| A practical approach to knowledge management (MKM) infers designing knowledge management systems (KMSs) that are useful and are concerned with purposeful actions and ethical decisions---practical reasons (Churchman, 1971; Hevner et al., 2004; Richardson et al., 2006). This attention to the practical approach to KM is particularly relevant to the healthcare field and is related to the historical reality of medical KMSs (MKMSs), which have not yet achieved the expected success because of the difficulty of acquiring and delivering relevant and meaningful knowledge and maintaining it up-to-date in a cost-effective manner (Bellazzi et al., 2010). Practical, meaningful usefulness of Health Information and Communication Technology (HICT) is also a primary focus of national policy makers. In fact, as part of the American Recovery and Reinvestment Act, which offers physicians financial incentives for meaningful use of an electronic health record (EHR), the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) on July 2010 released the new rules for the meaningful use of electronic health records EHRs. These new rules focus on: 1) improving quality, safety, efficiency, and reducing health disparities; 2) engaging patients and families in the decision making process; 3) improving care coordination; and ensuring privacy and security (http.//healthit.hhs.gov/portal/server.pt?open=512&objID=2996&mode=2). In addition to motivating adoption of HICT by healthcare providers, this call to focus on meaningful use of HICT also provides a unique opportunity and motivation for researchers to design, develop, and implement medical knowledge management systems (MKMSs) that help healthcare providers achieve these goals more efficiently and effectively. To accomplish this requires a shift in the stakeholders MKM's perspective and in the approach to the design of information systems (Hevner et al., 2004)---a new framework for information systems research to build and evaluate artifacts designed to meet recognized healthcare needs---business and clinical. This environment also offers interesting opportunities to explore the creative uses of information systems design that have the potential for addressing some of the pressing issues of our time: collaboration and knowledge translation.;We propose that a medical informatics integrative perspective provides a unique insight to a practical approach to information systems design, development, and implementation. This dissertation focuses on MKM for the oncology domain, uses a breast cancer care committee as the exemplar of a multidisciplinary cancer care (MCC) committee and takes advantage of exploring the above opportunities through three research essays, which are based on embedded case study for the design, development, and implementation of a MKMS for breast cancer care. |
