iRADiX

Subtitle: Knowledge management systems and the universal mind

What  knowledge management systems exist in your organisation?

In our explorations and conversations together we try to seek the difference between the individual mind and the universal mind. As the relation between these two (the individual and universal) gains concrete form, and its own proper shape and appearance, one finds a life of the universal individual.

On "Inevitable Attrition"

Addressing the issue of "inevitable attrition" which Dr.Alok Varshney and Dr.Anuj Mishra raised while commenting on the article "A performance agreement'http://www.iradix.in/515-A-Performance-Agreement.html made me reflect on the nature of knowledge management systems which exist within our medical organisations. Employees must have free-flowing lines of communication between one another and need access to sources of knowledge -both inside and outside the organisation. That knowledge is often the raw material of creative thought.

Some companies have developed elaborate knowledge management systems to capture knowledge, store it, and make it easily available to reuse. These systems help ensure that what was learned by someone in Unit A doesn't have to be learned anew by someone in Unit B. Lee Sage has described DaimlerChrysler's Engineering Books of Knowledge (EBOKs), a knowledge management database containing technical data, lessons learned, and best practices that is made available to the company's engineering community. The purpose of the EBOKs, according to Sage, is to capture the expert knowledge of technical employees and use it to improve engineering productivity, speed new product development, and avoid repeating past mistakes. Consulting and tax accounting companies use knowledge management systems in similar ways (1).

Bridging the gap between Idealism and Realism, (I can see my friends smiling at this EBOKs solution..as another of my unrealistic ways), I would like to add another thing radiologists do-Making DICOM CDs of interesting cases.

Who owns these can be subject to many (mis) interpretations.

It can be held by a community of Learners who have no fixed organisational allegiance and carry their knowledge work-books, EBOKs and Interesting cases with them on lines similar to how other service providers like maintenance companies carry their manuals and information.

But let us look at it from a Health care service industry angle rather than individual centres. Then we will be able to answer exactly where we fit  in.    (Blog: Do you do Level 5 Sonography http://www.iradix.in/500-Do-you-do-Level-5-sonography.html  

examines these issues with illustrative examples) 

On the nature of scientific knowledge

The phenomenology of mind examines the processes by which science in general comes about, the gradual development of knowing. Knowing, as it is found at the start, mind in its immediate and primitive stage, is without the essential nature of mind-is sense consciousness. To reach the stage of genuine knowledge, or produce the element where science is found-the pure conception of science itself-a long and laborious journey must be taken.

The task of conducting the individual mind from its unscientific stand point to that of science had to be taken in it's general sense ; we had to contemplate the formative development of the universal (or general) individual, of self-conscious spirit. As to the relation between these two (the particular and the general individual), every moment , as it gains concrete form, and its own proper shape and appearance, finds a place in the life of the universal individual. (2)

Renal imaging as an example

The scope of learning should include well established practices and newer technologies. Take the example of Kidneys which was covered in blog (http://www.iradix.in/407-Do-not-try-to-use-a-gun-to-kill-a-Mosquito.html ).

Despite marked improvements in technology, gray-scale renal sonography has changed little since the 1970s. Only basic information is obtained with the modality : renal length, cortical thickness, and grade of collecting sytem dilatation are assessed. A purely anatomic approach to renal sonography, coupled with improved yet less expensive platforms, has resulted in significant incursions on radiology turf by nephrologists, internists and urologists.(3)

One can start looking at Vascular Ultrasound and try to set up a Vascular ultrasound practice. This will help expand our horizons. The potential of Doppler sonography to serve as a useful adjunct for the gray-scale assessment or renal disease was advanced in a series from Michigan. In the initial work performed by Platt et al, renal biopsy results of 41 patients were correleted with RI analysis. Those patients with isolated glomerular disease had normal RI values (mean, 0.58), whereas subjects with vascular or interstitial disease had marked elevated RI values (mean, 0.87 and 0.75, respectively)(for those interested in studying these debates and issues further read references 3 and  4)

Problem centric organisation

Bashyam et al in an article have raised the issue of the large amount of unstructured textual information in medical records especially with aging population and increased occurrence of chronic diseases. They have presented a system that provides a gestalt view of the patient's record by organizing information about each disease along four dimensions (axes)

Time-Disease progression over time

Space- Anatomic (spatial) dimensions are fundamental to disease understanding.

In  a renal imaging unit one can add doppler parameters

Existence-Certainty of existence of a finding.(definitely exists,likely,possibly,less likely, cannot be ruled out, no evidence of, does not exist)

Causalty- Cause effect relationships amount variables of interest such as treatments, exposures, preconditions (Diabetes/Hypertension in renal disease) and outcomes.

(adapted from Reference 5)

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Adapting knowledge management systems around structured dimensions may be a way forward to evolving the Universal Mind and a raw material of creative thought.

Notes:

1. Katz R: Managing Creativity and Innovation.Page 104.Harvard Business Press.
2. Hegel GWF: The Preface to Phenomonology of Mind (1807) Translated by J.B.Baillie
3. Tublin M E et al, The Resistive Index in Renal Doppler Sonography: Where do we Stand?AJR 2003; 180:885-892 
4. Parolini C et al: Renal Resistive Index and Long-term outcome in Chronic Nephropathies.Radiology:Volume 252:Number 3-September 2009 
5.  Bashyam V et al: Informatics in Radiology:Problem centric organisation and visualization of patient imaging and clinical data.Radiographics 2009,29:331-343