Austin chapter 9

1
Austin chapter 9

• HSPM J713

2
The Knowledge-Enabled Organization

• Seeing the same ideas from different directions

3
Knowledge and the Quality of Care

• The physician as repository of knowledge
• Not good enough
• Too many errors
• More knowledge exists than one person can hold
• Information overload

4
Knowledge and the Quality of Care

• Organizational response
• Sensemaking systems to help decision-makers find
  their way through information overload

5
Knowledge Management

• Adapted idea from consulting firms (like the
  authors?)
• Organization explicitly builds, renews, applies
  intellectual assets to organizational goals

6
The Knowledge-Enabled Healthcare Organization

• Cant just provide more data
• Sounds like an argument for active, rather than
  passive, CPOE.
• Who are the decision-makers? Are there common
  design principles for Computerized Physician
  Order Entry and Executive Information Systems
  (EIS)

7
The Knowledge-Enabled Healthcare Organization

• Baking-in knowledge into workflows
• Reminders
• Alerts
• Evidence-based order sets
• Click-through to relevant scientific literature

8
The Knowledge-Enabled Healthcare Organization

• Analytics based on data warehousing and mining
• Patient-safety dashboards
• Real-time process and outcome reporting

9
Baked-in knowledge examples

• Alert
• Sounded when physician orders a drug that
  interacts badly with or duplicates another drug
  that the patient is taking (or supposed to be
  taking)
• Reminder
• Nurse reminded that its time to give a patient
  his or her meds

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Baked-in knowledge examples

• Evidence
• Provider can read relevant scientific literature
• Abstract from patient record and what doc is
  proposing
• Search literature
• Present choices
• Order sets
• Group drugs or treatments into sets that
  literature or practice says go together
• Automatic billing as stuff is ordered

11
Data Warehouse

• Flow chart symbols with arrows