Quotes from ICMCC Presentations

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The deployment of integrated care services for chronic patients (NEXES project)

“Abstract: The societal adaptations required for reducing the burden of chronic disorders and ageing have been recently framed by the WHO initiative on Innovative Care for Chronic Conditions. With this scenario in place, a successful deployment of innovative integrated care services to support healthier and independent living for chronic patients and elderly has emerged as an urgent unmet need. The NEXES project aims at undertaking the deployment of four integrated care programs addressing various aspects of chronic disorders selected because of promising outcomes generated by previous small-scale randomized controlled trials:

• Wellness-rehabilitation: Early diagnosis, promotion of healthy life-styles and patient self-management. Physical activity and cognitive aspects being main components
• Enhanced Care Support of unplanned hospitalizations
• Home hospitalization of patients with exacerbations
• Support: Transient remote support to diagnosis and/or treatment

The project focuses on the main factors modulating the success of an integrated care approach in delivering the services, namely: a) the co-morbidity challenge; b) articulation of healthcare and community services; c) organizational and educational issues; d) modularity, scalability and interoperability of the ICT platform, and, e) identification of business models ensuring service sustainability. Accordingly, the validation strategy prioritises the discovery of evidence supporting the extensive use of the services, applicable at the level of policy decision makers.
Technologically, the Linkcare platform (Linkcare eTEN 517435) sets the reference architecture. Modularity, flexibility and scalability are based on Service Oriented Architectures (SOA) using the IBM UML 2.0 Profile for Software Services. Briefly, the platform consist of a web-based application addressed to management of chronic patients and elderly, facilitating organizational interoperability following a distributed model. The following services are available at the moment: a) Health portal, b) Call centre service, c) Professional mobile access, d) Patient wireless monitoring service, e) Collaborative work service, f) Security modules, and g) Interoperability module with hospital information systems and shared electronic patient records. In the future, it will incorporate knowledge management applications and it is foreseen its evolution towards an IMS platform.”

Bárbara Vallespín, David Fonollosa, Albert Alonso, Josep Roca
Hospital Clinic de Barcelona. Villarroel, 170, 08036 Barcelona, Spain

To be presented at the ICMCC Event

From data to decisions: introducing Knowledge Management to effect superior operations in a radiology department

“Abstract
Contemporary healthcare organisations have to develop an ability to intelligently use the knowledge assets already inherent within them as well as incorporate the new data and information they create daily. To do this effectively, superior tools and methods are required while Knowledge Management (KM) presents itself as an ideal enabler for transforming data to sound decisions. KM is based on a paradigm shift in the business environment where knowledge is central to organisational performance and, by way of effective clinical knowledge discovery techniques, can be used as a process that solves organisational problems by analysing data to identify patterns and relationships that can explain and predict behaviour. This paper examines the efficacy of KM for effecting superior operations in a real-life Clinical Radiology Department in the UK.”
Abstract
T. Goodfellow, R.K. Bali, N. Wickramasinghe, R.N.G. Naguib, International Journal of Biomedical Engineering and Technology 2008 - Vol. 1, No.3 pp. 259 - 272, DOI: 10.1504/IJBET.2008.016960

ICMCC Event Preview 2

The Monday afternoon has 2 sessions, each having 2 parallel tracks.

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Knowledge Management: the key to network-centric healthcare

“The adoption and diffusion of e-health and the application of Information and Communication Technologies (ICTs) in healthcare is being heralded as the panacea. In this context, a model of network-centric healthcare operations has been proffered as the best way to maximise the benefits of ICT as well as to facilitate the rapid sharing of information and effective knowledge building required for the development of coherent objectives and their subsequent attainment. Integral to the success of such a model is the need to embrace the tools and techniques of Knowledge Management (KM) as elaborated upon in the following paper.”
Abstract
N. Wickramasinghe, R.K. Bali, International Journal of Biomedical Engineering and Technology 2008 - Vol. 1, No.3 pp. 342 - 352, DOI: 10.1504/IJBET.2008.016966

Knowledge Management Model for Teleconsulting in Telemedicine

Abstract:
The present article shows a study about requirements for teleconsulting in a telemedicine solution in order to create a knowledge management system. Several concepts have been found related to the term teleconsulting in telemedicine which will serve to clear up their corresponding applications, potentialities, and scope. Afterwards, different theories about the art state in knowledge management have been considered by exploring methodologies and architectures to establish the trends of knowledge management and the possibilities of using them in teleconsulting. Furthermore, local and international experiences have been examined to assess knowledge management systems focused on telemedicine. The objective of this study is to obtain a model for developing teleconsulting systems in Colombia because we have many health-in-formation management systems but they don’t offer telemedicine services for remote areas. In Colombia there are many people in rural areas with different necessities and they don’t have medicine services, teleconsulting will be a good solution to this problem. Lastly, a model of a knowledge system is proposed for teleconsulting in telemedicine. The model has philosophical principles and architecture that shows the fundamental layers for its development.

Lilia Edith Aparicio Pico^a, Orlando Rodriguez Cuenca^a, Daniel José Salas Alvarez^b, Piere Augusto Peña Salgado^b
a Distrital University Francisco José de Caldas, Colombia
^b Córdoba University, Colombia

To be published in “Medical and Care Compunetics 5″, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

Functional and Technological Description of a Real-Time Data Management System for Telehealthcare

Abstract:
In health systems, there has been an emergence of new types of data and new technologies that allow continuously monitoring the status of the patients and make easy the achievement of real time information. The storage of all the acquired information makes possible to identify trends in medical data by means of new Clinical Decision Support subsystems. Current knowledge management solutions are specific, proprietary and closed and can not perform real-time analysis to improve the patient’s diagnosis or treatment. There are neither solutions that integrate the large amount of heterogeneous information that nowadays are available in health environments. To overcome these objections, this paper proposes a new approach to design a data management system in a telehealthcare system with specific real-time constraints on knowledge acquisition and generation. It is a preliminary study and presents the main features of the system architecture and a preview of the technological solution implemented.

Fabiola FERNÁNDEZ^a, Laura M. ROA^a,b, Manuel PRADO^b,a
a Biomedical Engineering Group, University of Seville, Seville, Spain
^b Network Center of Biomedical Research in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Seville, Spain

To be published in “Medical and Care Compunetics 5″, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

Realising the Knowledge Spiral in Healthcare: the role of Data Mining and Knowledge Management

Abstract:
Knowledge Management (KM) is an emerging business approach aimed at solving current problems such as competitiveness and the need to innovate which are faced by businesses today. The premise for the need for KM is based on a paradigm shift in the business environment where knowledge is central to organizational performance. Organizations trying to embrace KM have many tools, techniques and strategies at their disposal. A vital technique in KM is data mining which enables critical knowledge to be gained from the analysis of large amounts of data and information. The healthcare industry is a very information rich industry. The collecting of data and information permeate most, if not all areas of this industry; however, the healthcare industry has yet to fully embrace KM, let alone the new evolving techniques of data mining. In this paper, we demonstrate the ubiquitous benefits of data mining and KM to healthcare by highlighting their potential to enable and facilitate superior clinical practice and administrative management to ensue.
Specifically, we show how data mining can realize the knowledge spiral by effecting the four key transformations identified by Nonaka of turning: (1) existing explicit knowledge to new explicit knowledge, (2) existing explicit knowledge to new tacit knowledge, (3) existing tacit knowledge to new explicit knowledge and (4) existing tacit knowledge to new tacit knowledge. This is done through the establishment of theoretical models that respectively identify the function of the knowledge spiral and the powers of data mining, both exploratory and predictive, in the knowledge discovery process. Our models are then applied to a healthcare data set to demonstrate the potential of this approach as well as the implications of such an approach to the clinical and administrative aspects of healthcare. Further, we demonstrate how these techniques can facilitate hospitals to address the six healthcare quality dimensions identified by the Committee for Quality Healthcare.

Nilmini WICKRAMASINGHE^a, Rajeev K BALI^b,c, M Chris GIBBONS^d, Jonathan Schaffer^e
a Center for the Management of Medical Technology, Stuart Graduate School of Business, Illinois Institute of Technology, Chicago, USA
^b Knowledge Management for Healthcare (KARMAH) research subgroup,
^c Biomedical Computing and Engineering Technologies Applied Research Group (BIOCORE), Coventry University, UK
^d Johns Hopkins Urban Health Institute, Johns Hopkins Medical Institutions, Baltimore, USA
^e The Cleveland Clinic, Cleveland, USA

To be published in “Medical and Care Compunetics 5″, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

InWiM: Knowledge Management for Insurance Medicine

Abstract:
Suva (Swiss National Accident Insurance Fund) is the most important carrier of obligatory accident insurance in Switzerland. Its services not only comprise insurance but also prevention, case management and rehabilitation. Suva’s medical division supports doctors in stationary and ambulatory care with comprehensive case management and with conciliar advice. Two Suva clinics provide stationary rehabilitation. Medicine in general, including insurance medicine, faces the problem of a diversity of opinions about the facts of a case. One of the reasons is a diversity of knowledge. This is the reason why Suva initiated a knowledge management project called InWiM. “InWiM” is the acronym for “Integrierte Wissensbasen der Medizin” which can be translated as “Integrated Knowledge Bases in Medicine”. The project is part of an ISO 9001 certification program and comprises the definition and documentation of all processes in the field of knowledge management as well as the development of the underlying ITC infrastructure. The knowledge representation model used for the ICT implementation considers knowledge as a multidimensional network of interlinked units of information. In contrast to the hyperlink technology in the World Wide Web, links between items are bidirectional: the target knows the source of the link. Links are therefore called cross-links. The model allows annotation for the narrative description of the nature of the units of information (e.g. documents) and the cross-links as well. Information retrieval is achieved by means of a full implementation of the MeSH Index, the thesaurus of the United States National Library of Medicine (NLM). As far as the authors are aware, InWiM is currently the only implementation worldwide – with the exception of the NLM and its national representatives - which supports all MeSH features for in-house retrieval.

Juerg P. Bleuer^a, Kurt Bösch^b, Christian A. Ludwig^b
a Healthevidence GmbH, Berne, Switzerland
^b Suva, Lucerne, Switzerland

To be published in “Medical and Care Compunetics 5″, IOSPress, 2008.
To be presented at the ICMCC Event 2008.

Knowledge Management and Electronic Care Records: incorporating social, legal and ethical issues

James Bassinder, Rajeev K Bali and Raouf Naguib
Pan Birmingham & Black Country Local Specialised Services Groups, Hosted Service for Eastern Birmingham Primary Care Trust, UK;
Biomedical Computing and Engineering Technologies Applied Research Group (BIOCORE), Coventry University, UK

Abstract

Many challenges face developers of secure computer-based clinical systems but the technical problems are overshadowed by many obstacles, key amongst them being social and ethical issues. A sound Knowledge Management (KM) structure within clinical environments can recognise the responsibility of healthcare professionals to keep patient clinical data (for example, electronic care record (ECR) systems) secure. An arrangement is proposed that gives the most senior clinician in a healthcare facility the ultimate responsibility for security of clinical data held in the organisation. Ideally, the senior clinician would possess training and experience in information systems and their security. Contracts should be developed between healthcare facilities and their patients, defining the limits to the use and disclosure of clinical health data. However, we are observing increasing confusion about the term ‘Knowledge Management’ which may be limited both its efficacy and effectiveness. Health organisations are referring to the term in various contexts and health informatics articles frequently use the term and interpret it in diverse ways. Given the divergence of views, this paper will attempt to establish KM’s efficacy for the implementation of electronic care record systems.

Improving Uptake of a Breast Screening Programme: a Knowledge Management approach for opportunistic intervention

Vikraman Baskaran*, Rajeev K Bali*, Hisbel Arochena*, Raouf NG Naguib*, Margot Wheaton**, Matthew Wallis**
* Biomedical Computing and Engineering Technologies Applied Research Group (BIOCORE), Coventry University, UK
** Warwickshire, Solihull & Coventry Breast Screening Service, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK

Abstract.

Reducing mortality from breast cancer through screening has been accepted as a viable tool and breast screening has attracted a lot of attention from healthcare organisations worldwide. Government funded screening programmes in Europe, the Americas and Australia have made good progress in diagnosing and treating breast cancer through effective screening programmes. The UK’s National Health Service (NHS) National Screening Programme manages one of the biggest publicly funded breast screening programmes. In the UK, only 75% of the intended population is screened and a diverse set of efforts has attempted to identify and initiate countermeasures to improve screening attendance. This paper identifies how innovative use of information and communication technologies (ICTs) can be the focus for strategising not only improved screening attendance but also better quality of care for women.

Clinical Knowledge Management

Rajeev K Bali, Coventry University, UK.
Ashish Dwivedi, Hull University Business School
Email: r.bali@ieee.org

Abstract:

This workshop will examine some of the key issues surrounding the incorporation of the Knowledge Management (KM) paradigm for clinical and healthcare environments. What is KM? Whom does it benefit? How is it carried out? Questions such as these will be addressed as well as discussions as to whether it would be beneficial for healthcare stakeholders to adopt the KM paradigm so as to facilitate effective decision-making and integration in the context of healthcare delivery. The key to the success of KM in the clinical and healthcare sectors is to achieve an effective integration of technology with human-based clinical decision-making processes. By doing so, healthcare institutions are free to disseminate acquired knowledge in a manner which ensures its availability to other healthcare stakeholders. This is of paramount importance as clinical and healthcare management continues its growth as a global priority area.