Knowledge Management in Public Health

Jay Liebowitz, Richard A Schieber, Joanne Andreadis, Jay Liebowitz, Richard A Schieber, Joanne Andreadis

• Publisher: CRC Press
• Year: 2018
• eBook ISBN: 9781351811644
• Edition: 1
• Topic: Computer Science
• Subtopic: Information Technology
• Index: Computer Science

Close collaboration across agencies and international borders is mandatory for public health officials. A powerful tool for sharing knowledge, knowledge management (KM) can help public health professionals quickly collaborate and disseminate knowledge for solving public health issues worldwide. The latest initiatives for reforming healthcare have put the spotlight on the need for maximizing resources. In addition to providing a platform for sharing knowledge, KM can help healthcare professionals do more with less. One tool, two problems solved. Yet the sharing of knowledge and KM continues to be a major challenge in the public health field.

Knowledge Management in Public Health provides a general introduction to KM and social networking in the public health arena. The book begins with coverage of basic principles, components, and methodologies as well as trends and key issues in public health. It includes ten case studies illustrating applications of KM and social networking in public health. The chapters are written by leading individuals from organizations involved in applying KM in public health worldwide. The editors and chapter authors explore the many elements of KM, delineating how and why to start such an initiative. They provide specific examples of the development and value-added benefits of KM in a variety of public health environments.

Tough or quick decision making has always benefitted enormously from knowledge based on the maximum amount of pertinent information available at the time—this has not changed. What is new in the present public health environment is the need to do this more often, with fewer personnel available, and increased expectations relative to the services expected by the public. Better use of information under a KM system is well suited to serve that purpose. This book explores the many ways to use KM to anticipate potential health issues and quickly resolve key incidents when they occur.

II

KNOWLEDGE MANAGEMENT APPLICATIONS IN PUBLIC HEALTH

Chapter 5

Examples of Knowledge Management in Public Health

Angela M. Fix, Sterling Elliott, and Irene Stephens

Contents

Introduction

Challenges of Knowledge Management

Components of Knowledge Management

Governance

Minnesota: Minnesota e-Health Initiative

Content

California: Targeted Content

Processes

Technology

Wisconsin: Enterprise Architecture

Kentucky: Louisville Health Information Exchange (LouHIE)

Conclusion

Knowledge Management Resources

Acknowledgments

Introduction

Definitions of knowledge management range from the practical to the conceptual and philosophical. The Association of State and Territorial Health Officials (ASTHO) publication Knowledge Management for Public Health Professionals provides a broad conceptual framework for better understanding knowledge management and its implications for public health. Fundamentally, knowledge management is the process of organizing and analyzing information to make it understandable and applicable to problem solving or decision making. This basic definition underlies the use of knowledge management by public health organizations.

This chapter provides an overview of practical approaches to knowledge management in public health and represents an update of the 2005 ASTHO publication titled “Examples of Knowledge Management in Public Health Practice.” The intent of the 2005 publication was to provide public health officials with basic information about the challenges they may face and the components of knowledge management they need to consider, and to illustrate examples undertaken by other public health agencies. It also provided a list of resources that public health officials could use to explore these components in greater detail. This updated chapter provides an overview of knowledge management from the perspective of state governmental public health and revisits the case studies highlighted in the original publication.

Challenges of Knowledge Management

Most organizations, including public health agencies, face common challenges in attempting to manage knowledge. These include:

Volume of information: Public health agencies manage vast quantities of information, most of which is collected for a specific purpose and not intended for “information reuse.” The sheer volume of information managed by most agencies is both a strong incentive as well as an impediment to being able to manage knowledge.

Information security: Public health information is derived from many sources and is frequently considered private or confidential. Though individual datasets may not reveal personal information, combining information from different sources might inadvertently reveal personal information about individuals. Agencies must ensure access controls to maintain information security and confidentiality.

Quality: Ensuring and understanding data quality are critical requirements for knowledge management but difficult to do. Standardized methods for processing data are needed, as is good documentation (or metadata). Data collected for one purpose and integrated with other data or used for another purpose may no longer meet data quality parameters established during initial data collection.

Ability to access and use information: While many agencies collect and compile large volumes of information, few have established the means to access and analyze the data with appropriate tools. This challenge is related to the challenge of maintaining security and the means for users to understand the quality of the data.

Components of Knowledge Management

There are four core components that an organization must consider when attempting to manage its knowledge:

■ The governance or leadership that commits to an organizational structure capable of managing knowledge and the subsequent policies that guide the use of the technology.

■ The quality and quantity of the data and information that is to be managed (the content).

■ The processes, standards, or guidelines that will be used to collect, manage, and disseminate information.

■ The technology that supports all of the above.

Many public health agencies are currently developing systems to better understand, manage, and use their existing information, as well as collaborating to create new repositories of knowledge. These activities require commitment and input from all levels and perspectives within the agency. Senior management must provide the leadership to develop a clear understanding of the business needs for knowledge and commit to the changes knowledge management requires. This leadership represents the governance component. Operations staff and content experts can contribute to the process through documentation and organization of the content. Involvement from information technology staff is critical when deploying the technology infrastructure. Technology expertise helps to facilitate knowledge management, but leadership sets the course and drives it through intra-agency policies and large state government policies that set the parameters or use.

Governance

The first step in knowledge management is to understand the business of the agency and how data, information, and knowledge support that business. An agency requires leaders willing to ask difficult questions about what and how work is done. This includes understanding where knowledge exists, how information flows, what data are collected, and who is involved in these processes. This is all part of the “governance” of knowledge management. Organizations must have the ability to critically evaluate information-sharing structures and identify potential bottlenecks. Original mandates of organizations may change, but the organizational structure often remains tailored toward the original mandate. Information silos or stand-alone information systems can often result from this organizational inertia; however, they are more likely the results of siloed and one-time funding streams. In the classic information silo, the focus is inward, and all communication is vertical. Managers in the silo serve as information gatekeepers, making coordination and communication among departments difficult to achieve. Information silos usually exist because:

■ There are no perceived benefits or incentives to an individual or division for sharing information.

■ There are no established forums where individuals from different divisions can share information.

■ The information that is shared in its original collection format may not be meaningful to individuals outside of the collecting office.

Organizations have adopted a variety of strategies to provide governance. States have begun to tackle the issue of information silos among public health and health care sectors by supporting health information exchange efforts. In Minnesota, the Minnesota e-Health Advisory Committee was charged by the state legislature with making recommendations to the commissioner of the Minnesota Department of Health (MDH) on achieving the vision of the Minnesota eHealth Initiative. This vision is to “accelerate the use of health information technology to improve healthcare quality, increase patient safety, reduce healthcare costs and enable individuals and communities to make the best possible health decisions.” Specifically, the committee advises on efforts to realize state mandates on the adoption of interoperable Electronic Health Records (EHRs), electronic prescribing, and data standards that support interoperability. System interoperability is the technological base for the exchange of information among public health and health care entities. The committee consists of representatives of all relevant stakeholder organizations, from provider organizations, health care facilities, state and local government, health plans, and consumers.

Effective leadership helps set the direction for a knowledge management approach and maintains the impetus for organizational transformation. Senior management can:

■ Initiate an information-sharing culture.

■ Develop mechanisms that recognize individual efforts to improve the quality of data.

■ Create a forum for discussions on information-sharing needs and identify bottlenecks.

■ Invest in technology that can make information useful and meaningful to many individuals (e.g., visualization tools).

Minnesota: Minnesota e-Health Initiative

A 2007 statute mandated that all health care providers in Minnesota have interoperable EHR systems by 2015. To reach the 2015 goal, the commissioner of the Minnesota Department of Health, in consultation with the Minnesota e-Health Advisory Committee, is charged with developing a plan to realize this mandate, including the adoption of uniform standards to ensure system interoperability. The stress of the legislation on system interoperability shows the foresight of leadership on ensuring the foundation of an information-sharing culture in the state. For its part, the Minnesota e-Health Advisory Committee is made up of twenty-six leaders representing consumers, the health care delivery community, purchasers, and public health. With its varied membership, the committee represents the broad array of stakeholder interests in state health information technology adoption and use. The committee ensures that the activities around health information exchange and technology adoption occur in a focused, coordinated manner.

Much of the work of the Minnesota e-Health Initiative is carried out in workgroups, which provide a forum for discussion and identification of bottlenecks and obstacles to the vision. Work groups make recommendations to the committee on standards; privacy and security; population health and public health information systems; and communications, education, and collaboration, as well as implementation of the 2015 mandate. Specific tasks have included:

■ Developing a statewide plan to ensure that all providers and care-delivery settings have effectively implemented interconnected EHRs by 2015.

■ Selecting health-data standards for the exchange of medication histories, prescriptions, and laboratory test results.

■ Identifying ways to ensure that the adoption of health information technology leads to improvements in quality and in population health.

■ Identifying which public health information systems are most critical to modernize as part of meeting the 2015 mandate and for protecting and improving the public’s health.

The ultimate promise of all the e-health activities is that linking health information across entities adds significant meaning and utility to that information for all participants, from government to health care provider to consumers.

Content

Data, information, skills, and expertise can be thought of as the content resources of an organization. Organizations often create content on an ad hoc basis and seldom have procedures to make the information accessible beyond the individuals who collect and manage the information (frequently perceived to be the only users). Making content electronically available does not necessarily ensure that it will be most useful. Data may need to be reformatted, translated, or integrated to optimize use.

Organizations often provide their staff and customers with an organizational view of their content (e.g., structured by hie...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Foreword
• Preface
• Editors
• List of Contributors
• Section I Knowledge Management: Today and Beyond
• Section II Knowledge Management Applications in Public Health
• Index