Development of an NMAHP eHealth e-Library and
Managed Knowledge Network (MKN)
JUNE 2007 /
/ Report on Needs Analysis for the
Development of an NMAHP eHealth e-Library and Managed Knowledge Network (MKN)
MAY 2007
Gillian Flett, Information Specialist /
Project Title / NMAHP eHealth MKN
Project Code / NM
Document Title / Report on Knowledge and Information Audit for the
Development of an NMAHP eHealth e-Library and
Managed Knowledge Network (MKN)
Document Type / Needs analysis
Author / Gillian Flett, Information Specialist
Version no. / Summary of changes / Date
0.1-0.4 / Various changes to draft format
1.0 / Final version for circulation to Project Board / 23/06/07
Sign-off
Distribution / NMAHP eHealth MKN Project Board / 24/06/07
KSG Team / 24/06/07
TABLE OF CONTENTS
EXECUTIVE SUMMARY 3
1 Background 4
2 Methodology 6
2.1 Interviews incorporated in a CPD package 6
2.2 Online Questionnaire 7
2.3 Literature collation/theming 7
2.4 Focus Group 8
2.5 Summary 8
3 Findings 9
3.1 Interviews incorporated in a CPD package 9
3.2 Online Questionnaire 21
3.3 Literature Collation/ Theming 30
3.4 Focus Group Discussion : what makes a successful network? 31
4. Discussion: Developing Knowledge Services for the NMAHP eHealth MKN. 33
4.1 User profile 33
4.2 Information Sources and Resources 35
4.3 Information organisation and retrieval 35
4.4 Social networking tools and services: building the network 36
4.5 Interface 37
4.6 Training and development for Knowledge Management competencies 38
4.7 Facilitating development of the NMAHP eHealth MKN 38
4.8 Outcomes and benefits 39
5. Next steps 41
6. References 41
EXECUTIVE SUMMARY
This paper reports the findings of a knowledge and information audit to determine the knowledge services needed to facilitate the full engagement of nurses, midwives and allied health professionals in eHealth developments. Recommendations are made for resources, services, tools, training and facilitation to underpin development of a Special e-Library and Managed Knowledge Network (MKN) for NMAHP eHealth.
Methodology
A triangulation approach was employed, highlighting the consistent themes from multiple methodologies. Semi-structured interviews, based on reflection on scenarios of real-life information need, provided in-depth insight into participants’ information-seeking behaviour and their understanding of knowledge management concepts. An online questionnaire survey provided more specific information on the range of topics, sources and services required. Both approaches sought to identify the support required at each stage of the knowledge management cycle( question- -search-evaluate- combine/create – share – adapt-apply). Theming of a selection of recent literature, and a focus group on characteristics of a successful network, reinforced and extended the findings of the interviews and questionnaires.
Findings: Knowledge Support for NMAHP eHealth
The Special e-Library and knowledge services developed to support NMAHP eHealth will need to support:
The diverse range of roles, subject interests of an audience which engages with and interprets eHealth in a multiplicity of ways. Clinical, managerial and educational perspectives need to be supported as well as the technical / systems aspects of eHealth and Health Informatics.
The fact that eHealth is a new, emerging field, with its common language still evolving and the associated challenges for information retrieval.
A varying range of knowledge management and information technology competences across the network - eg by offering basic and advanced options for functionality, access to knowledge management training resources, and support from information professionals or other MKN members.
Easy access to key published sources for this network, including
core bibliographic databases (eg MEDLINE CINAHL), journal articles, key informatics and discipline-specific journals;
information about current and recently completed eHealth projects;
local and national strategy and policy initiatives;
The way the NMAHP eHealth network already operates to a large extent through communities, placing a high premium on sharing information with colleagues and relying heavily on their combined expertise. This network approach can be strengthened through improved use of MKN member profiles providing information about subject interests, current projects and activities, and through more flexible, personalised management of contacts lists, online discussion and automated alerting services.
Future development strategy for this MKN needs to focus on developing a fuller understanding of how they can maximise the impact of the information retrieved in the “Ask-Search” stages of the knowledge management cycle by developing their skills in evaluating, combining and creating, and sharing information, and contextualising it for application to practice.
Ø A Managed Knowledge Network supported and developed along these lines will create a vital and responsive human and technology infrastructure to fulfil the strategic goals of NMAHP eHealth in terms of: clinical ownership and engagement; communication and awareness; building workforce capacity and leadership, all with the aim of benefiting patient care through effective use of information and communications technology.
1 1. BACKGROUND
Background
1.1 eHealth has been defined as “an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology.”(1)
eHealth developments are central to improving Scotland’s health and healthcare. Scotland’s eHealth Strategy aims to meet Delivering for Health’s (2) commitment to a comprehensive health information system built around and Electronic Health Record (EHR), to support the transition to a new, continuous and integrated model of care that works across boundaries of organisation and sector and is increasingly community centred.
1.2 NMAHP eHealth aims to strengthen the NMAHP engagement in development and expansion of the comprehensive health information system envisaged in the national eHealth strategy, founded on the integration of clinical knowledge and data standards. This engagement should enable NMAHPs to:
· use information to care for patients
· share information with their multi-disciplinary and multi-agency teams
· compare that information to improve health outcomes
There are four strands to NMAHP eHealth strategy (3):
3 Ownership and engagement
4 Education and staff development
5 Information and knowledge management in relation to electronic health record data
(e.g. data standards, primary and secondary information usage)
6 Defining and delivering information infrastructure and solutions to meet NMAHP requirements.
1.3 The NMAHP eHealth Managed Knowledge Network (MKN) project aims to develop a Managed Knowledge Network and supporting Specialist e-Library for NMAHP eHealth. The NMAHP eHealth MKN will foster all aspects of the NMAHP contribution to eHealth strategy by engaging the NMAHP community in accessing, sharing, creating and using knowledge resources in order to translate knowledge into practice in eHealth.
1.4 In developing this MKN, the overall goal is to embed quality information management and informatics practice into NMAHP clinical and managerial practice. Specific objectives have been defined (4) as (4):
· Support the clinical engagement necessary for the success/benefit realisation of the eHealth strategy
· Actively facilitate learning, development and sharing of information and best practice
· Identify priority areas for development of the NMAHP eHealth evidence base
· Develop partnerships with further education and NHS Boards around research and development
· Develop methodology to support clinical engagement more widely in eHealth
In practical terms, knowledge management tools should be developed to:
· support on-line NMAHP eHealth communities of practice through the umbrella portal
· manage the information resources used by the communities of practice
· facilitate a two way mechanism for consultation and communication on strategic and operational eHealth
1.5 The NMAHP eHealth MKN builds on the achievements of the Community Nursing Network (CNNet) and AHP eHealth in developing communities of practice, extending these lines of development to more active and developed facilitation of knowledge management for the wider network of NMAHP eHealth stakeholders.
1.6 This report outlines the findings of an information and knowledge needs analysis designed to define the knowledge management resources and tools required of a Specialist e-Library to support the new NMAHP eHealth Managed Knowledge Network to fulfil its objectives.
2. METHODOLOGY
2 Methodology
Four complementary strands of enquiry were employed in succession, each strand contributing to the next to build up a comprehensive picture of knowledge needs
2.1 Interviews incorporated in a CPD package
2.1.1 To encourage uptake and at the same time to generate a wider understanding of the knowledge management principles underpinning the MKN, stakeholder interviews were incorporated within a Knowledge Management CPD package mapped to KSF competencies IK 1 & 3 Level 4. Interviews adopted a reflective, scenario-based approach, incorporating elements of critical incident technique.
2.1.2 The package presented key Knowledge Management concepts, introduced respondents to the Knowledge Management Cycle (Question-Source-SearchFind-Evaluate-Combine/Create-Share-Adapt-Apply), and gave respondents an understanding of the Knowledge Management tools available through the NHS Scotland e-Library. The practical session involved the respondent reflecting on a recent scenario of information need, how they defined their questions, sources of explicit and tacit knowledge (eg colleagues) used, and barriers and facilitators of meeting that need. The aim of this scenario-based approach was to embed the knowledge needs analysis in real-life contexts. This in turn should help to ensure that the resulting knowledge management system supports day to day practice. The ensuing discussion engaged respondents in defining the different types of knowledge seeker (personas) that would use the MKN. Respondents were then asked to consider what forms of knowledge support they would find useful in relation to the seven stages of the Knowledge Management Cycle. An optional practical training session covered the Shared Space and e-Library. Due to time constraints this session could be left as a handout to be completed in the respondent’s own time.
2.1.3 Initially, the CPD package was piloted with the CNNet network, with participants interviewing each other. The remaining interviews were conducted by the Information Specialist with one respondent in most cases; occasionally two.
2.1.4 Invitations to complete the CPD package were sent to all members of the NMAHP Shared Space and invitations were also sent through the SNEF and CNNlink email distribution Lists. 20 interviews were completed over a 4 week period and the information collated was entered into an Access database for analysis of the results. Once the information had been inputted into the database, sections of the information were themed i.e. questions, task and activities, sources, barriers and areas where the MKN could potentially help.
2.2
3.2 Online Questionnaire
2.2.1 Findings from the CPD Package interviews helped to create the online questionnaire. This explored at a more detailed and specific level the respondents’ areas of focus, knowledge resources used and possible tools and services that could support the MKN. This approach helped to focus the options in building a knowledge management system for such a varied group/community.
2.2.2 Shared Space members were targeted as respondents and also email discussion lists for CNNet and SNEF. A timescale of two weeks was allowed for respondents to fill in the questionnaire, with a reminder at the beginning of the second week to help increase uptake. 52 respondents filled in the online questionnaire.
2.2.3 Survey Monkey was the online software used to produce the online questionnaire. The software collates the information collected from respondents and allows for basic analysis in the summary. Results can then be exported into Excel for in-depth analysis.
3.3 2.3 Literature collation/theming
3.3.1 2.3.1 eHealth & Health Informatics are relatively new areas of interest, with many varied definitions and interpretations of the term “eHealth” in circulation (5). Most published information is fairly new with recent published dates. Not all literature provided by the subject experts related to the health domain. Some literature was regarding other sectors and how they have been incorporating electronic access to information into their business.
2.3.23 The following sources were used to collate recent key literature to build an understanding of important themes and issues in the eHealth domain.:
· NMAHP Shared Space
· e-Library
· Internet (Google Search Engine)
The following people were asked to supply what they would consider to be key references:
2 Kathy Dallest – Consultant to NMAHP eHealth MKN project
3 Heather Strachan – eHealth Lead for NMAHPs in the Scottish Executive Department
3.4 2.4 Focus Group
2.4.1 The CNNet group were asked to participate in a focus group to evaluate their experience of working in a network. The CNNet group has been a working network for the last 6 years and have established a mature network over that period. The group were asked to discuss the advantages and disadvantages of working in a network, specifically looking at the key requirements for a network to function well.
2.4.2 In order to inform the development of the NMAHP eHealth MKN, the project team delivered a CPD Workshop on Benefits Realisation during the CNNet meeting on 25 May 2007. The group were asked to discuss the advantages and disadvantages of working in a network, specifically looking at the key requirements for a network to function well.
Four questions were posed to the network members present at the meeting. These were:
During your membership of CNNet, what has been your experience of:
· What worked well?
· What did not work well?
· What would have made a difference?
· What do you see as the key considerations for the NMAHP eHealth MKN?
2.4.32 12 people were present at the CNNet meeting and all contributed to the discussion about Networks.
2.5 2.5 Summary
This report presents the results from these four strands of knowledge needs analysis. It defines the implications for knowledge management support to be provided to the NMAHP eHealth MKN via its dedicated Special e-Library, and discusses some issues hat emerged from the analysis related to non-technical forms of facilitation. The findings highlight how improved management of knowledge will support the strategic and practical goals of NMAHP eHealth. This analysis will contribute to development of the forthcoming knowledge management strategy for NMAHP eHealth.
3. KEY FINDINGS
3 Findings
This section will look at key findings from each strand of the investigation, which will then feed into the following discussion section.