Km in Health Sector

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Knowledge Management Practices and Healthcare Delivery: A Contingency Framework Prantik Bordoloi and Nazrul Islam School of Management, Asian Institute of Technology, Bangkok, Thailand Prantik.Bordoloi@ait.ac.th nazrul@ait.ac.th

Abstract: Being a knowledge driven process, healthcare delivery provides opportunity to incorporate knowledge management practices to improve processes. But it has also been noted that knowledge management is systematically more complex in healthcare and minimal research exist to guide academic and organizational stakeholders. The purpose of this paper is to investigate the application and impact of knowledge management practices in healthcare delivery. The paper is conceptual in its nature and aims to propose a contingency-based framework to drive further empirical research. The paper is primarily based on a literature review of the healthcare knowledge management and associated information sciences research streams. The fundamental research questions are: ‘‘what and how do the various knowledge management practices affect the performance of healthcare delivery?’’ and ‘‘what are the contingent and contextual factors that needs to be considered when exploring the relationship between knowledge management practices and performance of healthcare delivery?’’ We first discuss facets of performance in healthcare delivery but thereafter focus on the technical and interpersonal care aspects of healthcare delivery. We investigate knowledge management practices in the areas of (i) knowledge acquisition and sharing, (ii) knowledge assimilation and application. In our paper we explore how the different knowledge management practices affect the performance of healthcare delivery through technical and interpersonal care. Thereafter we explore the factors of physician characteristic, ailment characteristics, organizational IT infrastructure and organization processes, on which the conceptual framework will be contingent on. We thereafter evaluate the conceptual framework with a case study. From an academic perspective our paper identifies some key knowledge management practices and explores their linkages with technical and interpersonal care, while from a practical point of view it provides implications for administrators and practitioners in healthcare delivery on the management of contingency factors so that the knowledge management practices can be properly implemented. Keywords: healthcare knowledge management; healthcare delivery performance; electronic medical records; clinical decision support; evidence based medicine

1. Introduction
Researchers have noted that knowledge management can be used to understand performance in organizations (Davenport and Prusak, 1998). Some recent studies such as those of Chen and Huang (2009) and Fugate et al. (2008) have noted that knowledge management process have positive effect on operational and organizational performance. Healthcare delivery is a knowledge driven process and hence knowledge management (KM) and knowledge management capacity provides an opportunity for improvement in process performance (Nilakanta et al., 2009). Recent reviews on knowledge management in the healthcare industry show important insights into the state of present research (Nicolini et al., 2008, Sheffield, 2008). Sheffield (2008) states that knowledge management is systemically more complex in healthcare because the three domain of knowledge creation, knowledge normalization and knowledge application correspond to three knowledge management perspectives i.e., personal values, social norms and objective facts, respectively, which have inherent tension between and within them. Nicolini et al. (2008, 247) has noted that knowledge management research in healthcare over the years has focused on three overarching themes: “the nature of knowledge in the healthcare sector, the type of KM tools and initiatives that are suitable for the healthcare sector, and the barriers and enablers to adoption...
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