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. 2010 Jan;79(1):44-57.
doi: 10.1016/j.ijmedinf.2009.09.003. Epub 2009 Oct 14.

The state of the art in clinical knowledge management: an inventory of tools and techniques

Dean F Sittig  1 , Adam Wright, Linas Simonaitis, James D Carpenter, George O Allen, Bradley N Doebbeling, Anwar Mohammad Sirajuddin, Joan S Ash, Blackford Middleton
Affiliations

The state of the art in clinical knowledge management: an inventory of tools and techniques

Dean F Sittig et al. Int J Med Inform. 2010 Jan.

Abstract

Purpose: To explore the need for, and use of, high-quality, collaborative, clinical knowledge management (CKM) tools and techniques to manage clinical decision support (CDS) content.

Methods: In order to better understand the current state of the art in CKM, we developed a survey of potential CKM tools and techniques. We conducted an exploratory study by querying a convenience sample of respondents about their use of specific practices in CKM.

Results: The following tools and techniques should be priorities in organizations interested in developing successful computer-based provider order entry (CPOE) and CDS implementations: (1) a multidisciplinary team responsible for creating and maintaining the clinical content; (2) an external organizational repository of clinical content with web-based viewer that allows anyone in the organization to review it; (3) an online, collaborative, interactive, Internet-based tool to facilitate content development; (4) an enterprise-wide tool to maintain the controlled clinical terminology concepts. Even organizations that have been successfully using computer-based provider order entry with advanced clinical decision support features for well over 15 years are not using all of the CKM tools or practices that we identified.

Conclusions: If we are to further stimulate progress in the area of clinical decision support, we must continue to develop and refine our understanding and use of advanced CKM capabilities.

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Figures

Figure 1
Figure 1
Screen print showing the search interface to the Partners Knowledge Management Portal.
Figure 2
Figure 2
Screen print showing table of contents of all clinical knowledge that has been extracted from the clinical information system.
Figure 3
Figure 3
Example of an online, guided discussion in Partners’ eRoom (Note: Clinician identifying information has been obscured for privacy.)
Figure 4
Figure 4
Screen print showing the tool that Kaiser Permanente uses to manage term relationships within their convergent medical terminology. (Courtesy of Robert H. Dolin, MD)
Figure 5
Figure 5
Top: Shows an alert for Deep Venous Thrombosis prophylaxis. Clicking on the >Comment< button at bottom right of the Alert screen (top) brings up theAlert Evaluation screen (bottom). Input to section 1 (check boxes) and section 2 (small comment box) are captured and stored for later reporting and review by rule owner. Input to section 3 (large comment area) is sent to the rule owner and any other person designated via email. Recipients are specific to each rule.
Figure 5
Figure 5
Top: Shows an alert for Deep Venous Thrombosis prophylaxis. Clicking on the >Comment< button at bottom right of the Alert screen (top) brings up theAlert Evaluation screen (bottom). Input to section 1 (check boxes) and section 2 (small comment box) are captured and stored for later reporting and review by rule owner. Input to section 3 (large comment area) is sent to the rule owner and any other person designated via email. Recipients are specific to each rule.
See this image and copyright information in PMC

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