1. Bob Marshall, MD MPH MISM DoD Clinical Informatics Fellowship
Knowledge Management
Bob Marshall, MD MPH MISM DoD Clinical Informatics Fellowship

2. Objectives Definitions of Knowledge Management (KM)
Why KM is important and some basic rules
What knowledge to leverage
Tools to use
Critical success and failure factors
Creating and implementing a successful KM program
When experts leave
Avoiding knowledge hoarding

3. Definitions of KM
"Knowledge management is a discipline that promotes an integrated approach to identifying, capturing, evaluating, retrieving, and sharing all of an enterprise's information assets. These assets may include databases, documents, policies, procedures, and previously un-captured expertise and experience in individual workers.“(Duhon, 1998 [Gartner])
Strategies and processes designed to identify, capture, structure, value, leverage, and share an organization's intellectual assets to enhance its performance and competitiveness.
Based on two critical activities:
(1) capture and documentation of individual explicit and tacit knowledge, and
(2) dissemination of that knowledge within the organization

4. Another Definition
Knowledge Management is the explicit and systematic management of vital knowledge - and its associated processes of creation, organization, diffusion, use and exploitation - in pursuit of business objectives
Critical aspects of a successful KM program:
Explicit - Surfacing assumptions; codifying that which is known
Systematic - Leaving things to serendipity will not achieve the benefits
Vital Knowledge - You need to focus; you don't have unlimited resources
Processes - Knowledge management is a set of activities with its own tools and techniques

5. Why KM is Important Facilitates decision-making capabilities,
While information overload or needing knowledge from people in other parts of the company for decision making can handicap managers,
Putting in place knowledge management systems can facilitate better, more informed decisions
Builds learning organizations by making learning routine, and,
After Action Reviews, learning from experience, builds knowledge that can then be used to streamline operations and improve processes
Stimulates cultural change and innovation
Actively managing organizational knowledge can also stimulate cultural change and innovation by encouraging the free flow of ideas

6. Some Essentials (Basic Rules)
It is important to note that knowledge encompasses both tacit knowledge (in people's heads) and explicit knowledge (codified and expressed as information in databases, documents etc.).
A good knowledge program will address the processes of knowledge development and transfer for both these basic forms
Many programs start by focusing on the thrust of better sharing of existing knowledge e.g. sharing best practices.
However, research indicates that it is the second thrust - the creation and conversion of new knowledge through the processes of innovation that gives the best long term pay-off

7. Additional basic information
Multidisciplinary approach to achieving organizational objectives by making the best use of knowledge
Knowledge management efforts typically focus on organizational objectives such as improved performance, competitive advantage, innovation, the sharing of lessons learned, integration, and continuous improvement of the organization.
These efforts overlap with organizational learning and may be distinguished from that by a greater focus on the management of knowledge as a strategic asset and a focus on encouraging the sharing of knowledge.
KM is an enabler of organizational learning

8. Major Central Theme
To capture and make available the information and knowledge, that is in people's heads as it were, and that has never been explicitly set down… so it can be used by others in the organization

9. DIRECTED INFORMATION & KNOWLEDGE SEARCH
COLLECTING (STUFF) & CODIFICATION
CONNECTING (PEOPLE) & PERSONALIZATION
DIRECTED INFORMATION & KNOWLEDGE SEARCH
EXPLOIT
Databases, external & internal
Content Architecture
Information Service Support (training required)
data mining best practices / lessons learned/after action analysis
(HARVEST)
community & learning
directories, "yellow pages" (expertise locators)
findings & facilitating tools, groupware
response teams
(HARNESS)
SERENDIPITY & BROWSING
EXPLORE
Cultural support
current awareness profiles and databases
selection of items for alerting purposes / push
data mining best practices
(HUNTING)
spaces - libraries & lounges (literal & virtual), cultural support, groupware
travel & meeting attendance
(HYPOTHESIZE)
COLLECTING (STUFF) & CODIFICATION
CONNECTING (PEOPLE) & PERSONALIZATION
From: Tom Short, Senior consultant, Knowledge Management, IBM Global Services

10. What Knowledge to Leverage
Customer (Patient) Knowledge - the most vital knowledge in most organizations
Knowledge in Processes - applying the best know-how while performing core tasks
Knowledge in Products (and Services) - smarter solutions, customized to users' needs
Knowledge in People - nurturing and harnessing brainpower, your most precious asset
Organizational Memory - drawing on lessons from the past or elsewhere in the organization
Knowledge in Relationships - deep personal knowledge that underpins successful collaboration
Knowledge Assets - measuring and managing your intellectual capital

11. KM Dimensions/Frameworks
One proposed framework for categorizing the dimensions of knowledge distinguishes tacit knowledge and explicit knowledge
A second proposed framework for categorizing knowledge dimensions distinguishes embedded knowledge of a system outside of a human individual from embodied knowledge representing a learned capability of a human body’s nervous and endocrine systems
A third proposed framework distinguishes between the exploratory creation of “new knowledge” (i.e., innovation) vs. the transfer or exploitation of “established knowledge” within a group, organization, or community
Collaborative environments such as communities of practice or the use of social computing tools can be used for both knowledge creation and transfer

13. KM Practices: 3 Large Categories
Creating and Discovering
Environmental Scanning; Knowledge Elicitation; Business Simulation; Content Analysis; Creativity Techniques; Data Mining; Text Mining
Sharing and Learning
Communities of Practice; Learning Networks; Sharing Best Practice; After Action Reviews; Structured Dialogue; Share Fairs; Cross Functional Teams; Decision Diaries
Organizing and Managing
Knowledge Centers; Expertise Profiling; Knowledge Mapping; Information Audits/Inventory; IRM (Information Resources Management); Measuring Intellectual Capital

14. Tools and Techniques Lots of tools in varying categories:
Infrastructure: groupware, intranets, document management, KM suites
Thinking: concept mapping, creativity tools
Gathering, discovering: search engines, alerting, push, data mining, intelligent agents
Organizing, storing: data warehousing, OLAP, metadata, XML
Knowledge worker support: case based reasoning, decision support, workflow, community support, simulation
Application specific: CRM, expertise profiling, competitive intelligence
OLAP - Online Analytical Processing
CRM – Customer Relationship Management

15. KM Technologies
Groupware—Technologies that facilitate collaboration and sharing of organizational information
Workflow—Workflow tools allow the representation of processes associated with the creation, use, and maintenance of organizational knowledge
Content/Document Management—Systems that automate the process of creating web content and/or documents
Enterprise Portals—Web sites that aggregate information across the entire organization or for groups such as project teams
eLearning—Enables organizations to create customized training and education software

16. KM Technologies cont
Scheduling and planning—Automate schedule creation and maintenance
Telepresence—Enables individuals to have virtual “face-to-face” meetings without assembling at one location

17. Common Motivations for KM
Making available increased knowledge content in the development and provision of products and services
Achieving shorter new product development cycles Facilitating and managing innovation and organizational learning
Leveraging the expertise of people across the organization
Increasing network connectivity between internal and external individuals
Managing business environments and allowing employees to obtain relevant insights and ideas appropriate to their work
Solving intractable or wicked problems
Managing intellectual capital and intellectual assets in the workforce

18. Critical Success Factors
Knowledge Leadership - a compelling vision actively promoted by senior management
Clear Business Benefits - tracking success and developing new measures
Systematic Processes - including knowledge mapping and IRM (Information Resources Management)
Knowledge Sharing Culture - teams that work across boundaries
Continuous Learning - though pilots and learning networks
Effective information and communications infrastructure - groupware and other collaborative technologies, such as an intranet

19. KM Failure Factors
Organized into two broad categories: causal and resultant:
Causal factors refer to the broad organizational and managerial issues that are required to implement KM successfully
Resultant factors on the other hand deal with specific problems and can be regarded more like the symptoms rather than the disease

20. Causal Failure Factors
Lack of performance indicators and measurable benefits
Inadequate management support
Improper planning, design, coordination, and evaluation
Inadequate skill of knowledge managers and workers
Problems with organizational culture
Improper organizational structure

21. Resultant Failure Factors
Lack of widespread contribution
Lack of relevance, quality, and usability
Overemphasis on formal learning, systematization, and determinant needs
Improper implementation of technology
Improper budgeting and excessive costs
Lack of responsibility and ownership
Loss of knowledge from staff defection and retirement

22. Creating a Successful KM Program
The best tool is only that; a tool that enables end users to locate and share knowledge.
Without continuous knowledge management efforts, the content housed within the perfect knowledge management tool will not remain valuable
Anticipate this and follow best practices that will ensure that the amazing knowledge sharing technology continues to wow your customers for a long time to come
To manage it properly, the most successful companies form a Knowledge Management Operations team with the mission to deliver the right knowledge to the customer at the right time throughout the customer lifecycle

23. Creating a Successful KM Program
KM Operations needs skills in user experience design, process and workflow design, data analytics and reporting, communication, marketing, and search engine optimization
Dotted-line arrangements are created to allow internal resources with specialized skills to be shared and allocated to KM Operations during peak times of need
Knowledge Management Steering Committee: should be comprised of 7-10 stakeholders to serve as representatives of their respective lines of business:
Provide critical input when strategic decisions are needed,
Communicate KM messages throughout their organizations, and
Identify opportunities for better knowledge management

24. Keep Knowledge Up-To-Date
Keeping knowledge up-to-date and relevant requires continuous maintenance
To hold customer trust, and that of team members who use the knowledge, must be able to find what they need easily, share their knowledge with each other, and flag information that needs to be updated
Workflows must include user feedback channels (internal and external) that are monitored and acted upon quickly
Processes have to be as lite as possible to minimize long term costs associated with knowledge management activities

25. Create Operational Dashboard
Knowledge management operations requires continuous monitoring of the program for impact and operational efficiencies
Highly visible programs are often very successful because they hold leaders accountable for impact
This level of scrutiny brings out the best performance and elevates visibility for those who participate in the hard work of keeping knowledge relevant and current
Metrics to monitor can include a few or many in the four major categories (as determined by KM oversight) :
Customer satisfaction
Business processes
Financial performance
Organizational health

26. Steps in the KM Program Journey
Establish Executive Sponsorship and Budgetary Constraints
Engage Experienced Knowledge Management Experts
Establish the Scope and Identify Tactical Solutions
Prepare a Budget that Executive Sponsors Support
Design the Roadmap to Get There

27. Implementing a KM Program
Map your knowledge assets
Unstructured (tacit) versus structured (explicit or codified)
Undiffused versus diffused
Interpret the map
Identify new opportunities
Mapping knowledge assets and discussing their implications often leads directly to strategic insights
It is helpful to systematically explore what would happen if knowledge were moved around on the map or different spheres of it were combined

29. When Experts Leave
Managers often don’t know what they have lost until after the expert leaves — and by then, it may be difficult to recover
Critical losses in four areas in particular: relationships, reputation, re-work and regeneration.
Most expensive knowledge to lose: regeneration, the capability to bring out the next new product
Price tag associated with such losses: estimated to be up to 20 times the more visible, tangible costs of recruitment and training
Can never extract and transfer all the deep smarts that an expert has accumulated, but it’s important to identify what needs to be captured before it walks out the door
In-depth succession planning & knowledge-sharing programs (even just questioning the experts before they leave the organization) are imperative steps to ensure an organization’s deep smarts stay within the walls of the organization

30. Preventing Experts from Hoarding Knowledge
Lack of time or resources can constrain knowledge transfer.
One barrier to passing deep smarts along to the next generation, often unaddressed, is expert’s inclination to hoard knowledge.
Financial incentives, personal ego, and discontent or frustration with the company are three of the top reasons individuals choose to keep their expertise to themselves
But they’re also three issues that managers can actually change

31. Overcoming Knowledge Hoarding
Financial Incentives
Hiring back retirees to run critical operations is shortsighted
Not only does it cost the Company more financially, but it also doesn’t guarantee the successful transfer of knowledge
Eventually those deeply smart people will depart for good, leaving the same knowledge gap behind them
Potential Solutions
Hire back retirees for the explicit purpose of mentoring and sharing knowledge with junior colleagues
Institute a formal knowledge transfer program to institutionalize knowledge sharing
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32. Overcoming Knowledge Hoarding
Many experts widely recognized as “go-to” person in some capacity; their deep smarts strongly linked to identity and organizational standing
Don’t wait until someone has a monopoly on certain kinds of knowhow — set systems in place to prevent it long before an individual’s retirement date (some options):
Employees cannot be promoted until they can prove that they have mentored a successor
Personal reputation depends not only on how skillfully people do their job, but how good they are at teaching others to do it
Compensation is based on how well the team is performing. That dependency breeds the necessity to help each other and for experienced operators to transfer their expertise to other team members
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33. Overcoming Knowledge Hoarding
Toughest expert to convince to share knowledge is someone who’s dissatisfied with the company they’re leaving
Take notice of those who may be bearing resentment.
Individual managers wield an inordinate amount of influence over whether or not experts feel their work is valued.
Acknowledging good work is the first step
Small acts such as providing frequent positive feedback, celebrating small wins, and removing obstacles to progress, pay huge, immediate dividends in productivity and creativity
Much research has shown that people who have been mentored themselves are much more likely to mentor others
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34. Questions