Medical Knowledge

A Core Asset for Healthcare Industry

Brigitte Stroetmann

, Anja Hasler

and Alena Leinfelder

Siemens AG Healthcare Sector, Allee am Röthelheimpark 3 A, Erlangen, Germany

Siemens AG Healthcare Sector, Henkestraße 127, Erlangen, Germany

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning

Organizations, Trust, Education.

Abstract: The main objective of this paper is to show how efficiently Siemens Healthcare connects knowledge holders

and knowledge recipients from various disciplines within the company.

Siemens offers its customers products and solutions for the entire range of patient care from a single source

– from prevention and early detection to diagnosis, treatment, and aftercare. Optimizing clinical workflows

always requires a multidisciplinary team and a collaborative structure between e.g. medical advisors,

researchers, scientists, and healthcare economists. This new form of collaboration brings together experts

with deep technical experience, physicians with specialized medical knowledge, as well as people with

comprehensive knowledge about health economics.

To create a knowledge network Siemens Healthcare introduced the Clinical Competence Centers for

specialized medical knowledge, the Clinical Knowledge Base as online platform for disease specific

information and the Healthcare Academy for medical education and web-based trainings. These are

impressive examples of the successful knowledge management and education strategy of Siemens- the

Knowledge Company.

1 INTRODUCTION

In healthcare, having the right information at the

right time can become a very difficult challenge due

to the sheer amount of ever-expanding knowledge.

Clinicians, administrators, industry managers, and

research scientists are facing a growing body of

knowledge that they have to routinely access,

absorb, and utilize (Wickramasinghe, 2007). The

volume of medical knowledge doubles every 17

years. New areas of research, such as

bionanotechnology and genetics, are growing at a

tremendous pace (Wickramasinghe, 2008). Taking

these aspects into account, it is not surprising that

knowledge management is attracting so much

attention.

The healthcare industry is currently trying to

develop into a knowledge-based community that

connects hospitals, clinics, pharmacies, physicians,

and customers for sharing knowledge, reducing

administrative costs, and improving the quality of

care (Metaxiotis

, 2006).

Thus, successful global firms also see a major

task in offering professional education programs that

fulfill the need of the organization. Most employees

at Siemens Healthcare have in-depth scientific

knowledge, process-, market- or organizational

knowledge, but not necessarily in-depth medical

expertise.

The aim of this paper is to suggest Siemens

Healthcare’s systematic knowledge management

approach to facilitate access to reliable, relevant

medical information with adequate depth and to

support lifelong medical education of its employees.

2 THE IMPORTANCE OF

MEDICAL EDUCATION

The healthcare industry has grown rapidly and is

projected to grow in the future due to advances in

medical knowledge and the increased need for

medical services required by an aging population, as

well as demographic changes. Moreover, the

growing complexity of healthcare delivery,

including advances in medical technologies, will

require skilled workers and scientists with in-depth

184

Stroetmann B., Hasler A. and Leinfelder A..

Medical Knowledge - A Core Asset for Healthcare Industry.

DOI: 10.5220/0004136701840189

In Proceedings of the International Conference on Knowledge Management and Information Sharing (KMIS-2012), pages 184-189

ISBN: 978-989-8565-31-0

 2012 SCITEPRESS (Science and Technology Publications, Lda.)

medical expertise.

Successful organizations, according to Dorothy

Leonard and Walter Swap in their new book, Deep

Smarts: How to Cultivate and Transfer Enduring

Business Wisdom, rely on people who possess

knowledge that provides a distinctive competitive

advantage (Leonard and Swap, 2005). As Tom

Peters described in his book,

The Little BIG Things:

163 Ways to Pursue Excellence, Lifelong Learning

Is a Mission Statement Must (Peters, 2010). “In our

rapidly gyrating world, learning-for-life is no longer

an option; it’s a professional life (or death) necessity

– as more and more are beginning to realize. This is

true of you age 16 or 26 or 46 or 66 – and God

knows it’s true of my great pal, The Little BIG

Things’ dedicatee, Warren Bennis, voracious in the

depth and breadth of his quest for knowledge at 85!”

(Peters, 2010, #35)

According to a survey recently conducted by

XCM Solutions Inc. (de Visscher, 2002), a

differentiating factor between high and low

performing firms also lies in the company’s

education program. High performers invest in their

people through education and training. They

understand that education and training is an

important component of knowledge management.

In addition, high performing firms seek out

opportunities to learn. Most professionals say that

they read newsletters, professional publications,

journals, blogs, etc. Top performers also get out

there and talk to peers in their networks and

associations; participate in technology events like

tradeshows, webinars, and user conferences; and

keep an open mind (de Visscher, 2002).

3 KNOWLEDGE IS A KEY

RESOURCE THAT MUST BE

ACTIVELY MANAGED

A tangible KM process is essential in modern and

successful organizations which look at knowledge as

a major factor in their competiveness. It can be

considered as fast response of threats and challenges

in a company’s business. As a key component in its

overall strategy, Siemens Healthcare established a

pro-active KM approach. It manages all process

steps in the knowledge life-cycle model, but most

important encourages people to disseminate

knowledge and use it.

Schendel and Heuermann (2002) look at the

advantages of active knowledge and describe how

knowledge management systems package together

existing know-how and simplify procedures. They

maintain that active knowledge management

includes the collection, evaluation, storage and use

of internal and external information. Its objective is

to systematically acquire knowledge as a resource

and to use it efficiently. Active knowledge

management is designed to provide each employee

of a company with access to the optimum

knowledge base in the organisation when

performing his or her duties.

Most of the Knowledge life-cycle models in

literature emphasis on the processes of knowledge at

the individual, organizational and inter

organizational level. The purpose of these processes

is to optimize individual and organisational

effectiveness by appropriate knowledge

management models. Sagsan and Zorlu (2010)

evaluated different knowledge management models

and provide a comprehensive review on the different

knowledge levels or stages. They identified a gap

between the practical and theoretical side of KM and

suggest one of the most holistic approaches to the

knowledge management at the organizational level.

This model called “Knowledge Management Life

Cycle Model” Sagsan (2007) is aligned with

business processes, knowledge types, data-

information-knowledge repositories based as well as

product / service based processes.

It is based on five basic processes such as

knowledge creating, sharing, structuring, using and

auditing. Siemens Healthcare identified these basic

processes essential for a practically implemented

Knowledge Management solution.

A dedicated team of KM “workers”, who are

actively managing the operational KM process, co-

ordinates the basic processes of the knowledge

management life-cycle. As the expertise of most

employees is related to economics, business, or

technical issues, the team actively manages the

timely dissemination of relevant medical

information into the organization.

To implement the knowledge life-cycle model,

the team first had to identify the organization’s

medical knowledge needs.

If the necessary medical knowledge was not

available, the “creation process” was initiated. The

company focuses on a person-centered view of

knowledge creation to enable the constructive and

subjective nature of such a process. In this regard,

the utilization of diverse knowledge sources,

drawing upon different organizational functions and

professional disciplines is an essential success

factor. Medical knowledge is provided by dedicated

Clinical Competence Centers; they provide the

MedicalKnowledge-ACoreAssetforHealthcareIndustry

185

necessary broadness of medical knowledge

combined with extensive clinical expertise.

Storage

Identification

of Need

Creation

Sharing

Update

Knowledge

Management

Collection

Sh i

Figure 1: Knowledge life-cycle model.

The “new” information together with the existing

information is “collected and stored” in a web-based

database called “Clinical Knowledge Base”. Any

input to the knowledge base is evaluated and

commented on by the medical experts and thus

adapted to the need of the organization. This meta-

information serves to give an overview of the

relevance of a publication, the author, etc. and to

allow for an improved keyword search.

Siemens Healthcare’s approach to successful

medical knowledge “sharing” is the implementation

of push-pull strategies within the organization. KM

Services offered are a combination of pull (self-

service) and push services (facilitated transfer)

specially designed to meet the needs of the

organization.

For example: the information is pulled from

operational, technical and clinical areas and pushed,

in the shortest time possible, to the staff of the

organization and decision makers.

The KM program offers three services. First, pull

services (self-service) – contribute & retrieve

knowledge as and when it is needed. Second, push

services (facilitated transfer of knowledge) driven by

the need of the organization. And third, individual

expert advice where peers and experts join hands to

discuss and share knowledge.

Since the “Clinical Knowledge Base” serves as

the central platform for medical knowledge, the

company places the utmost importance on keeping

the stored information updated and current.

Basically, the medical knowledge is updated

whenever new medical findings are made available.

Every single document has a time stamp, which

reminds the responsible physician of the respective

Clinical Competence Center to review the document

and approve or reject it for the knowledge base.

4 CLINICAL COMPETENCE

CENTERS – THE UNIQUE

SOURCE OF MEDICAL

KNOWLEDGE

The foundation of Clinical Competence Centers

(CCC) within Siemens Healthcare three years ago

was aimed at providing direct access and assistance

e.g. to technical engineers, scientists, sales

representatives, and managers that do not necessarily

have a medical background. Today’s Clinical

Competence Centers focus on cardiology, oncology

and neurosciences because cardiovascular disease

(CVD), cancer, and stroke are the leading causes of

death globally and present a huge economic burden

to healthcare systems worldwide.

The members of the Clinical Competence

Centers have profound expertise on the diagnosis

and treatment of a specific disease or group of

diseases. Their activities cover counselling and

guidance of more technically-minded colleagues, as

well as high-quality education and training sessions.

They orchestrate cross-functional teams that jointly

develop new products for dedicated medical fields,

thus providing a forum for the exchange of

information and discussion of new ideas.

With others, these physicians also regularly

monitor scientific medical literature to identify new

trends and write for selected publications and

international medical journals.

Furthermore, the members of the Clinical

Competence Centers build and maintain networks of

key opinion leaders in their specialties to identify

future disease trends at any early stage. They are

involved in intensive international scientific

cooperation and closely linked to expert centers and

patient organizations. This acquired information is

used to support the overall portfolio strategy of

Siemens Healthcare.

As the healthcare field is in a constantly

changing process, the physicians of the CCCs are

also practicing in hospitals to keep up with medical

progress and advances within their specialties.

KMIS2012-InternationalConferenceonKnowledgeManagementandInformationSharing

186

5 CLINICAL KNOWLEDGE

BASE – THE ONLINE

PLATFORM FOR MEDICAL

INFORMATION

Best-practice information, white papers, and select

literature, as well as experts’ comments and relevant

metadata, e.g. ICD10 codes, are stored in the

Clinical Knowledge Base. The Clinical Knowledge

Base is a specialized database that aims to ensure

that Siemens Healthcare will have access to high-

quality medical knowledge in a comprehensive,

useful, and accurate way.

Figure 2: Clinical knowledge base.

With its primary focus on cardiology, oncology,

and neurosciences, it allows online access to

scientific medical information, review articles, and

graphical presentations of disease workflows

provided by the members of the Clinical

Competence Centers. The unique feature of the

papers presented in the Clinical Knowledge Base?

Every single paper is reviewed and commented on

with respect to its relevance for the Siemens

Healthcare business. While it is relatively easy for

clinical experts to identify relevant medical

publications, it is rather complex to perform a

scientific, as well as a business-related interpretation

of each paper.

Transferring medical and clinical workflow

knowledge is clearly another important focus of

Siemens Clinical Knowledge Management. Disease-

specific sales activities are for example supported by

medical workflows that have been visualized with

VISIO software for main diseases, like stroke,

prostate and breast cancer, as well as acute

myocardial infarction. The whole knowledge of

workflows, the deep understanding of medical

technology and profound IT expertise is combined,

so that each single process step is described by the

optimal Siemens solution, as well as its medical

benefits.

This close connection with ongoing business

activities is considered to be the key to successful

knowledge management.

The Clinical Knowledge Base is available to

everyone and can be accessed freely from any level.

There is a special application built on the Microsoft

SharePoint® collaboration platform for capturing,

organizing, and sharing knowledge throughout the

organization. It also uses workflows to guide the

user through the collaboration process. The content

of the Clinical Knowledge Base is updated, which

not only includes adding new information, but also

cleaning out outdated information.

5.1 Ask the Expert Function

The Clinical Knowledge Base enables its users to

post urgent requests via a simple web-based

interface. Unlike emails, which have to be directed

to a specific recipient, the Clinical Knowledge Base

guides the inquiry to the medical experts best suited

to answer it. The selected expert receives an email

notification with a direct hyperlink to the question.

The expert answers the question in a main text field

and can add attachments as desired. Via a simple

“send to requester” button, the answer is sent to the

questioner. He also has the opportunity to comment,

for example, on the quality of the provided answer

via the feedback button. The system is very user-

friendly, so that even newcomers quickly have

medical information at their fingertips.

All requests are stored in a central database in

which the members of the Clinical Knowledge

Management group and the Clinical Competence

Centers can search.

6 SIEMENS HEALTHCARE

ACADEMY - MEDICAL

EDUCATION & WEB-BASED

TRAINING

Medical education plays a vital role in the healthcare

industry. Continuous learning and a drive for

excellence are necessary in order to achieve best

solutions for patient care.

To successfully claim its market position as a

solution provider in the healthcare industry, it has

MedicalKnowledge-ACoreAssetforHealthcareIndustry

187

been a strategic decision of Siemens Healthcare to

anchor medical knowledge within the entire team of

employees. Thereby two major challenges need to

be mastered. One challenge is to provide access to

medical education to a large international target

group. The other one is to do so most effectively and

efficiently by delivering the fitting level of medical

knowledge to a highly heterogeneous target group.

Therefore the Siemens Healthcare Academy

(SHA) had been founded in 2005. It plays a crucial

role at Siemens Healthcare and contributes to the

company’s educational program in a major way.

Siemens Healthcare Academy provides anytime

access to a dynamic, online catalogue of high-

quality medical web-based trainings. To targetedly

address the needs of different job roles the course

portfolio is subdivided into a basic and an advanced

category. Basic courses provide a broad

understanding of the healthcare world including a

minimum level of medical basics, clinical pathways

and healthcare systems to employees with no

medical background. It has been a strategic decision

that the majority of employees need to acquire this

level of knowledge within their first months at

Siemens Healthcare via a comprehensive on

boarding course called ‘Healthcare Essentials’.

Between 2009 and 2012 over 17 thousand Siemens

Healthcare employees worldwide successfully

completed this course that is offered in five

languages. More than 82% of participants rated the

course excellent or very good – proving that the

high-quality didactical design is acknowledged by

the learners.

Figure 3: Healthcare Essentials web-based training –

discovering basic healthcare knowledge in a virtual city.

‘Healthcare Essentials’ lays the foundation for

understanding more in-depth medical knowledge

that is crucial for employees in certain job roles,

such as product development, sales and marketing.

In a joint effort the experts from the Clinical

Competence Center and the SHA team provide a

comprehensive portfolio of advanced clinical web-

based trainings as well as classroom trainings, for

example, on cardiology, electrophysiology,

neurosciences, and oncology.

Among others, the courses cover the most

important diseases or clinical questions, the clinical

key drivers for imaging and therapy, clinical

applications, and workflow topics. Constantly

accessible web-based trainings allow for a flexible

integration of advanced clinical education into daily

work. The classroom trainings are organized in

clinical settings and allow to dive deeper into

subtopics. For example, the participants have the

unique opportunity to see live procedures, e.g. from

the EP lab or operating rooms. Upon successful

completion of a course, the participants will receive

their own certificates as a proof of learning.

Figure 4: Siemens Healthcare Academy – animations

illustrate cardiology basics in a web-based training.

In addition to the course offerings, the Siemens

Healthcare Academy provides anytime online-access

to glossaries explaining medical, business and

healthcare terminology as well as to knowledge base

articles illustrating medical basics.

So, the user is able to get information regarding,

for example, what hypertension is, its causes and

symptoms and how it is treated on less than two

pages. This narrowly focused information allows for

an efficient distribution of knowledge.

7 SIEMENS HEALTHCARE - THE

KNOWLEDGE COMPANY

KM as a whole is a complex process, which requires

more than an optimal information and

communication infrastructure. “Too often,

companies implement state-of-the-art technology

KMIS2012-InternationalConferenceonKnowledgeManagementandInformationSharing

188

and then discover that culture and behavior are slow

to change, which impacts their consistency with the

organization’s broader business strategy and culture.

The success of KM initiatives depends equally on

the active involvement of everyone throughout the

organization, as well as on their consistency with the

organization’s broader business strategy and

culture.” (Ergazakis, 2005, p.23)

Today, KM is absolutely indispensable for the

company. For many years, Siemens has followed a

KMS with clear objectives and approaches and had

strong commitment from top management.

Since 2001, Siemens has been among the best

finalists in MAKE, the European Most Admired

Knowledge Enterprises ranking, which is conducted

annually by the UK-based consulting firm Teleos. In

2010, the organization placed first-place for the third

time (2003, 2004, 2010).

The Siemens Healthcare Academy, the Clinical

Competence Centers, as well as Clinical Knowledge

Base of Siemens Healthcare are a constructive

example of the company’s successful KM- and

education strategy.

The organizational benefit of the Siemens

Healthcare Clinical Knowledge Management

concept is the improved operational efficiency of

finding relevant information when needed and a

higher confidence in the quality and relevance of

that information. Also, Siemens employees are

respected worldwide for their clinical and workflow

expertise, as well as their awareness of and

responsiveness to customer needs.

The whole point of KM is to make sure that the

knowledge available in an organization is applied

productively for the benefit of the organization.

REFERENCES

Ergazakis, K. 2005. Knowledge Management in

Enterprises: a research agenda. Intelligent Systems in

Accounting, Finance and Management, Vol.13, pp.

17-26.

Leonard, D., and Swap, W., 2005. Deep Smarts: How to

Cultivate and Transfer Enduring Business Wisdom

Harvard Business School Press.

Metaxiotis, K., 2006. in Schwartz, D. G.: Healthcare

Knowledge Management. Encyclopedia of Knowledge

Management, pp.204-210.

Peters, T., 2010. The Little BIG Things: 163 Ways to

Pursue Excellence, Harper Studios, #35.

Sagsan, M., 2007 Knowledge management from practice

to discipline: a field study, AID TODAIE’s Review of

Public Administration, 1(4):123-157.

Sagsan, M., and Zorlu, K., 2010 An Emprical Test of the

Knowledge Management Life Cycle Model at a

Turkish Petroleum Oil Industry Firm, 7th

International Conference on Intellectual Capital,

Knowledge Management & Organisational Learning,

Hong Kong, China, pp. 405-413.

Schendel, J., and Heuermann, R., 2002. Advantages of

Active Knowledge Management, World Cement July

2002.

Siemens Medical Solutions USA, 2010. The Future of

Care. Siemens.

de Visscher, F., 2002. Seven Habits of Highly Effective

Companies. University of Massachusetts Family

Business Centre, Boston.

Wickramasinghe, N., 2008 Building a Learning

Healthcare Organization by Fostering Organizational

Learning through a Process Centric View of

Knowledge Management. International Journal of

Innovation and Learning, Chicago, Vol.5, No 2/2008,

pp. 201-216.

Wickramasinghe, N., Geisler, E., 2007. Epistemetrics:

Conceptial Domain and Applications of Knowledge

Management (KM) in Health Care. PICMET '07.

Portland International Conference on Management of

Engineering & Technology 2007, pp. 1056-1061.

MedicalKnowledge-ACoreAssetforHealthcareIndustry

189