Knowledge Management Problems in Healthcare - A Case Study based on the Grounded Theory

Erja Mustonen-Ollila, Helvi Nyerwanire, Antti Valpas

Abstract

Knowledge management describes how information communication technology systems are applied to support knowledge creation, as well as in the capturing, organization, access, and use of an organization’s intellectual capital. This paper investigates knowledge management problems in healthcare. The major conclusions regarding the problems identified are: access to patient data in ICT systems or lack of data, complex medical data, and problems in saving data to ICT systems; ICT system integration, architecture, cost and regulations by political decisions and knowledge transfer problems; tacit knowledge missing in ICT systems; communication and communication barriers between primary and special healthcare; ICT security and trust problems; negative attitude or limited support from "peers" or superiors; patients’ resistance to recommendations; physicians’ stress and control-sharing problems, too short time in the policlinic to search for patient information, limited personnel resources, and work pressure. A conceptual framework of knowledge management is developed by the Grounded Theory approach. The data validates past studies, and reveals relationships between categories. The relationships between the knowledge management categories enhance confidence in the validity of the categories and relationships, and expand the emerging theory.

References

  1. Alavi, M. and Leidner, D.E. (2001) 'Review: Knowledge Management and Knowledge Management Systems: Conceptual Foundations and Research Issues', MIS Quarterly, vol. 25, no. 1, pp. 107-136.
  2. Ammenwerth, E., Talmon, J., Ash, J. S., Bates, D. W., Beuscart-Zephir, M. C., Duhamel, A., Elkin, P. L., Gardner, R. M. and Geissbuhler, A. (2006) 'Impact of CPOE on mortality rates - contradictory findings, important messages', Methods of Information in Medicine, vol. 45, no. 6, pp. 586-593.
  3. Benbasat, I., Goldstein, D.K. and Mead, M. (1987) 'The Case Study Research Strategy in Studies of Information Systems', MIS Quarterly, vol. 11, no. 3, pp. 369-386.
  4. Blakeman, T., Macdonald, W., P., Gately, C. and ChewGraham, C. (2006) 'A Qualitative Study of GPs' Attitudes to Self-management of Chronic Disease', The British Journal of General Practice, vol. 56, no. 527, p. 407.
  5. Burgess, C., Cowie, L. and Gulliford, M. (2012) 'Patients' perceptions of error in long-term illness care: qualitative study', Journal of Health Services Research & Policy, vol. 17, no. 3, pp. 181-187.
  6. Creswell, J.W. (2007) Qualitative Inquiry and Research Design: Choosing Among Five Approaches, California: Sage Publications.
  7. Dalkir, K. (2005) Knowledge Management in Theory and in Practice, London, UK: Butterworth-Heinemann Publisher.
  8. Denzin, N.K. (Ed.). (1978) The research act: A theoretical introduction to sociological methods, New York: McGraw-Hill.
  9. Edwards, M., Wood, F., Davies, M. and Edwards, A. (2012) 'The Development of Health Literacy in Patients with a Long-term Health Condition: the Health Literacy Pathway Model', BMC Public Health, vol. 12, no. 1, p. 130.
  10. Eisenhardt, K.M. (1989) 'Building Theories from Case Study Research', Academy of Management Review, vol. 14, no. 4, pp. 532-550.
  11. Eksote. (2013)'Etelä-Karjalan Sosiaali- ja Terveyspiiri', Available: http://www.eksote.fi/Fi/Eksote/Hallinto/raportit/Docu ments/Terveydenhuollonjarjestamissuunnitelma.pdf [10 November 2013].
  12. Fisher, W.G (2013) 'Doctors are drowning in too much data, not enough appropriate information', MedCity News, Available: http://medcitynews.com/2012/03/ doctors-are-drowning-in-too-much-data-not-enoughappropriate-information/ [23 May 2013].
  13. Glaser, B. and Strauss, A.L. (1967) The Discovery of the Grounded Theory: Strategies for Qualitative Research, Chicago: Aldine.
  14. Glaser, B.G. (1992) Emergence vs. Forcing: Basics of Grounded Theory, Mill Valley, CA: Sociology Press.
  15. Greig, G., Entwistle, V.A. and Beech, N. (2012) 'Addressing complex healthcare problems in diverse settings: Insights from activity theory', Social Science & Medicine, vol. 74, no. 3, pp. 305-312.
  16. Grimson, J.,Grimson, W. and Hasselbring, W. (2000) 'The SI Challenge In Health Care', Communications of the ACM, vol. 43, no. 6.
  17. Grover, V. and Davenport, T.H. (2001) 'General perspectives on knowledge management: Fostering a research agenda', Journal of Management Information Systems, vol. 18, pp. 5-21.
  18. Gupta, P. (2008) 'IHE and CPOE: The Twine Shall Meet for Healthcare', SETLab Briefings, Infosys Technologies Limited, Available: http://www.taurus glocal.com/images/ihe-cpoe-infosys.pdf, [30 March 2014]
  19. Heilmann, P. (2010) 'To have and to hold: Personnel shortage in a Finnish healthcare organization', Scandinavian Journal of Public Health, vol. 38, no. 5, pp. 518-523.
  20. Hill, K.S. (2010) 'Improving quality and patient safety by retaining nursing expertise', The Online Journal of Issues in Nursing, vol. 15, no. 3.
  21. Hämäläinen, P., Reponen, J., Winblad, I., Kärki, J., Laaksonen, M., Hyppönen, H. and Kangas, M. (2013) 'e-Health and e-Welfare of Finland: Check Point 201178, National Institute for Health and Welfare.
  22. Häyrinen, K., Saranto, K. and Nykänen, P. (2008) 'Definition, structure, content, use and impacts of electronic health records: A review of the research literature', International Journal of Medical Informatics, vol. 77, pp. 291-304.
  23. Jonkers, H., Steen, M. and Bryant, B.R. (2003) 'Towards a Language for Coherent Enterprise Architecture Description', IEEE International Enterprise Distributed Object Computing Conference (EDOC), Brisbane, Australia.
  24. Kaye, R., Kokia, E., Shalev, V., Idar, D. and Chinitz, D. (2010) 'Barriers and success factors in health information technology: A practitioner's perspective', Journal of Management & Marketing in Healthcare, vol. 3, no. 2, pp. 163-175.
  25. Koskinen, J. (2010) 'Phenomenological view of health and patient empowerment with personal health record', Proceedings of the Well-being in the information society (WIS) conference, Turku: University of Turku, pp. 1-13.
  26. Kothari, A., Rudman, D., Dobbins, M., Rouse, M., Sibbald, S. and Edwards, N. (2012) 'The use of tacit and explicit knowledge in public health: a qualitative study', Implementation Science, vol. 7, no. 1.
  27. Laki 159/2007. (2007) 'Laki sosiaali- ja terveydenhuollon asiakastietojen sähköisestä käsittelystä', Available: http://www.finlex.fi/fi/laki/alkup/2007/20070159 [10 October 2013].
  28. Lin, C., Tan, B. and Chang, S. (2008) 'An exploratory model of knowledge flow barriers within healthcare organizations', Information & Management, vol. 45, no. 5, pp. 331-339.
  29. Linthicum, D.S. (2004) Next generation application integration, Boston: Addison-Wesley.
  30. Martikainen, S., Viitanen, J., Korpela, M. and Lääveri, T. (2012) 'Physicians' experiences of participation in healthcare IT development in Finland: Willing but not able', International Journal of Medical Informatics, vol. 81, no. 2, pp. 98-113.
  31. Miles, M.B. and Huberman, A.M. (1994) Qualitative Data analysis, Thousand Oaks, California: Sage Publications.
  32. Myers, M.D. and Avison, D.E. (ed.) (2002) Qualitative Research in Information Systems: Review, London: Sage Publications.
  33. Nilakanta, S., Miller, L., Peer, A. and Boija, V.M. (2009) 'Contribution of Knowledge and Knowledge Management Capability on Business Processes among Healthcare Organizations', Proceedings of the 42nd Hawaii International Conference on System Sciences, IEEE, pp. 1-9.
  34. Niskanen, J.J. (2002) 'Finnish care integrated?78, International Journal of Integrated Care, vol. 2, no. 2.
  35. Nonaka, I. (1994) 'A dynamic theory of organizational knowledge creation', Organization Science, vol. 5, no. 1, pp. 14-37.
  36. Nykänen, P., Kaipio, J. and Kuusisto, A. (2012) 'Evalution of the national nursing model and four nursing documentation systems in Finland-Lessons learned and directions for the Future', International Journal of Medical Informatics, vol. 81, no. 8, pp. 507-520.
  37. Pawluch, D. and Neiterman, E. (2010) 'What is Grounded Theory and Where Does is Come from?78, in Bourgeault A., Dingwall, R. and De Vries. R. (ed.) The SAGE Handbook of Qualitative Methods in Health Research, London: Sage Publications, pp. 174- 192.
  38. Polanyi, M. (1966) The Tacit Dimension London: Routledge.
  39. Puusa, A. and Eerikäinen, M. (2010) 'Is Tacit Knowledge Really Tacit?78, Electronic Journal of Knowledge Management, vol. 8, no. 3, pp. 307-318.
  40. Raudasoja, S. (2013) 'Eksote's Strenght is its strong customer orientation', External Publication of South Karelia and Social and Health Care District, Available: http://www.eksote.fi [20 January 2013].
  41. Reddy, M.C., Paul, S.A., Abraham, J., McNeese, M., DeFlitch C., and Yen, J. (2009) 'Challenges to effective crisis management: Using information and communication technologies to coordinate emergency medical services and emergency department teams', International Journal of Medical Informatics, vol. 78, no. 4, pp. 259-269.
  42. Räisänen, T., Oinas-Kukkonen, H., Leiviskä, K., Seppänen, M. and Kallio, M. (2009) 'Managing Mobile Healthcare Knowledge: Physicians' Perceptions on Knowledge Creation and Reuse', in Olla, P. and Tan, J. (ed.) Mobile Health Solutions for Biomedical Applications, New York, New Hersey: IGI Global, pp. 111-127.
  43. Stair, R. M. and Reynolds, G.W. (2006) Fundamentals of Information Systems, Boston, Mass: Thomson Course Technology.
  44. STM. (2013) 'Sosiaali- ja terveysministeriö. Tietojärjestelmähankkeet: sähköinen potilasarkisto ja sosiaalialan tiedonhallinta', Available: http://www. stm.fi/vireilla/kehittamisohjelmat_ja_hankkeet/tietojar jestelmahankkeet/kysymyksia_kanta_hankkeesta#vast aus [5 October 2013].
  45. Suomi, R. and Salmivalli, L. (2002) 'Electronic Prescriptions: Developments in Finland', In Proceedings of the IFIP Conference on Towards The Knowledge Society: E-Commerce, E-Business, Kluwer, BV, E-Government, pp. 481-495.
  46. Suurla, R., Markkula, M. and Mustajärvi, O. (2002) 'Developing and implementing knowledge management in the parliament of Finland', The committee for the future: The Parliament of Finland, Available: http://web.eduskunta.fi/dman/Document. phxdocumentId=gk11307104202716&cmd=download [4 September 2012].
  47. Timonen, T. (2013) 'Key figures: statistics from the hospital', Internal Publication of South Karelia Social and Health Care District.
  48. Viitanen, J., Hyppönen, H., Lääveri, T., Vänskä, J., Reponen, J. and Winblad, I. (2011) 'Nationality questionnaire study on clinical ICT systems proofs: Physicians suffer from poor usability', International Journal of Medical Informatics, vol. 80, no. 10, pp. 708-725.
  49. Yin, R.Y. (1994) Applications of Case Study Research, Applied Social Research Methods series 34, Newbury Park, London: Sage Publications.
  50. Yin, R.K. (2003). Case study research: design and methods. California: Sage Publications.
  51. Young, R.J., Horsley, S.D. and McKenna, M. (2000) 'The potential role of IT in supporting the work of junior doctors', Journal of the Royal College of Physicians of London, vol. 34, no. 4.
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Paper Citation


in Harvard Style

Mustonen-Ollila E., Nyerwanire H. and Valpas A. (2014). Knowledge Management Problems in Healthcare - A Case Study based on the Grounded Theory . In Proceedings of the International Conference on Knowledge Management and Information Sharing - Volume 1: KMIS, (IC3K 2014) ISBN 978-989-758-050-5, pages 15-26. DOI: 10.5220/0005028200150026


in Bibtex Style

@conference{kmis14,
author={Erja Mustonen-Ollila and Helvi Nyerwanire and Antti Valpas},
title={Knowledge Management Problems in Healthcare - A Case Study based on the Grounded Theory},
booktitle={Proceedings of the International Conference on Knowledge Management and Information Sharing - Volume 1: KMIS, (IC3K 2014)},
year={2014},
pages={15-26},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0005028200150026},
isbn={978-989-758-050-5},
}


in EndNote Style

TY - CONF
JO - Proceedings of the International Conference on Knowledge Management and Information Sharing - Volume 1: KMIS, (IC3K 2014)
TI - Knowledge Management Problems in Healthcare - A Case Study based on the Grounded Theory
SN - 978-989-758-050-5
AU - Mustonen-Ollila E.
AU - Nyerwanire H.
AU - Valpas A.
PY - 2014
SP - 15
EP - 26
DO - 10.5220/0005028200150026