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Knowledge Management and Translation in Health Systems Research

Knowledge Management and Translation in Health Systems Research. Concepts of Knowledge in Healthcare Knowledge Management and Translation in Healthcare A KMT Framework in Health Systems Research Examples in HIS Evaluation, Terminology Standards and End-of-Life Care Surveillance Next Steps.

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Knowledge Management and Translation in Health Systems Research

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  1. Knowledge Management and Translation in Health Systems Research • Concepts of Knowledge in Healthcare • Knowledge Management and Translation in Healthcare • A KMT Framework in Health Systems Research • Examples in HIS Evaluation, Terminology Standards and End-of-Life Care Surveillance • Next Steps KMT in Health Systems Research

  2. Concepts of Knowledge in Healthcare Knowledge is a mix of experience, values, expert insights and contextual info that provides a framework for evaluating and incorporating new information, experiences (Davenport & Prusak 1998) Explicit/Tacit Knowledge A process that organizationally amplifies knowledge created by individuals and crystallizes it as part of knowledge system of an organization (Nonaka et al. 1996) KMT in Health Systems Research

  3. Knowledge Management and Translation in Healthcare • Public Health – Tobacco Control, Surveillance • Acute/Tertiary/Continuing Care – Patient Safety • Primary Care – Chronic Disease Management • Care – Continuity, Circle, Collaborative, Self • Health Systems – Complex, Interdependent, Dynamic, Feedback-loops Research-based Knowledge Knowledge Translation Practice-based Knowledge Knowledge Management Large-scale Health Systems KMT in Health Systems Research

  4. Knowledge Management and Translation in Healthcare Social Context (structures, values, preferences) Production Collection, Generation, Synthesis, Identification Codification, Storage Packaging, Coordination Integration, Evaluation, Reflection, Sustainability Explicit/Tacit Knowledge Explicit/Tacit Knowledge Use Refinement Distribution, Sharing, Application, Adaptation KMT in Health Systems Research

  5. Knowledge Management and Translation in Healthcare Ecological Context (organizational, political, cultural, media) Audience Combination, Articulation, Internalization, Socialization Policy maker, Practitioner, Researcher, the Public Explicit/Tacit Knowledge Mechanisms Motivations Decision, Education, Innovation, Advocacy KMT in Health Systems Research

  6. Knowledge Management and Translationin Healthcare EXPLICIT/TACIT KNOWLEDGE Evidence Policy Experience Contact KNOWLEDGE MANAGEMENT Production Use Refinement Social Context KNOWLEDGE TRANSLATION Audience Motivations Mechanisms Ecological Context KMT in Health Systems Research

  7. Knowledge Management and Translationin Healthcare KMT in Health Systems Research

  8. A Knowledge Management and TranslationFramework in Health Systems Research EXPLICIT/TACIT KNOWLEDGE Evidence Policy Experience Contact KNOWLEDGE MANAGEMENT Production Use Refinement Social Context KNOWLEDGE TRANSLATION Audience Motivations Mechanisms Ecological Context OUTCOMES Evidence Base for Dissemination Knowledge Base for Linking Science and Practice Implementation Framework Interaction and Collaboration Methodology KMT in Health Systems Research

  9. KNOWLEDGE MANAGEMENT EXPLICIT/TACIT KNOWLEDGE KNOWLEDGE TRANSLATION KMT STRATEGIES 4P’s Purpose People Process Product STRATEGY MAPS KMT Infrastructure 4P-KMT Infrastructure 4P-KMT INFRASTRUCTURES Organization, Information, Technology, Finance OUTCOMES KMT in Health Systems Research

  10. KMT in Health Systems Research

  11. KMT in Health Systems Research

  12. A Knowledge Management and TranslationFramework in Health Systems Research KMT in Health Systems Research

  13. A Knowledge Management and TranslationFramework in Health Systems Research KMT in Health Systems Research

  14. A Knowledge Management and Translation Framework 4P-KMT OUTCOMES KNOWLEDGE MANAGEMENT AND TRANSLATION AUDIENCES Policy maker Practitioner Researcher Public MOTIVATIONS Decision Education Innovation Advocacy MECHANISMS Combination Articulation Internalization Socialization Purpose Evidence Base People KNOWLEDGE MANAGEMENT Science-Practice Linkage PRODUCTION Creation Collection Generation Synthesis Identification Organization Codification Storage Packaging Coordination USE Distribution Sharing Application Adaptation REFINEMENT Integration Evaluation Reflection Sustainability Process Implementation Framework Product Interaction & Collaboration Methodology INFRASTRUCTURES Organization, Information, Technology, Finance KMT in Health Systems Research

  15. Examples in HIS Evaluation,Terminology Stds, EOL Care Surveillance • eHealth Observatory to Monitor Effects of HIS Deployment in Canada • Adoption, Use and Impact of Terminology Standard in Palliative Care • End-of-life Care Surveillance Team Network Development KMT in Health Systems Research

  16. Examples in HIS Evaluation,Terminology Stds, EOL Care Surveillance eHealth Observatory to Monitor Effects of HIS Deployment in Canada HIS Users Early Adopters Advanced-users Late Adopters Intermediate-users Basic-users Non-users HIS Lifecycle Requirements DeploymentUseAdaptation Telescopic Views Close-up In-motion Fixed-anchor Wide-angle Meta-analysis And Review HIS Effects Impact Evaluation Usability Engineering Process Evaluation KMT in Health Systems Research

  17. Examples in HIS Evaluation,Terminology Stds, EOL Care Surveillance PharmaNet-MedRec Study Phases – 6 months each Baseline Implementation-1 Implementation-2 Followup-1 Followup-2 No PharmaNet PharmaNet1 PharmaNet2 PharmaNet1/2 Site-3 Site-2 Time series cohort design Site-1 No MedRec Control Group MedRec Intervention Group Admission Discharge Usability engineering ? = MedRec-1 MedRec-2 (Un)/Intentional Discrepancies ? = Case finding Expert consensus Potential Adverse Drug Events KMT in Health Systems Research

  18. Examples in HIS Evaluation,Terminology Stds, EOL Care Surveillance Terminology = Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) KMT in Health Systems Research

  19. 211334007|Abrasion, ankle| 399963005|Abrasion|:     363698007|Finding site|=67269001|Skin structure of ankle| 64572001|Disease|:     116676008|Associated morphology|=400061001|Abrasion|,     363698007|Finding site|=67269001|Skin structure of ankle| 243796009|Situation with explicit context|:     246090004|Associated finding|=(          64572001|Disease|:               116676008|Associated morphology|=400061001|Abrasion|,               363698007|Finding site|=67269001|Skin structure of ankle|     ),     408729009|Finding context|=410515003|Known present|,     408731000|Temporal context|=410512000|Current or specified|,     408732007|Subject relationship context|=410604004|Subject of record| KMT in Health Systems Research

  20. Examples in HIS Evaluation,Terminology Stds, EOL Care Surveillance An Interactive EOL Care Surveillance System Data Sources Information Products CIHI/BC EOL datasets Common Data Definitions Administrative Databases Web assessment tool Scannable paper Teleform MS-Access assessment tool ISAAC tool for ESAS/PPS EOL Epidemiologic Profiles RAI/MDS Databases Web Interface Module EOL 1-year Survival Profiles VIHA MDS-HC/RC datasets Clinical Quality Module Epidemiologic Profile Module Survival Analysis Module EOL Resource Use Profiles Assessment/ Prognostic Databases Resource Use Module Scenario Modeling Module Meta-analysis Module VH/Edm Prognostic datasets EOL Clinical Quality Profiles Data Translation Module Regional/ Provincial Databases Published Secondary Sources SNOMED CT Terminology Server Common EOL Metadata Dictionary Common EOL Database Repository Meta-analysis Published EOL Studies EOL Care Scenarios KMT in Health Systems Research

  21. Data Sources Extracted Datasets Additional Datasets Consolidated Datasets Administrative Data Vital Statistics Discharge Abstracts Pharmacy Prescriptions Palliative Benefits Plan Medical Service Plans Home/Community Care EOL Care Surveillance Framework, Methods, Data Sources Western EOL dataset BC Branch EOL dataset Updated BC EOL dataset RAI/MDS Data MDS-Home Care MDS-Residential Care Client Grouping/CHESS Vancouver Island HA MDS datasets BC EOL dataset + BC MDS + BC palliative resource + BC program + BC known cancer + VH prognostic AB EOL dataset + Edm prognostic + AB known cancer? + AB palliative resource? Yukon, Ottawa datasets BC MDS datasets Assessment/Prognostic Data Demographics, PPS ESAS/MMSE/PNHA/PPS PaP/PPI/ECOG/KPS/PPS Victoria Hospice (VH) prognostic dataset Edmonton (Edm) prognostic datasets Updated VH and Edm prognostic datasets Regional/Provincial Data BC Cancer Agency Info System VH Palliative Program Regional Information Systems BC known cancer dataset VH Program dataset BC Palliative resource datasets Meta-analysis datasets Published Secondary Source (e.g. EOL epidemiology, clinical quality, resource use, burden of dying) Meta-analysis datasets KMT in Health Systems Research

  22. Sample EOL epidemiologic profiles Example - EOL Epidemiologic Profiles KMT in Health Systems Research

  23. Sample EOL 1-year survival profiles KMT in Health Systems Research

  24. Sample EOL 1-year survival profiles KMT in Health Systems Research

  25. Sample EOL clinical quality profiles KMT in Health Systems Research

  26. Surveillance Strategy Better Understanding Of EOL Care Learning Strategy Health System Perspective Improve Data Quality Improve Data Use Enhance EOL Care Build Analytic Capacity Engage in KT Patient/Family Perspective Epidemiologic Profiles 1-yr Survival Profiles Resource Use Profiles Clinical Quality Profiles Team Network Perspective Common Data Definitions Meta-analysis EOL Studies EOL Care Scenarios Startup Consolidation Enhancement Integration Planning Construct platform Obtain data access Refine data definitions Assemble datasets Conduct meta-analysis #1 Publish 1st info products Conduct KT workshop #1 Write progress report #1 Consolidate datasets Conduct meta-analysis #2 Publish 2nd info products Conduct KT workshop #2 Plan yr-2 data extraction Write progress report #2 Enhance datasets Conduct meta-analysis #3 Publish 3rd info products Conduct KT workshop #3 Write progress report #3 Expand datasets Conduct meta-analysis #4 Publish 4th info products Discuss integration plans Conduct KT workshop #4 Conduct impact evaluation Write renewal plan Learning/Growth Perspective Technology: A Web based Interactive EOL Care Surveillance System Platform Information: Data Sources  Extracted Datasets  Additional Datasets Consolidated Datasets People: Project Team, Steering Committee, Executive Co-Sponsors, CPAC Network Secretariat Organizations: Team, Partners, Collaborators, CPAC Surveillance, Other Networks KMT in Health Systems Research

  27. Next Steps • Applying the KMT Framework for Health Systems Research … • eHealth Observatory for HIS Evaluation • Models, methods and metrics; Evidence and better practices; KT and capacity building; eLearning resources/tools, eHealth community • Adoption/Use/Impact of SNOMED CT Terminology Standard • Encoding methodology; Encoding/mapping rules; Encoded terms/maps; Terminology assets; Prototype for trial use; Lessons for KT • Interactive EOL Care Surveillance System and Team Network • Knowledge based info products; Community of practice; KT and capacity building; KMT strategy/process/infrastructure KMT in Health Systems Research

  28. Knowledge Management and Translation in Health Systems Research • Questions, Comments, Feedback? • Acknowledgments • Canadian Institutes for Health Research – STIHR and NET • CIHR Institute of Health Services and Policy Research • Canada Health Infoway • College of Pharmacists of BC • BC Ministry of Health, Pharmaceutical Services Division • Canadian Partnership Against Cancer and Partner Organizations • Canadian Institute for Health Information • HINF, UVic, colleagues • Staff, trainees, collaborators …. • Contact Francis Lau fylau@uvic.ca KMT in Health Systems Research

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