Implementing Knowledge Management in Primary Care

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Implementing Knowledge Management in Primary Care

• Simon de Lusignan
• GP Woodbridge Hill Surgery
• Senior Lecturer, Primary Care Informatics St
  Georges
• www.gpinformatics.org

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Meaning context independent
High levels of understanding
Wisdom
Requires brain power
Knowledge



Information
Requires processing power
Data
Meaning totally context dependant
Low level of understanding
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Overview

• Why me?
• KM primary care informatics!
• My definition of KM
• Two key KM themes to implement
• Access to information/knowledge base
• Creating learning opportunities
• Conceptual framework for implementation
• Summary

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Why me?

• KM sits within the scope of primary care
  informatics (Lusignan 2002)
• The scientific study of data, information and
  knowledge and how they can be modelled,
  processed or harnessed to promote health and
  develop primary medical care.
• Its methods reflect the biopsychosocial model of
  primary healthcare, the longitudinal
  relationships between patients and professionals
  and the heuristic approach to decision making
  within the consultation.

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Why me? (2)

• Many informatics projects are usefully
• conceptualised using KM models
• Information centred knowledge management
• NeLH-PC http//www.nelh-pc.nhs.uk
• Primary Care National electronic Library for
  Health
• Delivers highly formalised explicit K, called
  EBM
• Learner centred knowledge management
• PCDQ http//www.pcdq.org
• Primary Care Data Quality.
• Clinicians learning from their own data, call
  clinical audit.

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Why me? (3)

• Technology alone changes little
• No benefit in hardware or networking alone
• Often cant see how a new information system will
  achieve any more for me of may patients?

• Technology enables access to information
• People have to be engaged
• See as congruent with organisations aims
• Part of professional development quality
  initiatives

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What is KM?

• in my view

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KM Definition

• Knowledge is what you know
• KM is managing what you know
• Implicit is that you will know more,
• OR learn new things faster
• Therefore
• KM Accelerating learning
• to promote health and primary medical care.

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Two themes to implement

• .Information centred KM
• .Learner centred KM
• Look at tools to implement Explicit and Tacit KM
  within primary care

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KM ThemesExplicit Knowledge
Information Centred KM
Evidence- based medicine
Formalised Explicit K
NeLH-PC
Learner Centred KM
PCDQ
Clinical Audit
Metrics of own Performance (explicit.)
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Tacit knowledge
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KM ThemesTacit Knowledge
Information Centred KM
Heuristic decision- making
Tacit K Know how
Intranet discussion forum
Learner Centred KM
GP Registrar Year
Patient- centred consulting
Mentorship about performance
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Implementing KMin Primary Care

• A balanced portfolio of
• Information centred and
• Learner centred tools
• Containing opportunities for the creation, and
  sharing of both
• Tacit knowledge
• Explicit knowledge
• A simple model combines these elements

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Model for KM in Primary Care
Explicit
Tacit
Information Centred KM
EBM Domain
Intranet Domain
Clinical Audit Domain
Mentorship Domain
Learner Centred KM
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The clinical governance cycle

• a conceptual framework for KM in Primary Care

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Clinical Governance Cycle
Intranet
On-line Clinicians
Access to EBM
Mentorship Domain
Improved Patient Care
Data recording/Clinical Coding
Data extraction
Feedback on Data Quality Quality of care
Clinical audit Domain
Data pooling
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Model implementation

• The model is designed to be implemented at three
  levels
• Individual
• Practice or Clinical Team
• Primary Care Trust
• There needs to be associated metrics some may
  be process measures.

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Summary

• Knowledge Management
• Must incorporate use of brain power
• KM Definition
• Accelerating learning
• Needs to be
• Aligned with strategy
• Part of professional development Quality
  improvement
• Practical model for implementation

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The End!

• Thanks for listening
• Contact
• slusigna_at_sghms.ac.uk
• http//www.gpinformatics.org
• Tel [phone]
• Fax [phone]