By Q. Cole. University of Hawai`i, Manoa.

Copying or distributing in print or electronic forms without written permission of Idea Group Inc buy zofran 4 mg without prescription. So buy generic zofran 4mg on-line, the context—in the sense of the situation in which the user is immersed—plays a major role (Johnson, 2003; Lawrence, 2000). Budzik, Hammond and Birnbaum (2001) discuss two common approaches to handle different user contexts: 1. Relevance feedback: The user begins with a query and then evaluates the answer set. By providing positive or negative feedback to the IR system, this can modify the original query by adding positive or negative search terms to it. In an iterative dialogue with the IR system, the answer set is then gradually narrowed down to the relevant result set. However, as studies (Hearst, 1999) have shown, users are generally reluctant to give exhaustive feedback to the system. Building user profiles: Similar to the relevance feedback, the IR system builds up a user profile across multiple retrieval sessions, that is, with each document the user selects for viewing, the profile is adapted. Unfortunately, such a system does not take account of “false positives”, that is, when a user follows a link that turned out to be of no value when inspecting it closer. Additionally, such systems integrate short term user interests into accumulated context profiles, and tend to inhibit highly specialized queries which the user is currently interested in. Budzik, Hammond & Birnbaum (2001) presented a system that tries to guess the user context from open documents currently edited or browsed on the work space. In an evaluation of their system both achieved consistently better results than standard search engines are able to achieve without context.

This is one of the fundamental reasons why KM does not have a widely accepted framework that can enable healthcare institutions in creating KM systems and a culture conducive to KM practices buy zofran 4mg visa. KM is underpinned by information technology paradigms such as Workflow zofran 8 mg low cost, Intelligent Agents and Data Mining. According to Manchester (1999), a common point about software technologies such as (1) information retrieval, (2) document management and (3) workflow processing is that they blend well with the Internet and related technologies (i. As KM deals with the tacit and contextual aspects of information, it allows an organi- zation to know what is important for it in particular circumstances, in the process maximizing the value of that information and creating competitive advantages and wealth. Applicability of the KM Paradigm in Healthcare A KM solution would allow healthcare institutions to give clinical data context, so as to allow knowledge derivation for more effective clinical diagnoses. In the future, healthcare systems would see increased interest in knowledge recycling of the collaborative Copyright © 2005, Idea Group Inc. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Issues in Clinical Knowledge Management 7 learning process acquired from previous healthcare industry practices. This chapter puts forward the notion that this sector has been exclusively focused on IT to meet the challenges described above and reiterates that this challenge cannot be met by an IT led solution. KM initiatives should be incorporated within the technological revolution that is speeding across healthcare industry. There has to be balance between organizational and technological aspects of the healthcare process, that is, one cannot exist without the other (Dwivedi et al. This chapter emphasizes the importance of clinicians taking a holistic view of their organization. Clinicians therefore need to have an understanding of IT in a healthcare context and a shared vision of the organization. Clinicians and healthcare administrators thus need to acquire both organizational and technological insights if they are to have a holistic view of their organization. The KM paradigm can enable the healthcare sector to successfully overcome the information and knowledge explosion, made possible by adopting a KM framework that is specially customized for healthcare institutions in light of their ICT implementation level. Adoption of KM is essential for healthcare institutions as it would enable them to identify, preserve and disseminate “best context” healthcare practices to different healthcare stakeholders.

For example purchase zofran 8 mg amex, Marwick (2003) outlines similar views and responses as having greeted the introduction in the USA of the privacy rule of the Health Insurance Portability and Accountability Act buy cheap zofran 4 mg online. However health organisations need to increasingly strive to create a culture that respects and protects health information, and seek to demonstrate and reinforce that culture through a number of basic or initial communication, human resource or technical steps. These include creating with, and communicating to, their communities clear open policies around the nature and purpose of health information flows and utilisation. These include the risks and benefits of information flowing or not flowing and respective privacy versus sub-optimal care risks. In pragmatic terms this may take the form of conversations, leaflets, posters or web-sites. Human resource processes may include training and development and professionalisation of all healthcare workers in terms of their attitude to health information and clear disciplinary procedures for malicious use. Anderson (1996) has highlighted the impor- tance of training and procedures for the high-risk area of providing patient information on the telephone. Davis, Domm, Konikoff and Miller (1999) have suggested the need for specific medical education on the ethical and legal aspects of the use of computerised patient records. Technical processes may include ensuring that an electronic information system has at least an audit trail that allows who has viewed or accessed a particular piece of health data to be monitored, providing some degree of psychological reassurance to patients and psychological deterrence against malicious use. While having highlighted some of the concerns around restriction of information flows, particularly if the clinician is not advised of the suppression there is of course a place for restricted access for sensitive information. This may include allocating graded access levels to certain categories of information and graded access levels for providers or users, with the user only able to access information for which they have an appropriate level of clearance. The system may also include a “break glass” or override facility for emergencies, which allows access to restricted information, but triggers a formal audit or justification process.