Knowledge Management Model for Teleconsulting in

Telemedicine

LILIA EDITH APARICIO PICO

The present research shows a study

of requirements for teleconsulting in
telemedicine solution in order to make
a knowledge management system.
 Knowledge Management Model for Teleconsulting in
Telemedicine

• The teleconsulting has been defined by diverse

authors in several ways. The American
Telemedicine Association (ATA) defines the
teleconsulting like: service that uses the
telecommunications to provide medical data,
which can be audio, photograph or videos,
between a patient and a professional of health to
use it in attendance, diagnostic or a treatment
plan. This could be originated from a remote
clinic to an office using a connection of direct
transmission that can include communications
on the Web.
 Knowledge Management Model for Teleconsulting in
Telemedicine

Knowledge Management Systems

• A knowledge management system is
defined as "the process of administering
knowledge of all type continually to
satisfy present and future necessities, to
identify and to exploit resources of
knowledge so much existent as acquired
and to develop new opportunities."
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Knowledge management methodologies

– Tiwana methodology.

This methodology is proposed by Amrit

Tiwana and adapted by Coviello and other ,
which conform it 4 phases and 10 stages
(see Figure 2).
 Knowledge Management Model for Teleconsulting in
Telemedicine
Phase 1: Evaluation of the infrastructure
1) Analysis of the existent infrastructure
2) Alignment of knowledge management and the strategy of the
business

Phase 2: Analysis, Design and Development of the System of MK

1) Design of the architecture of the managment knowledge and
integration of the existent infrastructure.
2) Audit of Knowledge Resources and Systems existents

3) Design of knowledge management Team

4) Creation of knowledge management project
5) Develop of Management Knowledge System
Phase 3: System Deploy
6) Deploys, using Methodology Incremental Handling of Results
(RDI)
7) Change of management, Culture and Structures
Phase 4: Evaluation
8) Evaluation of the yield, Menstruation of the ROI, and incremental
refinement of the system of management knowledge

Figure 1. . Methodology Knowledge Management: Tiwana Source: Adapted by Coviello and others of Tiwana (2002, pp. 64)
 Knowledge Management Model for Teleconsulting in
Telemedicine

- EKMF methodology
The methodology of the EKMF project (European
Knowledge Management Forum) is an initial proposal of a
possible standard methodology for the implementation of
the knowledge management, which is structured in two
levels.
• Level 1: General implementation of Knowledge Management
This level, is compound by 6 phases and 16 stages,
(see Figure 2.)

• Level 2: Implementation of Knowledge Management Project Pilot. It

refers to knowledge management of specific problems and it can turn
like a part of the general methodology, (see Figure 3).
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Methodological application of knowledge

management
Structurally the methodology is composed by phases that
it picks up the initial position of a situation, with the whole
chain of stocks that it is necessary to carry out until
arriving to the new wanted situation. These phases
facilitate the development of a procedure to modulate, in
such a way that they carried out parts of the system like
independent subsystems that cover their performance
environment, in the course of the full integration of them
 Phases Stages

Phase 1: Knowledge 1 Interest in management knowledge and their benefits

2 To involve to top management organization

Fase 2:
3 Working Team
Initial valuation
4 Existent infrastructures
5 Economic compatibility
6 Knowledge management and sources of business
7 Estimates

Fase 3: Iniciativas Piloto 8 To select alternatives to develop

9 To design and to throw a project pilot of knowledge management

Fase 4: Expansion 10 State of knowledge management

11 Expansion possibility

12 Personalization and application of knowledge management

13 To throw the expansion of the project knowledge management

Fase 5: Maturity 14 Strategies and organizational structures

15 Result of management knowledge

Fase 6: Continuous improvement

16 improvement

Figure 2. General implementation of knowledge management : EKMF Source: Project EKMF, Coviello and
other (2002, pp. 82)
 Knowledge Management Model for Teleconsulting in
Telemedicine

Implementation of a Knowledge Management

Project Pilot

Resources

Training

Sources

Activities

Costs

Estimate of Times
Analysis of System Results

Evaluation

Improvement

Figure 3. Implementation of Knowledge Management Project Pilot: EKMF Source: Project EKMF, Coviello and
other (2002, pp. 83)
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Methodological application of knowledge

management
The phases are formed by a group of activities that should
carry out when the phase is executed. In a general way,
each task can be structured by: Available Sources of
information, steps or processes to carry out or factors that
can have incidence in their execution, support tools,
products or results and advice to facilitate the execution of
each task.
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Knowledge management architecture

There are diverse technological focuses to support the knowledge
management architecture in an organization. Therefore, they have been
accepted by the scientific community such as the architecture of: Ovum,
Tiwana and technological Integration (Kerschberg)

• Ovum Architecture
Ovum has developed a model of knowledge management architecture it
is shown in Figure 4, it has main components: the repository of
knowledge, the map of knowledge, the services of collaboration, the
discovery services and the portal of knowledge
 Knowledge Management Model for Teleconsulting in
Telemedicine

Interface Administration of projects, competitive intelligence,

relationship administration with the clients
Level Knowledge Portal
Services of
management Discovery services Services of collaboration
knowledge
Corporate
Knowledge maps
Taxonomy
Management of
information Repository of knowledge
and processes

Infrastructure E-mail, file server, internet/intranet services

Sources of
information and of WP DBMS EDM E-MAIL WWW People
knowledge

Figure 4. Architecture of Management knowledge Model Ovum. Source: Ovum Ltda. Woods (1998)
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Tiwana Architecture
Tiwana gives knowledge in seven layers integrated by means of Web,
it is shown in Figure 5.

Figure 5. Architecture of Tiwana. Source: Amrit Tiwana (2002, pp. 127)

 Knowledge Management Model for Teleconsulting in
Telemedicine

• Knowledge Management Model For

Teleconsulting In Telemedicine.
This model is based in: the ubiquity principles, costs, use
of the specialized human resource, communications
technology, positive knowledge exploitation. The
structures the technological layers should be kept in mind
to implement this model.
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Principles of the proposed pattern

It is necessary to build the pattern to have principles
they are:

- Ubiquity: The Information and Knowledge Technologies

(TIC´s) provide us advantages. It is no necessary to be
present with doctors to use health services it is possible
to take it through the internet ant other networks.

-Costs: It is chipper to use information and knowledge

information systems than use direct services with the
doctors, Doctors can offer their services through the
teleconsulting system
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Principles of the proposed pattern

Communications Technology: There are many
networks in order to offer communication services,
it is important to have this medium for giving
knowledge.

-Positive exploitation of the knowledge: The

knowledge will go growing,and it will be of more
utility by the different clients of the knowledge.
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Organizational model
It represents the main components of the pattern it Figure 6., there
are primary nodes (Clients of the knowledge non experts) conformed
by actors that need to obtain a knowledge but advanced or a second
opinion, the technological agents that take charge of mediating
between the primary nodes and the specialized ones with the purpose
of deciding if the consultation made by a primary node can be solved
with the repository of knowledge or it is necessary to go to a
specialized node, the repository of knowledge stores the whole
experience in the exchange of knowledge among the primary and
specialized nodes with the purpose of reusing it, lastly the specialized
nodes are the group of people that you/they possess the knowledge
at a superior level to people of the primary nodes.
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Technological architecture

The technological architecture is a combination of the

architecture mentioned Kerschberg previously of the present
document) and the patron MVC of Buschmann 1980

It has four components (see Figure 6), it is to say to the

architecture of Kerschberg was added a new knowledge
management layer, it was divided in two layers. The layers
called components in the architecture technological
proposal are detailed next.
Knowledge Management Model for Teleconsulting in
Telemedicine

Figure 6. It structures of the pattern organizational Source: Own elaboration

 Knowledge Management Model for Teleconsulting in
Telemedicine

• Technological architecture

Component Controller: it takes all users´petitions and to

coordinate the answers appropriately, it is the responsible of
capturing the interaction of all applications services. The
controller authenticates the users and to evaluate their
necessities of information knowledge, a middleware of HL7
(Health Level Seven level protocol 7) that formats the
information from and toward the repository of knowledge.
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Technological architecture
Component of Repositories: They store the knowledge that
has been mined by a middleware of mining of knowledge; it
is an extract of knowledge from following layer to facilitate
the work to the technological agent, it stores the
experience in the knowledge exchange between the
primary nodes and the specialized nodes.

Component of sources: This component refers to all the

sources explicit and potentials that generate knowledge,
among other are (Databases, documental Databases,
Database of means, external sources, etc.), (See Figure 7).
 Knowledge Management Model for Teleconsulting in
Telemedicine

Figure 7. Structures. of the Architecture Technological. Source: Own elaboration

 Knowledge Management Model for Teleconsulting in
Telemedicine

• Summations

The management system knowledge can be used to

strengthen the simple systems of information in the diverse
areas of their applications. It has intended in this document
an example of it, when formulating a model of management
knowledge for a teleconsulting system in telemedicine
where they combine the theories, models and architectures
of management knowledge especially with a computer
case, generating some principles, an organizational
structure and an architecture technological matter.
 Knowledge Management Model for Teleconsulting in
Telemedicine

• Summations
Besides this, we can assert that the proposed pattern of a
knowledge management model for the implementation of
the teleconsulting in telemedicine, it will serve like
conceptual guide for works that require to develop and to
implement systems of information in telemedicine and
systems of knowledge management in telemedicine. In
order to make a decision for teleconsulting in Colombia, it
is possible to analize the model in irder to connecting
Management Systems in Bogotá and Cauca Solutions for
giving services between Bogotá, and other rural places
this is the next research.
TELEMEDICINE GROUP
DISTRITAL UNIVERSITY
BOGOTA COLOMBIA

medicina@udistrital.edu.co