KM in Clinical Dentistry

Dr.Kannika Chukiatmun DDS.,MD.,MsIT At Thammasart U.

23 Jan 08

Explicit knowledge VS Tacit knowledge

Documented Codified Archived

Customer list Patent Trademark Business plan Marketing research

Not documented Difficult to identify

Know how Experience Personal talent Intuitive Innovative

Evolution of KM

Wave 1 IT dominated approach Misleading dichotomy of tacit/explicit ?

Wave 2 Importance of relationships, connections Recognized rise of social capital Decline of CKO ?

Wave 3 COP Focus on how people make decision Alignment with business imperative, quality management, risk

management etc.

Knowledge Society I

“Knowledge Explosion”

Productivity Competitiveness Market mechanism Survival of the fittest

Knowledge Society II

“Knowledge Management”

Harmony Learning Organization Community of Practice Knowledge Broker Knowledge Master : Content Management (Informaticist Model)

Excellent Center

Performance Excellence Organization Competency Learning Knowledge Blended-Learning

Technology

Choosing Your Knowledge Management Strategy

KM has been applied to a very broad spectrum of activities designed to manage, exchange and create or enhance intellectual assets within an organization, and that there is no widespread agreement on what KM actually is.

Knox Haggie, John Kingston (2003)

Choosing Your Knowledge Management Strategy

IT application that are termed “KM applications” range from the development of highly codified help desk systems to the provision of video conferencing to facilitate the exchange of ideas between people.

One fact that does seem to be agreed on is that different situations require different knowledge management strategies.

KM Strategies

Classification By Knowledge Nonaka & Takeuchi’s Matrix of Knowledge Types Boisot’s I-Space Model

“The process of growing and developing knowledge assets within organizations is always changing.”

Classification By Business Process APQC International Benchmarking Clearing house Study Mckinsey & Company

KM Strategies

Classification By End Results Treacy & Wiersema’s Value Disciplines Zack’s Knowledge Strategy

A Synthesised Approach Binney’s KM Spectrum (2001)

KM Strategies Derek Binney (Binney, 2001) provides a framework, The KM

Spectrum, to help organisations make sense of the large diversity of material appearing under the heading of KM, and to help them assess where they are in KM terms. His focus is on the KM activities that are being carried out, grouped into six categories:

Transactional KM: Knowledge is embedded in technology. Analytical KM: Knowledge is derived from external data sources,

typically focussing on customer-related information. Asset Management KM: Explicit management of knowledge assets

(often created as a by-product of the business) which can be reused in different ways.

Process-based KM: The codification and improvement of business practice and the sharing of these improved processes within the organisation.

Developmental KM: Building up the capabilities of the organisation's knowledge workers through training and staff development.

Innovation/creation KM: Fostering an environment which promotes the creation of new knowledge, for example through R & D and through forming teams of people from different disciplines.

Examples of technologies that can support or enhance the transformation of knowledge :

IBM Journal “Knowledge management technology” by A. D. Marwick Tacit to Tacit Tacit to Explicit

E-meetings Answering questions

Synchronous collaboration (chat) Annotation

Explicit to Tacit Explicit to Explicit

Visualization Text search

Browsable AV of presentations Document categorization

KMS workout Knowledge Engineering Approach to KM

Mapping CommonKADS task type to The KM spectrum

Selecting KM Strategies Link the value disciplines with the Strategies

Customer intimacy (CRM, Data mining, Business Intelligence) Operational excellence (Best Practice Transfer, TQM, BPR,

Process Improvement) Product Leadership (choose KM strategies supporting

Communities, Collaboration, Discussion Forum)

Identify External Driver Synthesized approach

Key concept : ….more than simply collections A collection of data is not information .

A collection of information is no t knowledge .

A collection of knowledge is not wisdom .

A collection of wisdom is not truth. (Ref: Knowledge Management—Emerging Perspectives : Gene Bellinger)

1

Key concept : ….more than simply collections

Ref: Knowledge Management—Emerging Perspectives

Quote - Neil Fleming

Context =attribute of meaning +association

Without context = without meaning

Y is a meaningful X

1

Knowledge = Content + Context

Key concept : ...Individual – Organization synergy by making most benefit from Utilizing Tools and Technology Tacit / Implicit / Explicit Knowledge

(ความรู้��ฝังลึ ก/ความรู้��แฝัง/ความรู้��ที่��ตี�พิ�มพิ�-เปิ�ดเผย-แสดงได�)

2

Tacit Expert

connectivity Implicit

Knowledge Presentation

Knowledge acquisition / extraction

Explicit KnowledgeInformation

retrieval

KM : What model ? !!!

ปิลึาที่� Virtual

ปิลึาที่� ปิลึาที่�เปิ นๆ

KM in Clinical Dentistry

Dr.Kannika Chukiatmun DDS.,MD.,MsIT Thammasart U.

23 Jan 08

Present situation

Information overload Paradoxical information Technologies have increased the dissemination

of information, but worsened the problem of unwanted information

Difficulty in retrieval of relevance information

The foreseeable future

Rapid access to a growing body of knowledge : “Competitive intelligent”.

To find out “Competitive advantage”. The skill required by the practitioner is to know

how to sift and find information, rather than how to remember facts.

Health informatics is going to be an essential clinical skill.

The foreseeable future Access to the information by itself will not result

in its use or raise the quality of service. However, as patient and public gain access to

clinical information there is a rising that professional staff will also be “information empowered”.

Service organization and delivery are “information driven and information dependent”.

Record keeping and the use of information is an important factor in delivering quality patient care.

The purposed KM model for clinical practice

The purposed outline

The need to manage information-overload, paradoxical information, unwanted information, effective retrieval of wanted information and bodies of knowledge

To ensure that learning about the best practice actually takes place and as a result, quality standards are actually implements.

To revise and develop strategies that are well-adapted to dynamic and complex process of health care service for the patients

Problems How can information / knowledge be transferred

to working doctors? What makes health care service to archive best

practice? The provision “catch up” or “consolidate”

programs for established clinician. (It is apparent that there are many gaps in current level of awareness, attitude, knowledge and skills about health information amongst clinicians.)

Practice VS Process

The way tasks are done

Spontaneous Improvised Responds to a

changing, unpredictable environment

Driven by tactic knowledge

Web-like

The way tasks are organized

Routine Orchestrated Assume a predictable

environment Relies on explicit

knowledge Linear

Knowledge

Explicit knowledge Implicit / Tacit knowledge Situation specific knowledge Mundane science

Explicit knowledge

Knowledge Access Knowledge Validation Knowledge Valuation Knowledge Optimization Knowledge Dissemination

Explicit knowledge

Knowledge AccessKnowledge divide / Digital divideUbiquitous

Knowledge Validation Knowledge Valuation Knowledge Optimization Knowledge Dissemination

Explicit knowledge

Knowledge Access Knowledge Validation

Research Methodology Critical Appraisal of evidences Systematic Review

“ Evidence-base medicine / dentistry ” Knowledge Valuation Knowledge Optimization Knowledge Dissemination

Explicit knowledge

Knowledge Access Knowledge Validation Knowledge Valuation

AssessmentCost-benefitSocial, Economy, Culture value etc.

Knowledge Optimization Knowledge Dissemination

Explicit knowledge

Knowledge Access Knowledge Validation Knowledge Valuation Knowledge Optimization

Knowledge MasterPractical education / training

Knowledge Dissemination

Rules & regulations

Standard & Norms

Best practice

Manuals & Lesson learned

Explicit knowledge

Knowledge Access Knowledge Validation Knowledge Valuation Knowledge Optimization Knowledge Dissemination

Knowledge Sharing / BrokeringEdutainmentCollaborative tools

Knowledge cycle

กำ��หนดรูปแบบองค์�ค์ว�มรู �

(Capture Knowledge)

สรู��งองค์�ค์ว�มรู �

(Create knowledge)เผยแพรู�องค์�

ค์ว�มรู �(Disseminate knowledge or

knowledge transfer)

ปรู�บปรู�งองค์�ค์ว�มรู �

(Refine Knowledge)

จั�ดเกำ�บองค์�ค์ว�มรู �(Store

knowledge)จั�ดกำ�รูองค์�ค์ว�มรู �

(Manage knowledge)

Knowledge Engineering

Knowledge acquisition

Knowledge validation

Knowledge representation

Inferencing

Explanation and justification

การู้ใช้�ความค�ด(Intelligence Phase)

การู้ออกแบบ(Design Phase)

การู้เลึ'อกแนวที่างที่��ด�ที่��ที่��ส(ด(Choice Phase)

การู้น)าไปิใช้�(Implementation phase)

การู้ตี�ดตีามผลึ(Monitoring Phase)

กรู้ะบวนการู้แก�ไขปิญหา(Problem solving process)

กรู้ะบวนการู้ตี.ดส�นใจ(Decision making process)

Thinking

Critical Thinking Creative Thinking Decision Making Problem Solving

Model for knowledge management in primary care

Explicit

Knowledge

Tactic

Knowledge

Information-centered

EBM Domain Intranet Domain

Learner-centered

Clinical Audit Domain

Mentorship Domain

The Future of KM

Implication C for KM:

The best use of ‘knowledge professionals’ is working in tandem with (or even as part of) the organization’s IT professionals, devoting the bulk of their time to scheduled, one-on-one ‘personally productivity’ sessions with front-line workers to improve these workers’ competency with worktools, and ability to do their own research & analysis.

Mentor Apprenticeship

“On the Job Training”

Knowledge Society II

“Knowledge Management”

Harmony Learning Organization Community of Practice Knowledge Broker Knowledge Master : Content Management (Informaticist Model)

Outcomes and Standard for Health Informatics

Communication Authoring and reading health Clinical language Team-working

Knowledge management Data quality and management Confidentiality and security Secondary uses of clinical data and information Clinical governance and service audit Working clinical systems Telemedicine and telecare

Outcomes and Standard for Health Informatics

Knowledge management

Understand decision support, expert systems and artificial intelligence and their use in the support of clinical activity.

Using accredited health related online sources be able to summarize, evaluate / appraise and present information / evidence relevant to a particular healthcare issue.

Examine and understand current key initiatives and developments in IT based knowledge resources.

Understand the implications of the development and local implementation of care pathway / guidelines.

Appreciate and analyze sources of information about patient and public views of and expectation of health and relayed service.

The Comprehensive approach KM model in Clinical Dentistry

Content management + Organizational learning + e-learning Best practice, performance support tools, collaboration tools On-the-job performance support Excellent center Service organization/delivery are “information driven and information

dependent”. Record keeping and the use of information is an important factor in

delivering quality care.

The Comprehensive approach KM model in Clinical Dentistry

Informaticist Model ………. “Information Empowered” Knowledge Access Knowledge Validation Knowledge Valuation Knowledge Optimization Knowledge Dissemination

Clinical Decision Making

Clinical Reasoning

Clinical Problem Solving Skills

Competencies for Complexity Management

Self-directed learning

Be-aware

Knowledge is between your

two ears…. If you want to

manage it….. Manage here !

R2R : Routine to Research

Traditional (Modern) ResearchStatistics Clinical research / EpidemiologyEvidence based medicine

Post-Modern ResearchData mining / Knowledge base / AIBringing the evidence to the

point of careClinical research / Community-

based / Population-based Medicine

R2R : The extension - BMDE

Evidence-based Medicine

Personalized Medicine

Translational Medicine

R2R : The extension - Management

EBP + HTA HIS +HIM

Personal Medical Record + Remote sensor device

BMDEBI

KM technologies for global organizationFlow of knowledge :

Identify, Validate, Codify, Store, Retrieve and Share

Knowledge resource directories / Corporate Yellow Pages

CRM / Contact management

Massaging / E-mail

Groupware or collaboration technologies

Remainders / Web Calendars

Decision support systems

Workflow and tracking

Web casting

E-learning / Web based training / multimedia based training / CBT

Content management

Portals BI / Data

warehousing

Document management

Intelligent agents

Search engines

COP to N

OP

tools

Key concept : ...Individual - Organization synergy By making most benefit from Utilizing Tools and Technology““KM : why now?”KM : why now?”

Knowledge Engineer encodes Expert knowledgefor distributing and sharing of both theoretical and practical knowledge in the organization (for the other to “Learn”) . “Knowledge Engineering Techniques”

Competitive advantage for organization Organization behavior VS “2T for 2P” PTTP : “4 together for KM”

2

R2R

Data Processing pipeline

Open source

Invention Innovation

(research output

research out come)

KM tools

Data mining toolsDB

Warehouse

WWW

KM

R2R

Data mining