Thursday, October 23, 2008

ICKM 2008 - Knowledge Management in Health Care

This is a case study on using KM in Health Care, specifically diabetes care.
Started when a physician looking for solutions for improving health care. Formed a interdisciplinary team with Rutgers University to develop a theory based practice. They developed a social and technical model of KM, looking to impact both the process management and the social relationships.
Phase 1 : modeling and taxonomy
Phase 2 : Case Studies and Hypothesis Formulation
Phase 3 : Pilot & Full study
Theoretical base - Theory of reasoned actions - what factors predict a physician's intention to perform a behavior. Theory of planned behavior - how do physicians perceive their ability to perform a certain behavior.
People's expectations, and the expectations of their social network, influence their behavior. People's environment influences their behavior.
Research sample-> 4 health care practices located in NJ. They were interviewed, observed and surveyed. These observations were used to develop hypothesis.
The 4 were broken out into high performing and low performing groups. One key differentiation was the introduction of the researcher into the organization. The high performing practices introduced the researchers through a series of scheduled meetings and in a organized way. The low performing groups did not have a organized, in person introduction. Instead, the researcher was introduced in a impersonal note included in the pay packet.
Other differentiating factors were: use of manuals and procedures, meetings, face to face communication. High performing practices use manuals and procedures, have less formal meetings and more ad hoc meetings, and use face to face communication more frequently.
Found that Knowledge sharing is being done in practices, but it is not being done well in even the high performing office. So even within the high performing practices, there was not a consistency of practice and procedures. Your level of care varied greatly from one doctor to the next.
Interestingly, coders were not told which practices were high or low performing, but were able to predict them based on KM practices.
The work they are doing indicates that the Doctor's are trained to work as individuals, not as a group. The plan is to intervene through practice changes, actual changes will be measured via medical records, customer surveys and KM throughput measures.

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