Knowledge Management in Evidence Based Medical Practices
Kiera F. Verburg
Aug 24, 2022
Unlocking the power of medical data for better healthcare outcomes. Bridging the gap between information overload and evidence-based practices.
The medical industry is a delicate industry in which the effect of any mistake can be a matter of life or death. Therefore, within this industry it is essential that physicians and healthcare workers implement evidence-based medical practices (EBMP). EBMP is the integration of clinical expertise and medical research, decreasing the gap between research and practice (Bordoloi & Islam, 2012). EBMP does not only maximise the likelihood of a positive outcome, it also makes physicians more accountable for their actions (Boateng, 2010). In order, to successfully make these evidence-based decisions, knowledge must be created, stored and managed. The medical industry is in the midst of a knowledge explosion (Shellum et al., 2018). From a theoretical standpoint, this knowledge explosion will increase EBMP and therefore decrease errors. However, in reality health care workers are unable to keep up with the vast amount of knowledge therefore, possibly missing out on important information.
This difficulty to keep up with the amount of information that they are exposed to is not unexpected. Between 2010 and 2020 the amount of globally registered clinical trials published results, has increased by 393,22% (NIH, 2020). Further studies have shown that less than 1% of all this knowledge is likely to be relevant to a particular health care worker or physician (Shellum et al., 2018). However, this 1% may contain crucial information for a health care worker to apply EBMP. Not only is the research output increasing also the amount of sub-specialisation is increasing making it harder to know who has the right expertise to answer their question. This huge amount of information, which is cause for confusion, is also known as knowledge overload and is a concept that the medical industry currently struggles with. This knowledge overload demonstrates the importance and need for successful knowledge management (KM) and the importance of useful tools to apply KM.
The importance of useful tools for KM is highlighted by a recent study on knowledge creation. According to Hongsermeier et al. (2011) technology is an important aspect of knowledge management, especially in cases with such high volumes of knowledge creation. There are multiple information technology (IT) tools that support knowledge creation, storage, retrieval, transfer and application, such as data management and learning tools, knowledge repositories and other data-bases. These tools play a vital role in KM within the medical industry (Butler & Murphy, 2007). In order to support EBMP, the right KM strategy must be implemented. To create a well-rounded view of KM applied to EBMP, we will discuss (1) the implementation of KM in the medical industry, (2) Tools for KM in the medical industry, and finally (3) possible obstacles and future of KM in the medical industry.
Implementation of KM in the Medical Industry
Knowledge is made up of two components: (1) tacit-knowledge and (2) explicit knowledge (Nonaka, 1994). Tacit knowledge can be defined as knowledge that you do not gain from being taught or reading books, but that you gain from personal experiences, therefore making it hard to translate to others. In contrast, explicit knowledge can be defined as knowledge that can be expressed in words, numbers and symbols and that can be stored. EBMP relies on both explicit and tacit knowledge. The ability to create and apply knowledge plays a vital role in this and is created through the interaction of both explicit and tacit knowledge (Anggraeni et al., 2017). In order to widely use the created knowledge, it is crucial that successful knowledge transfer is applied. Knowledge transfer allows for ‘the exchange of explicit or tacit knowledge between two agents, during which one agent purposefully receives and uses the knowledge provided by another’ (Kumar & Ganesh, 2009). This transfer then allows for organisations to exploit and use the existing knowledge (Sheng et al., 2013). This highlights that knowledge that is created has not reached its true potential until it is succesfully shared and although this may seem as a given it is often overlooked and undervalued resulting in poor methods to stimulate knowledge sharing within a company.
Most companies seek KM to gain a competitive advantage. However, within health care institutions it is mainly sought in order to increase effectiveness and efficiency (Pentland et al., 2014). Predominantly, knowledge sharing is a major issue to be addressed in order to increase EBMP. Competency is expected at all levels in the medical industry, meaning all health care professionals are required to continuously learn. To achieve successful knowledge management within the health care system, implementing knowledge sharing and harboring the importance of knowledge creation by their staff’s experience and input from clinical trials, is of great importance. Previous research has also confirmed that the key aspect to achieve this is knowledge transfer (Easterby-Smith et al., 2008). Therefore, to support EBMP, there is a high need for a system that continuously summarizes and appraises literature and experiences.
Tools for KM in the medical industry
In such a large industry as the medical industry, technology plays a vital role in the tools to achieve successful knowledge transfer. These tools should support professional interactions whilst capturing knowledge and best practices from clinical work. However, as knowledge within the medical industry consists of highly tacit and distributed organisational knowledge, the tools should not apply an expert-driven codification approach (Ghosh & Scott, 2005). Previously, the African Medical Research Foundation (AMRF) — a leading knowledge hub in the medical industry — has implemented a KM strategy that implemented tools such as their website, AMRF intranet, AMREF library e-bulletin, digital library and the ART online knowledge hub platform, to support their KM (Shoo, Mataku, Ireri, Nyagero & Gatonga, 2012). This same research showed that similar to AMREF’s approach, healthcare workers would appreciate a ‘wiki’ or a ‘collaboratively editable web page’. Systems such as these would increase both knowledge sharing and transfer. Studies have also shown that healthcare workers prefer electronic formats over hard copies (Karamitri, Talias & Bellali, 2017). However, some studies have also found charts to be very useful, in supporting bulletins promoting best practices.
Further research also showed that healthcare workers only seem prepared to use KM systems when awareness is built, trainings on how to use it are offered, and the usage of it is prompted (Peirson et al., 2012). A further important tool which has proven to stimulate KM in healthcare settings is knowledge brokers. These are employees who are prepared to share their knowledge with others, therefore closing the prevalent gap between theory and practice in healthcare (Booth., 2011). Due to the hierarchical nature of the healthcare system, it is important that leaders recognize knowledge brokers and support them in promoting KM therefore indirectly promoting EBMP.
Obstacles and Future of KM in the Medical Industry
Applying KM in the medical industry has both negative and positive effects on EBMP. However, uncovering these barriers is the best way of overcoming them and providing an even better future for KM in the medical industry. Studies have shown that one of the biggest barriers for KM in the medical industry is time restriction. Healthcare workers expressed that they do not have enough time to read up on new knowledge, nor do they have time to share and explain their best practices with others (Aqeel, 2022). Others also mentioned that they are sometimes simply overwhelmed by the volume of the information that is provided, explaining that it is often too detailed (Roy et al., 2022).
Other common barriers are related to the flow of knowledge. Healthcare workers mentioned that the delays in receiving the information are problematic and even when receiving the knowledge, a lot of it is not relevant to them (Alrahbi et al., 2021). Further studies also suggest that a lack of a sufficient incentive is cause for physicians not to use or share knowledge (Shoo et al., 2012). Many seemed also to be unaware of the existence of certain systems that were put in place to realise knowledge sharing. Other barriers, specifically with respect to EBMP, are that healthcare workers are unable to easily locate needed information due to poor interface usability and problems in accessing the IT applications put in place.
The above displays not only the importance of EBMP but it also describes some of the challenges that EBMP and in turn KM faces. These challenges can be managed and KM within the medical industry is worth investing in as it will not only lower costs but also stimulate EBMP. It is important that the vast amount of available information is made approachable. This can be done by improving user interfaces and implementation strategies. Dashboards or user friendly searchbanks with an underlying robust datawarehouse can stimulate and improve knowledge management. A further possible tool that will improve KM even more is the implementation of an AI in the system. AI’s are already increasingly being used to recognize medical conditions however it may also play a vital role in storing the created information and making it more accessible by using similar algorithm’s that Google uses based on search history (Williams et al., 2015). This way healthcare workers are presented with information that is useful to them based on information they have already reviewed. Moreover, it is also important to appoint a leader and knowledge brokers to stimulate the usage of the systems put in place and create awareness. By applying such strategies KM systems will gradually improve and in turn EBMP will increase too.
The future and innovation of the medical industry relies on EBMP and EBMP is mostly stimulated through KM. We have discussed the multifaceted nature of KM and with complex structures there will always be challenges. However, with the rapid advancing technology we have all the tools in place to make a complex structure more managable and in turn stimulate innovation.
At Kinsman we understand that every situation is unique and we realise that there is no 'one size fits all' method for high qulaity solutions. Interested to see how we can help you manage your knowledge and what systems and methods best suit your situation? Get in touch.