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INFORMATION IN PRACTICE: Jennie Lyons and Alex Khot Infopoints: Managing information overload: developing an electronic directory BMJ 2000; 320: 160 [Full text]

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Why are we still waiting for the chief knowledge officers & their strategies for managing knowledge?

Clare Robson   (9 February 2000)

Evidence Based Practice: Proposing a Global Medical Knowledge Database.

Martin Dawes, Marshall Godwin   (29 March 2000)

A British program that helps

Adrian Midgley   (13 May 2000)

Re: Why are we still waiting for the chief knowledge officers & their strategies for managing knowle

Gray Southon   (23 May 2000)

Why are we still waiting for the chief knowledge officers & their strategies for managing knowledge? 9 February 2000
Clare Robson, Health Intelligence Officer North Wales Health Authority Send response to journal: Re: Why are we still waiting for the chief knowledge officers & their strategies for managing knowledge?	Much has been written about implementing “Information for Health” and the Local Implementation Strategies but what about Knowledge for Health? We are all "drowning in information, and starving for knowledge" [John Naisbitt, Megatrends]. Knowledge enables information and data to be transformed into effective action. The three key components involved in managing knowledge are PEOPLE, Content and Technology. The technology now exists to enable the development of an extensive knowledge management architecture, linking the multitude of "pieces" within the NHS Knowledge base "Jigsaw". Key to success will be the adoption of national standards and best practices including common web-based technological approaches. An excellent example of this is the Digerati “intranet in a box” system currently being developed by Simon Goodchild of the NHS Information Authority (see The Bedfordshire Web as a best practice site: http://nww.beds-ha.anglox.nhs.uk/). Implementing successful Knowledge Management Strategies within the NHS will require nothing less than a Knowledge Mangagement Revolution - a revolution which will require virtually every NHS employee (and the wider health and social care family) to make their own (often unique) contribution. The beginnings of progress towards the establishment of the new profession of NHS Knowledge Management can be seen in the work of Drs Tim Wilson, Paul Robinson, Trefor Roscoe & Tim Ringrose as cited on this site. Drs Roscoe & Ringrose have adopted the term "Knowledge Architect" as an additional function to their normal roles. The roles associated with the development of the NHS Knowledge Architecture should be developed, in the main, as extentions to normal job functions. It will be necessary though, for some roles to become permanent positions - particularly relating to the Knowledge Architects of large NHS Organisations. The Knowledge Hierarchy should consist of the following roles - Knowledge Architect, Knowledge Analysts, Knowledge Authors & Knowledge Workers. These roles are briefly outlined below: Knowledge Architects are responsible for ensuring the KM architecture is funded, designed, built and administered. They should create a successful KM infrastructure in the face of technical, cultural and logistical barriers. They need to mobilise resources and identify information leverage points, as well as undertake knowledge audits. Knowledge Analysts are aligned with the knowledge architecture rather than departmental structure. They assume overall responsibility for specific specialist areas and ensuring users' easy access to information that is useful to them. They also develop end-user profiles to determine critical information needs, conceptual designs and translate them into technical realities. Knowledge Authors handle the day-to-day business of publishing information on a web server or by means of other communication vehicles. They work with the K Analyst to deliver current and accurate information to a specialised audience. Knowledge Workers - the aim should be for all members of staff to achieve this status after formal corporate training and appropriate standards reached. They understand the concept of corporate ownership of data, information and knowledge. They partake in activities related to Communities of Practice where appropriate. They utilise web-based systems to easily retrieve information and make effective contributions to the corporate knowledge base. The biggest challenge will be making appropriate changes to the prevailing corporate cultures and the widespread passive approaches of traditional IM&T professionals. The "Cyber Pioneers" have reached a ceiling in their approaches. They need to learn from "Purchasing Intelligence" lessons from the past and make way for (and join in) the Knowledge Management Revolution.
Evidence Based Practice: Proposing a Global Medical Knowledge Database. 29 March 2000
Martin Dawes, Director centre for Evidence Based Medicine Oxford, Marshall Godwin Send response to journal: Re: Evidence Based Practice: Proposing a Global Medical Knowledge Database.	If every doctor, who produced a critical appraisal in response to clinical uncertainty, shared that learning globally then access to medical knowledge would be greatly enhanced. What are the difficulties facing the knowledge seeking clinician? The Cochrane Library, Best Evidence, Clinical Evidence, or guidelines in hardcopy might be searched. If the answer does not seem to exist in a synthesized format the practitioners might do a Medline search. There is then the problem of actually getting the full text of the article. The next step is appraising the article(s) for validity and to identify the results. The process that should be used when evaluating the different types of individual articles has been formalized and outlined in detail in the series of articles published in the Journal of the American Medical Association (1). This is time consuming and requires skill and practice. Finally the results should be presented in a format that is easily recognizable (Critically Appraised Topic - CAT) such as that used by the Journal of Evidence Based Medicine, with a declarative title, bottom line and comments relating to real patients. Realistically it is practical for a clinician to question, search, select, acquire the paper(s), appraise and act only 3 or 4 times a year. More importantly that knowledge remains inaccessible to any other professional. If we could share these appraisals on a web based (& CD- ROM) database then we could avoid a massive duplication of effort. Secondly we could make access to the knowledge very much faster. The Global Medical Knowledge Database will match each clinical query as closely as possible with both answered and unanswered questions. If there is an answer the software will display this, in the form of a CAT, automatically. If the question is unanswered the doctor will be able to see whether someone is trying to answer it (and can offer to help). If the question were not on the database then the doctor would be prompted to post the question. Doctors offering to answer questions would search, appraise, and synthesize the evidence into a summary answer using free software available from the Centre for Evidence Based Medicine. The doctor would then post the answer, via a peer review process, to the Database so the next person finds the answer in the database and does not repeat this work. The non-profit making database will have 24-hour access, be comprehensive, valid, up-to-date, and easy to search providing answers to questions within seconds. References 1. Guyatt GH, Rennie D. Users' guides to the medical literature [editorial]. JAMA 1993;270(17):2096-7.
A British program that helps 13 May 2000
Adrian Midgley, GP Exeter Send response to journal: Re: A British program that helps	Good stuff here, but while WAX has some benefits in reducing the volume of the hypertext on the Web, stopping down the flow a bit to let it be interpreted, my Practice is still getting a lot of very quick usefulness out of Idealist. Originally by Blackwell, Idealist is a program we have used for years, and I am only just beginning to think we might manage the same searchability on ht://dig or managing gigabytes, both of which are int(er|ra)net search engines, the former form the University at San Diego, the latter at The Digital Library of New Zealand. Rapid searching on a full free text index is at least as valuable as careful construction of books and reading via a hierarchy.
Re: Why are we still waiting for the chief knowledge officers & their strategies for managing knowle 23 May 2000
Gray Southon, Senior Lecturer in Knowledge Management University of Technology, Sydney, Auatralia Send response to journal: Re: Re: Why are we still waiting for the chief knowledge officers & their strategies for managing knowle	It is good to see some recognition of the concept of knowledge management in health - some years after many other industries. However, Claire Robson needs to consider the inherent nature of knowledge in health services before prescribing rather unproven technologies and titles. Health has always been very knowledge intense and has well established knowledge management systems such as professional colleges and education and research institutes. These form the basic skills, values and capabilities of our front line knowledge workers - the clinical staff. While these systems are far from perfect, they must be the centre of any understanding of knowledge and what initiatives would be most effective. Gray Southon