Practical Approaches to Knowledge Management and Clinical Decision Support

Roberto A. Rocha, Saverio M. Maviglia, Margarita Sordo, Beatriz H. Rocha

Partners Healthcare System, Boston, MA, USA

Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA

Harvard Medical School, Boston, MA, USA



Clinical decision support (CDS) is widely recognized as a critical feature of any modern clinical information system or electronic health record. However, current healthcare CDS efforts frequently fail to consider the important aspects of knowledge content curation and long-term maintenance. Similar to what has been observed in other industries, healthcare must create processes to identify the “best” knowledge, ensure knowledge currency and specificity, align the application of knowledge to organizational goals, and systematically deploy the knowledge using IT-based and non-IT-based interventions. This tutorial describes strategies, processes and best practices to create and maintain the clinical knowledge assets necessary for effective and sustainable decision support interventions. Attendees will learn about the different types of clinical knowledge assets and their application to support evidence-based medical practice and research. Knowledge curation and maintenance processes will be presented through practical and illustrative examples from real clinical settings. The instructors will explain practical approaches to collaborative knowledge asset management, leveraging their experience within large and integrated healthcare delivery organizations. A variety of examples will be used to illustrate curation and maintenance lifecycles from real clinical settings, including details about governance processes, personnel skills and roles, and software tools.


Outline of topics

  1. Clinical Knowledge Management Program

    1. Strategic, governance, and business issues

    2. Implementation and staffing considerations

    3. Technology and configuration options

  2. Knowledge Content Lifecycle

    1. Content modeling and selection of sources

    2. Collaborative development and review

    3. Sustainable long-term maintenance

  3. Knowledge Management Software Infrastructure

    1. Requirements of different CDS modalities

    2. Curation tools for reference and executable knowledge

    3. Reference standards and knowledge exchange

  4. Future Directions and Opportunities

    1. Advanced and personalized CDS

    2. Intelligent curation and maintenance tools

    3. Knowledge socialization and CDS beyond organizational boundaries

All materials will be made available to the attendees via a “wiki,” including additional examples and reference materials. Attendees will be encouraged to access the tutorial wiki before the event, once their registration is confirmed. During the event, attendees will be encouraged to participate actively in the discussions, and all questions and comments will be documented in the tutorial wiki.


Learning objectives

  1. Describe the main characteristics of a Clinical Knowledge Management program and the importance of well defined knowledge management practices

  2. Describe the lifecycle phases of different clinical knowledge content types, including relevant tools, reference sources, and representation standards

  3. Describe and categorize the knowledge content required for the successful implementation of different modalities of CDS interventions

  4. Explain the common mechanisms to overcome CDS functionality limitations found in commercially available clinical information systems and electronic health records

  5. Outline opportunities for CDS and Knowledge Management innovation and advancement


Target audience

Physicians, nurses, and other healthcare professionals involved with the configuration and maintenance of clinical knowledge content and CDS interventions; Knowledge engineers, informaticians, and business analysts involved with the curation and deployment of clinical knowledge content and CDS interventions; Computer scientists, system architects, and software engineers involved with the implementation of CDS and Knowledge Management functionality within clinical information systems and electronic health records, Decision makers seeking to understand the rationale for implementing Clinical Knowledge Management programs and CDS tools and interventions.