Saturday, March 19, 2011

The Process of CKM

The process of clinical knowledge management involves the capturing, classifying, retrieving, evaluating and sharing of clinical data and information in a way that creates actionable knowledge and provides the context for effective care decisions and therapeutic actions.

But what does this really mean?
Capturing: The process of gathering data while it is being used for a separate purpose
Joe Smith visits his PCPs office for an annual exam. While there, his weight is measured and entered into the electronic medical record.
Classifying: The policies and procedures that determine where, how and when data is stored
The office policy is to measure and record weight in kilograms to one decimal point. The weight is a mandatory field in the electronic intake form and must be completed to finalize the nursing documentation.
Retrieving: The act of collecting data in an organized way from wherever it has been stored
A researcher writes a program to query the electronic medical record and gather all recorded weights at the office of Joe Smith’s PCP.
Evaluating: The purposeful analysis of retrieved data to generate information and create knowledge
The researcher determines that the average weight of patients at the office of Joe Smith’s PCP increased 3 kg after the opening of a new ice cream shop.
Sharing: The communication of actionable knowledge in a manner that allows for effective care delivery
The researcher presents his findings at a staff meeting with all the physicians at the office along with the nutritional information provided on the ice cream shop’s website.
Action:  The purposeful activities resulting from the knowledge that has been shared.
The physician group meets with the owner of the ice cream shop, and agrees to sponsor a nutritionist to work with the owner to develop lower calorie options.
Since the weights will continue to be captured at each visit, the process of clinical knowledge management can be repeated to determine the effect of the physician’s intervention.

The above example may seem straightforward, easy, and even trivial. But that’s because it used a single data element. When examining actual clinical questions with dozens of data elements and millions of datum, the process is far from straightforward and easy. And the generation of actionable knowledge for a real clinical problem is rarely trivial.

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