title: Knowledge as a Service at the Point of Care.
abstract: An electronic health record (EHR) can assist the delivery of high-quality patient care, in part by providing the capability for a broad range of clinical decision support, including contextual references (e.g., Infobuttons), alerts and reminders, order sets, and dashboards. All of these decision support tools are based on clinical knowledge; unfortunately, the mechanisms for managing rules, order sets, Infobuttons, and dashboards are often unrelated, making it difficult to coordinate the application of clinical knowledge to various components of the clinical workflow. Additional complexity is encountered when updating enterprise-wide knowledge bases and delivering the content through multiple modalities to different consumers. We present the experience of Mayo Clinic as a case study to examine the requirements and implementation challenges related to knowledge management across a large, multi-site medical center. The lessons learned through the development of our knowledge management and delivery platform will help inform the future development of interoperable knowledge resources.
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Shellum
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Freimuth
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Steve G
authors.initials: SG
authors.lastname: Peters
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Rick A
authors.initials: RA
authors.lastname: Nishimura
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Chaudhry
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Steve J
authors.initials: SJ
authors.lastname: Demuth
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Knopp
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Miksch
authors.affiliation: Office of Information and Knowledge Management, Mayo Clinic, Rochester, MN.
authors.forename: Dawn S
authors.initials: DS
authors.lastname: Milliner
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records; D005103:Expert Systems; D006801:Humans; D058436:Knowledge Management; D008910:Minnesota; D010346:Patient Care Management / Q000458:organization & administration; D019095:Point-of-Care Systems; D057188:Workflow