Effective Knowledge Management Model (KM) for Healthcare

Integrating Success Factors and Knowledge Management Strategy

Nor’ashikin Ali , Associate Professor, Universiti Tenaga Nasional UNITEN, Malaysia

Introduction
The emphasis on the importance of knowledge as the new competitive advantage has led to the
adoption of knowledge management (KM)in healthcare organisations (Omotayo, 2015; Wills,
Sarnikar, El-Gayar and Deokar, 2010). KM has been ascertained as a new management tool which
can facilitate healthcare organisations to effectively manage their internal and external knowledge
(Omotayo, 2015; Wills, Sarnikar, El-Gayar and Deokar, 2010). It is a discipline that enables
healthcare organisations to transform large amounts of medical data into relevant clinical information
(Dwivedi, Bali, James, and Naguib, 2001), and to promote sharing of knowledge gained through
years of experience among healthcare professionals.

Generally, any KM implementation requires processes such as create, locate, capture, and share
knowledge (Alavi and Leidner, 2001). In order for KM processes to function effectively, the right KM
strategies and the essential factors of success in implementing KM should be considered. Most KM
literature discusses KM processes, strategies and success factors separately. However, this paper
addresses the integration of KM processes, strategies and success factors as guides for the
successful KM implementation.

Background
Previously, the focus of KM in healthcare was solely on the implementation of technology-based KM
for KM processes in healthcare organisations. For instance, Bose (2003) discussed the KM
capabilities, the technical infrastructure, and the decision support architecture for healthcare.
Besides, Falkman, Torgersson, Jontell, and Gustafsson (2005), argued that IT plays a supporting
role in KM processes by using virtual community tools to support collaboration, community building
and learning between clinicians and patients. In addition, Dwivedi, Bali and Naguib (2005) pointed
out that KM-related tools and technologies could be used to produce Clinical Knowledge
Management (CKM) solutions. Koumpouros, Nicolosi, and Martinez-Selles(2006) promote
knowledge creation and utilisation by chronic patients through the introduction of a virtual, private,
disease-specific patient community called ‘Health Community KM System”. As reported by
Davenport, De Long, and Beers (1998) in their study on successful KM projects, any KM initiatives
should have a balance between organisational and technological aspects for successful
implementation.

As a matter of fact, the current models of successful KM are based on technology-enabled factors.
For instance, Hwang, Chang, Chen and Wu (2008) carried out a survey study on the users of KMS
in the hospital in Taiwan to assess the perceived value of KMS. With respect to this study, users of
KMS were discovered to be voluntary physicians from departments such as clinical departments,
infection control, insurance claims, and disease classification. In their job description, they managed
to identify these factors as critical to KMS use:perceived usefulness, system quality, and information
quality. Besides, Koumpouros et al. (2006), in their studies on KMS in cardiology, mentioned that the
quality of knowledge and the use of right terminology are important for doctors when utilising KMS.
Additionally, up-to-date and reliable source of knowledge were also essential in the use of KMS.
Based on the studies conducted, doctors were shown to exhibit a higher tendency of using such
systems if they are user-friendly, easily accessible and practical to their work. Undeniably, the
security of the systems, which is closely related to the protection of contributor’s knowledge and the
integrity of knowledge, is considered a significant success factor. Based on the survey conducted by
Ali, Tretiakov, Whiddett, and Hunter (2017) on physicians in hospitals in New Zealand regarding the
factors determining the success of KMS, it was discovered that organisational factors such as
leadership and incentives are significant factors for KM success.

The previous models were developed independently from KM strategies and they solely focused on
the success factors. In connection with the KM initiatives in healthcare, the integration of KM
processes and success factors with KM strategy was proposed to provide a comprehensive
overview on the effective implementation of KM.

Theoretical and Conceptual Framework

The primary reason organisations encourage the incorporation of KM efforts into the system is to
enable themselves to convert tacit knowledge into explicit knowledge. In this context, the conversion
of knowledge will greatly enhance its transferability so that it can be made available to others and
reused. These efforts involve several processes that allow firms to recognise, create, transform, and
distribute knowledge (Gold, Malhotra, and Segars, 2001). With regards to the healthcare context,
KM is defined as a systematic process of capturing, storing, dissemination and reuse of clinical
knowledge that can optimise information, collaboration, expertise and experience of healthcare
practitioners. Hansen, Nohria and Tierney (1999) described two knowledge management strategies
to managing knowledge: codification and personalisation. Codification strategy makes explicit
knowledge such as routine cases available to healthcare professionals so that they can reuse and
apply knowledge in solution of everyday problems. Personalisation means providing individuals with
the tacit knowledge such as creative solutions to solve problems by communication with other
experts. For these strategies to be effective, the essential factors of success should be considered.

Proposed Integrated Model for Effective KM

KM Processes

In the process of converting tacit knowledge to explicit knowledge, some processes involved are as
follows:
Knowledge capture. First, knowledge capture process is the process of acquiring knowledge from
the internal of external sources. In healthcare, knowledge is primarily derived from the sharing of
clinical experiences, skills, and know-how while delivering healthcare to patients. Through this
interaction between the physician and the patient, knowledge is created and stored in the KMS by
the physician. As a matter of fact, methods of capturing can be in various forms including:

1. Use blogs, knowledge portal or knowledge bases

2. Expert directories where the physicians enter their contacts, which are linked to their
knowledge afterwards
3. Collaborative virtual workspaces
4. Video sharing, where knowledge is recorded
5. A platform for communities of practice, e.g. electronic discussion forum
6. Structured interview technique.

Knowledge storage. Second, the knowledge that is captured is stored in a knowledge repository. In
this context, knowledge in the mind is often difficult to access; thus individuals’ knowledge needs to
be acquired and stored so that it is accessible for reuse. Generally, the methods available for storing
knowledge are as follows:

1. Knowledge portal
2. Blogs
3. Electronic knowledge repository that contains medical databases, physicians’ experiences
4. Document libraries that keep all documents related to clinical treatment, research articles
5. Evidence-based repository.

Knowledge dissemination. Third, knowledge dissemination involves sharing and transferring of

clinical activities or decision making from healthcare practitioners or repository to other practitioners.
In this respect, healthcare practitioners are allowed to share their experiences in solving patients’
illness. The importance of sharing culture or dissemination of knowledge was also highlighted by
Gagnon (2011) which stated that knowledge must be made available in a readily accessible manner
and practical format to whoever needs it in the organisation anywhere and anytime. In this process,
the methods used are as follows:

1. Knowledge cafes
2. Workshops
3. Web-based communities of practice
4. Social media
5. Online community
6. Blogs

Knowledge reuse. Fourth, the purpose of KM is to avoid reinventing solutions that are already
available in the organisation through reusing knowledge that is stored. In particular, knowledge that
is stored and codified can be-reused by other practitioners to solve similar problems encountered
with other patients. Significantly, this process of reusing knowledge is time-saving (time taken to
source for solutions is significantly minimised or omitted) as it tackles various problems with existing
knowledge. In fact, new knowledge can be generated based on the existing knowledge as the
current knowledge repository contains algorithms of the symptoms of more than 500 illnesses
(Hansen, Nohria, and Tierney, 1999). Most importantly, in this case, healthcare is not inventing a
new way to cure diseases since physicians have the privilege of accessing available knowledge to
comprehend sophisticated situations. The benefits of this process are:

1. To enable good search engine to retrieve knowledge

2. To improve quality of knowledge
3. To provide platforms for meaningful communication through newsletters, training, websites
4. To promote the use of lessons learned and best practices via push technology.
KM Strategies

In this paper, two knowledge management strategies are proposed for the purpose of sharing
explicit and tacit knowledge: personalisation strategy and codification strategy.

Personalisation strategy

First and foremost, a personalisation strategy is a social-organisational approach that employs

dialogue, and collaboration as means to disseminate best practices and lessons learned throughout
the organisation. This strategy focuses on the transfer of tacit knowledge, which is hard to access in
documents. Essentially, it promotes interactions between individuals to communicate ideas and
share their expertise. Besides, professionals are also able to obtain knowledge which occasionally
cannot be found in the knowledge repository. For instance, this strategy involves a series of
conversations among individuals and groups whereby they provide questions, responses, and
comments that are difficult to be presented in documents. Similarly, the use of technology such as
groupware, online chat, conferencing tools such as video conferencing and teleconferencing can
assemble healthcare practitioners simultaneously despite being separated by distance. Indeed, a
personalisation strategy is often observed in communities of practice where groups of professionals
share similar interests and job roles. To sum up, this strategy promotes generation of new and
refined knowledge whereby respective individuals in a group contribute ideas, knowledge and
expertise acquired through interaction among group members.

Codification strategy

The codification strategy involves the identification, capture, and indexing of knowledge. This
knowledge is later made accessible to professionals who are keen on reusing and applying the
relevant knowledge to support routine problem solving. Interestingly, this strategy adopts a ‘people
to document, which emphasises on the connection of healthcare practitioners to documents that
contain explicit and codified knowledge (Hansen, et al., 1999). Moreover, codified knowledge is
accessible in various forms including printed documents and electronic documents (e.g., health
portal, software algorithms, clinical practice checklists).For instance, codified knowledge at
healthcare organisations includes scientific research outputs, clinical guidelines, and operating
manuals (Denis and Lehoux, 2013).Most importantly, the primary goal of this strategy is to enable
the re-use of explicit knowledge at a specified time later depending on the user’s need while
optimising the accessibility of this knowledge at a widespread level. As a result, this strategy can
prevent knowledge loss as well as remove duplication of efforts in looking for solutions that are
already available in the organisations.

Success Factors

The success factors are categorised into organisational and technological factors.

Organisational Factors

 The commitment and dedication from top level management are needed to support
knowledge management
 Developing a knowledge-oriented culture where trust, openness, and collaboration are being
practiced
 Facilitating access to the dissemination of knowledge
 Training programmes
 Establishing monetary and non-monetary incentive systems.
Technological Factors

Efficient and effective information and communication technology (ICT) is a critical enabler for KM. In
particular, healthcare organisations must incorporate ICT into their KM initiatives and pay
considerable attention towards the following technological factors:

 ICT that enables rapid search, access and retrieval of information, and supports
collaboration and communication between organisational members
 ICT that can facilitate KM activities through the codification of knowledge and support
interactive forms of communication through the Internet and email
 Effective infrastructure for knowledge management processes
 The simplicity of technology, ease of use, suitability to users’ needs, relevance of knowledge
content, and standardisation of a knowledge structure orontology.

Conclusion
In conclusion, it is crucial that healthcare organisations incorporate KM processes, KM strategies,
and success factors into their existing system for the successful implementation of KM in healthcare.
From this perspective, it is important for KM processes and KM strategies to be addressed in a
systematic and structured manner. Clearly, an effective KM model compliments the previous KM
success models by integrating the success factors with the KM strategies and processes as
fundamental components of KM success model. Essentially, the proposed components can function
as a basis for healthcare organisations to evaluate their KM practices.

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