Coming of Age for Healthcare Knowledge Management

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Harnessing and reusing knowledge constructively in healthcare settings is complex. Additionally, knowledge has become paradoxically a thing and a process, if we are to believe Snowden.^[1] During the first age of knowledge management, knowledge was identified, captured and retrieved in a form that was mostly content management. From the mid-1990s, when Nonaka and Takeuchi^[2] declared that tacit knowledge can be made explicit by means of externalisation, socialisation, internalisation and combination, knowledge management entered its second age.
 
Knowledge management in health care has progressed to the third (and current) age, according to Snowden,^[1] in which knowledge has become simultaneously a process and a thing; a dialectic and dynamic combination of the first two ages. Not only are content and relationships between knowledgeable people important, but contextual culture, abstraction, time and learning are key in healthcare knowledge management.
 
But knowledge management is not intuitive, nor is it something people "pick up" in the course of their healthcare professional lives. Two papers in this edition are authored by students of the Health Knowledge Management course offered by the School of Population Health at the University of Auckland. The students are encouraged to embrace the complexity of knowledge management in terms of its context, process and content. The students of this course are invited to prepare a paper for publication, of which the best papers are represented in this issue.
 
Mohammad Mousa provides an historical description of the development of knowledge management in anaesthetics practice. This overview provides examples of the complexity of knowledge management and the paradoxes of knowledge as a thing and knowledge as a process, culture and abstraction. It is clear that anaesthetics practice is in the third age as described by Snowden.
 
Simone Newsham on the other hand, explores the expansion of clinical information systems into community-based rehabilitation services in a large region of New Zealand. In her paper she makes use of lessons learned from other disciplines that have an extended history of computer-based knowledge management, shortening the journey through Snowden’s ages of knowledge management.
 
References
1. Snowden D. Complex acts of knowing: paradox and descriptive self-awareness. Bulletin of the American Society for Information Science and Technology. 2003; 29(4):23-8.
2. Nonaka I, Takeuchi H. The knowledge-creating company. London: Oxford University Press; 1995.