Applying the Practice Theoretical Perspective to Healthcare Knowledge Management

A primary focus of healthcare knowledge management is to provide clinical practitioners with appropriate knowledge resources for making the best patient care decisions. Over the years, advances in information technology have enabled a knowledge-rich healthcare system with accessible databases and repositories. However, healthcare knowledge remains largely under-utilised, and often wrongly utilized, in patient care decision making. As greater considerations of social and organizational contexts began to emerge, concepts and techniques of the practice theoretical perspective have gained relevance as a tool for providing a rich set of findings required to making sense of how healthcare knowledge is utilized at the point of care and for designing systems to support that use. In this chapter, we describe a research effort at developing an e-health system for clinical decision support and knowledge sharing across organizational and geographical boundaries using the practice theoretical approach. The chapter concludes with a roadmap for the critical goal of designing healthcare knowledge management systems and user interfaces that meet the information, collaboration and workflow needs of healthcare professionals at the point of care

Integrated clinical pathway management for medical quality improvement-based on a semiotically inspired systems architecture

Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems