterprises to facilitate the delivery of their health care product. Computers originally entered the medical domain solely as tools aimed at the business functions of the hospital. Having demonstrated their utility in this area, computers were perceived by certain innovators to have usefulness in the clinical domain. As clinical computer applications were successfully developed and implemented, they have over time been merged together into systems offering multiple areas of functionality directly impacting the clinical aspects of health care delivery. Such health information systems have now assumed major importance in the provision of health care in a complex medical environment. Although the focus of substantial investment for development and implementation, relatively little work has been done to assess the value of such health information systems. The business information technology literature and the medical informatics literature each include only a small number of published reports examining the value question in an incomplete manner. No generally accepted valuation strategy has been developed for information systems in either the business or health care domains. Several valuation methods with potential applicability to health information systems have evolved: cost-effectiveness / cost- benefit analysis, return on investment, information economics, measurement systems, the Strassmann approach, the Japanese approach, and the strategic value approach. None of these valuation strategies is clearly superior; each has different strengths and weaknesses. A matrix comparing these strategies on the bases of explicitness and ease of implementation is proposed. Intermountain Health Care (IHC) has been instrumental in the development of health information systems and a leader in the application of such technology in clinical health care delivery. IHC's HELP system has played a seminal role as a catalyst to the development of the health information system industry. Although both historically and functionally important, detailed financial information regarding HELP'S origins and implementation no longer exists. Current IHC budget information demonstrates the major financial commitment underway within this health care enterprise totaling approximately $157 million over the last decade and with additional expenditures of$47 to $61 million projected annually through fiscal year 2004. The complex budgetary relationships between HELP and the other health information systems at LDS Hospital further obscure the magnitude of the information technology investment within this institution. Benefits of health information systems are potentially most substantial within the domain of clinical integration. IHC has not implemented any formal valuation strategy for its health information systems, but the ad hoc measurement systems valuation approach applied to date is practical, flexible, and the most appropriate of the available systems. Adequate valuation of health information systems cannot readily be achieved given the existing traditional hierarchical accounting structure; an alternative accounting framework patterned after a relational database is proposed