Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 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.

PubMed Disclaimer

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

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kohn L, Corrigan J, Donaldson MS. Institute Of Medicine. The National Academy Press; Washington, DC: 2000. To Err Is Human: Building a Safer Health System. - PubMed
    1. Committee on Quality of Healthcare in America . Institute Of Medicine. The National Academy Press; Washington, D.C.: 2001. Crossing the Quality Chasm: A New Health System for the 21st Century.
    1. Linder JA, Ma J, Bates DW, Middleton B, Stafford RS. Electronic health record use and the quality of ambulatory care in the United States. Arch Intern Med. 2007 Jul 9;167(13):1400–5. - PubMed
    1. Osheroff JA, Pifer EA, Teich JM, Sittig DF, Jenders RA. Improving Outcomes with Clinical Decision Support: An Implementer’s Guide. Health Information Management and Systems Society; 2005.
    1. Rocha RA, Bradshaw RL, Bigelow SM, et al. Towards ubiquitous peer review strategies to sustain and enhance a clinical knowledge management framework. AMIA Annu Symp Proc. 2006:654–8. - PMC - PubMed

Publication types