Just-in-Time Delivery Comes to Knowledge Management

Like all primary care physicians, Dr. Bob Goldszer must stay on top of approximately 10,000 different diseases and syndromes, 3,000 medications, 1,100 laboratory tests, and many of the 400,000 articles added each year to the biomedical literature. That's no easy task. And it is, quite literally, a matter of life and death. The Institute of Medicine's 1999 report, To Err Is Human, suggests that more than a million injuries, and 90,000 deaths are attributable to medical errors annually. Something like 5% of hospital patients have adverse reactions to drugs, another study reports, and of those, 43% are serious, life threatening, or fatal. Many knowledge workers have problems similar to Dr. Goldszer's (though they're usually less life threatening). No matter what the field, many people simply can't keep up with all they need to know. In the early years of knowledge management, companies established knowledge networks and communities of practice, built knowledge repositories, and attempted to motivate people to share knowledge. But each of these activities involved a great deal of additional labor for knowledge workers. A better approach, say the authors, is to bake specialized knowledge into the jobs of highly skilled workers. Partners HealthCare has started to embed knowledge into the technology that doctors use in their jobs so that consulting it is no longer a separate activity. Now when Dr. Goldszer orders medicine or a lab test, the order-entry system automatically checks his decision against a massive clinical database as well as the patient's own medical record. Knowledge workers in other fields could likewise benefit from a just-in-time knowledge-management system tailored to deliver the right supporting information for the job at hand.