SARS Information, Communication and Knowledge Management

SARS Information, Communication
and Knowledge Management
An Overview of Managing SARS Information

and Your Community of Practice
Carl Ditzler, Texas Department of Health
November 19, 2003

SARS | Information, Communication & Knowledge Management
Information, Communication & Knowledge Management
Information and Communication
z A discussion about the types of information

and current communication methods used by
public health agencies, and with clinicians and
other stakeholders.
Knowledge Management
z A look at how technical tools may assist with

and improve the management of information, and
facilitate collaboration.
Slide 2
What Is Known About SARS

z The amount of information, from various sources,
about SARS grows.
Slide 3
SARS Activity
z SARS activity requires the sharing of various types of
information or data, related to specific cases.
Slide 4
The Experience of SARS
z Reviewing the Canadian response to SARS, the

National Advisory Committee on SARS and Public
Health explained:
z Having the right information and knowledge with

coordination of activities in a carefully planned
infrastructure is important in public health because
of a population-wide and preventive focus.
z Essential if we are to be effective in

managing public health emergencies.
z Recommendation to “build capacity by strengthening
individual skills and by sharing knowledge across
jurisdictions.”
Slide 5
Information and Knowledge
z Information: a description, definition or

perspective (what, who, when, where).
z Knowledge: “the facts, feelings or experiences

known by a person or group of people” ...
Patterns and implications (how).
Slide 6
Information and Knowledge
z Knowledge originates from information (“the

range of one’s information”) and includes
familiarity, awareness, association, and
understanding.
z “Applied Information”
Slide 7
Types of Knowledge — Explicit
Two Types of Knowledge: Explicit and Tacit
z Explicit: Knowledge represented by an object,

such as a document, database or video.
z Generally, such information is organized or

presented in a certain manner for
communication or future use by another
person.
Slide 8
Types of Knowledge — Tacit
z Tacit: Knowledge a knower knows
z Generally, such information is organized or

presented in a certain manner for
communication or future use by a person.
Slide 9
Knowledge Communicated — In Person
z Knowledge is not automatically stored, notes

are generally recorded during group meetings by
individuals.
z No central repository for the information

gained.
z No method to add to or modify the knowledge

shared among participants.
z Advantage of in person communication

compared with other forms of communication:
open communication with the ability to read non-
verbal communication (gestures and body
language may add emphasis or provide a
‘message.’)
Slide 10
Knowledge Communicated — Conference Calls
z Knowledge is not stored and there is no

method to add to or modify the knowledge
shared among participants.
z Not all stakeholders receive same information

as information received by participating
individuals.
z “Effective but highly inefficient. Individuals

who were key players in the response at all
levels spent many hours every day on
conference calls.”
National Advisory Committee on SARS and
Public Health, Learning from SARS: Renewal of Public
Health in Canada, October 2003.
Slide 11
Knowledge Communicated — Conferences
z One time event and there is no method to add

to or modify the knowledge shared among
participants.
z Difficult to reuse the knowledge shared ― Will

you find your handout if you need it in the future?
z Advantage of conferences compared with

other forms of communication: networking
(synchronous).
Slide 12
Knowledge Communicated — E-Mail
z The management of the email inbox is

necessary to retain knowledge.
z Management of the inbox relies on a specific

user. If a user leaves, email is easily lost and
everyone is in the dark.
z Eventually the IT Department reduces or limits

the size of an inbox.
Slide 13
Knowledge Communicated — E-Mail
z The knowledge gained is, at best, known by a

recipient, then probably difficult to find or
becomes lost.
z Cannot search through emails and

attachments easily.
z Allows for distribution to users only specified

and it is possible someone is initially left off or
will be dropped from the distribution list during
future email conversations.
Slide 14
Knowledge Communicated — Network Drive
z Does not facilitate comments and discussions

around documents.
z You do not know which files you have seen

and you cannot indicate which files are the most
important to you.
Slide 15
Knowledge Communicated — Network Cont’d
z It is difficult to develop documents

collaboratively.
z You have to search shared drives and your

email application to find information.
z Generally, meant to facilitate storage and not

collaborate (communicate knowledge).
Slide 16
Knowledge Communicated — Online Messaging
z Examples include message boards and instant

messaging (online chat and meetings).
z At a meeting or conference, the person

speaking controls the exchange and with online
communication, context must always be
reestablished.
z Difficult to store and organize.
Slide 17
Knowledge Communicated — Online Messaging
z For successful online communication:
z An individual should identify when he or

she is available to receive or respond to
communication.
z Individuals should maintain rapport and

continuity on a regular basis.
z May be asynchronous.
Slide 18
Knowledge Management
“Knowledge management involves efficiently

connecting those who know with those who
need to know, and converting personal
knowledge into organizational knowledge”
The Yankee Group
Slide 19
Management of What?
“We should
write that
spot down.”
Slide 20
Knowledge Management Should At Least Enable…
z Individuals to create, capture, classify, and

share/reuse knowledge at a centralized location.
Slide 21
Knowledge Management Goal — Collaboration
z Apply your organization’s (and other

organizations) collective wisdom to achieve
specific objectives, regardless of geographic or
physical constraints.
Slide 22
Knowledge Management Goal — Effectiveness
z Ensuring the right people have the right

knowledge they need, where they need it,
when they need it.
Capture/Collect Share
Gather, compile, store Transfer between
in a repository. Individuals and Groups
Organize
Classify, categorize
for retrieval.
Discover/Create Access
See patterns, analyze Dissemination
data, produce new
knowledge
Slide 23
Knowledge Retention / Centralization
z Knowledge Retention / Centralization
z All information and content is stored in

a central and secure online location and
is searchable.
z The information may be disseminated.
z Knowledge is stored with use of

classification schemes/codification.
Slide 24
Knowledge Retention / Centralization
Slide 25
Benefits of Retention
z Knowledge Retention / Centralization Benefits
z Find information:
z You generated yourself;
z Someone completed, sometime and

someplace;
z You believe to exist, somewhere; and
z Not known to an individual (because the

information was presented, an individual finds
such information helpful);
Slide 26
Benefits of Retention
z for new staff members to quickly come up to

speed; and
z relevant from inside and outside your community.
Slide 27
Connectivity / Collaboration
z Connect People — Knowledge

management allows for informal groups of
experts to connect (or reconnect) with one
another in a self-organizing, boundary
spanning community.
z Maintain valuable contacts and

facilitates the generation of new ideas.
Slide 28
Connectivity / Collaboration
z Comments and discussions displayed with

attached or associated documents.
z Associate information with knowledge

― who knows what.
z Facilitate questions and comments,

and sharing of similar information.
z Research and share new things.
z A participant may begin a new discussion

or ask a question.
Slide 29
Benefits of Collaboration — Collective Intelligence
z Collaboration harnesses the collective

intelligence of individuals who approach
problems from different directions.
Slide 30
Benefits of Collaboration — Creativity/Depth
z Creativity: Involving others broadens the

range and quality of options.
z Depth: Hidden knowledge becomes

known.
Slide 31
Benefits of Collaboration — Trust/Speed
z Building Trust: By obtaining information

“found” or known by others; a sense of the
group’s shared purpose is felt/evident.
z Speed: Communication of potential issues

and ability to see possibilities.
Slide 32
Benefits of Collaboration — Best Practices
z Experience gained in one organization or

by one individual can be shared with others.
z Avoid re-invention of the wheel.
Slide 33
Result of Knowledge Sharing — Proactive
z Foundation for a Proactive Approach
z Through a culture of knowledge

sharing, health care professionals across
different organizations work together to
identify issues before they become high
risk.
Slide 34
Result of Knowledge Sharing — Public Information
z The public requires SARS information as

soon professionals are willing to provide
such information.
z Knowledge management may

facilitate identification of public
information, which may then be readily
released in an electronic format.
Slide 35
Why Now?
z Knowledge management has received

attention in recent years, with use primarily
by technology companies.
z Recognition many jobs involve

“knowledge work” ― a job depends
more on knowledge than manual skills.
z Availability of technical solutions

allowing efficient creation, use and
sharing of knowledge among
organizations.
z The benefits “sound good.”
Slide 36
Is Knowledge Management Necessary?
z Do we know everything we should know?

Are there gaps in our knowledge?
z Do we share what we know and what we

learn?
z You have your own knowledge and it

is important. Is your knowledge available
to others? To yourself, later?
z Is knowledge lost when a staff

member leaves or retires?
Slide 37
Is Knowledge Management Necessary?
z Is there knowledge sharing between

individuals and organizations?
z Relationships are important —

Clinicians, epidemiologists and other
professionals depend on one another.
Slide 38
Why Is Knowledge Management Important for SARS?
z New information and advances concerning

SARS are constantly available and,
therefore, new knowledge is available for
stakeholders to know.
z Such information is from multiple sources,

leading to an exponential increase in the
amount of information to review.
Slide 39

z New Information New Questions
How would we know that animals have SARS? Would the vets be testing for it, is there some
kind of test for animals that would confirm SARS? If SARS was found among animals, how
would it be handled?
Any compensation (monetary) being offered to individuals that are quarantine due to TDH
guidelines if they have lost income?
How can we realistically deal with all of the febrile patients with respiratory symptoms who will
be coming in to our ER's this season?
Can the state step in if it should become difficult to obtain supplies necessary for a SARS
outbreak....things like N95 respirators.
Will TDH lab be able to confirm SARS cases this fall or do we have to await for month to hear
from CDC?
How do infection control staff get SARS results and describe what the various results mean to
us, as well as how we use results to define the SARS status of a patient?
How extensive an isolation do we have to achieve of someone who has traveled from a SARS
affected area and may have some mild sx. (this would help with crowd control as others go
into a state of panic).
What is the assessment of the occupationally-acquired cases among staff members who were
reportedly using personal protective equipment? Specifically, was the respirator used
adequate for SARS?
Will the presence of a bacterial or viral pathogen negate any further testing?
Slide 40
z The review of information is important

considering the risk factors associated with
missing critical information.
z Critical information, previously reviewed,

must be quickly found and delivered once
required.
z Expectation of a timely response

introduced by use of instantaneous
communication tools including email and
mobile telephones.
z Rapid transmission of SARS.
Slide 41
z For SARS, people from different organizations

are informally bound together by common interest
and have exposure to a common set of problems.
z Seek information and to further

understanding.
z Knowledge management can be a tool to help

bring people together.
Slide 42
Uses of Knowledge Management Systems
z CDC’s Epidemic Information Exchange (Epi-X)
z World Health Organization network for the

multi-center research project on SARS diagnosis.
z SARS Accelerated Vaccine Initiative

(SAVI) ― British Columbia
Slide 43
Uses of Knowledge Management — Epi-X
CDC’s Epidemic Information Exchange (Epi-X)
z Notification of ongoing and complete outbreak

investigations, submitted by epidemiologists, via
email to federal, state and local epidemiologists.
z Review of information in a secure web-based

environment with the ability to read and add
comments, and include attachments.
Slide 44
Uses of Knowledge Management — Epi-X
CDC’s Epidemic Information Exchange (Epi-X)
z Members of Epi-X may retrieve contact

information, bio, and area of expertise of other
members.
z Accessible via a search function and

the author’s name associated with posted
information.
Slide 45
Uses of Knowledge Management — WHO
World Health Organization network for the

multi-center research project on SARS
diagnosis.
z Email and use of secure web site to share

outcomes of investigation of clinical samples
from SARS cases in real time.
Slide 46
z Sharing includes: electron microscopic

pictures of viruses, sequences of genetic
material for virus identification and
characterization, virus isolates, and samples
from patients.
z Sharing can be analyzed in parallel by

several laboratories.
z Allows for instant validation of laboratory

findings between network members.
Slide 47
“This resulted in a very early exchange of

ideas, results, reagents and protocols and
significantly speeded up identification of the
coronavirus and confirmation of its link to
SARS…. This successful process should be
studied, codified, strengthened, and
replicated wherever necessary.”
National Advisory Committee on SARS

and Public Health, Learning from SARS: Renewal
of Public Health in Canada, October 2003.
Slide 48
Uses of Knowledge Management — SAVI
SARS Accelerated Vaccine Initiative

(SAVI) ― British Columbia
z Team of scientists and researchers share

knowledge and collaborate online as a way
to accelerate the vaccine discovery process.
z Coordinate research activities such as

vaccine formulation, genomics, and
immunology.
z Identify domain experts.
Slide 49
Future Use of Knowledge Management — TDH

Texas Department of Health, accessible via
the Health Alert Network by local, regional
and state clinical, public health, and law
enforcement professionals.
z Enhance information sharing during a

biological event, and during a non-event,
including the sharing of disease information,
resources, and decision-making processes.
z Tool for simulation-encounter training

using the same knowledge and skills that will
be called upon during a real pandemic.
z Relationship building within TDH, with

local and regional levels, and between
organizations.
Slide 50
How Implement?
z For success, there is a direct relationship

between an organization’s approach to
knowledge management and its ability to
achieve its objectives.
z What are the objectives?
z What knowledge management

initiative helps the organization meet
those objectives (while meeting financial
constraints)?
z Will the organization be in front of (via

executives) and support (via “knowledge
workers”) knowledge management?
Slide 51
A Knowledge Environment Requires Change

z Creating a knowledge environment may
require changing organizational values and
culture.
z Breaking down “silos” by reaching

across organizational lines.
z Changing the habits of individuals who

seek to leverage knowledge for his or
her personal gain.
Leadership
Knowledge Culture
Knowledge
Creation Infrastructure
Sharing
Slide 52
Which Solution, Specifically?
z Copying the practices or technologies of

one organization to another will likely be
unsuccessful.
z Each organization faces different

challenges and environments. People in
an organization may create, share and
use information by different methods
than people of another organization.
Slide 53
Your Organization’s Solution
z Knowledge management requires

significant investment to deliver results. A
knowledge management solution must fit an
organization’s:
z specific needs (tied to objectives);
z current processes of knowledge

management including the creation,
capture, classification, and sharing of
knowledge; and
z people (keep it simple and it should

not add or duplicate a current work
process).
Slide 54
A Complementary Solution
z Existing functions, including a library or an

organization’s intranet, should become part
of a wider knowledge management scheme.
z Knowledge management should

complement existing structures by allowing
for collaboration, information exchange and
sharing of best practices across boundaries
of time, hierarchies and organizational
structures.
Slide 55
Knowledge Management Technologies
z Technology is an enabler of knowledge

management by connecting people with
information and people with each other.
z It is not the complete solution.
z Over promising benefits results in

disappointment and may reinforce
scepticism and lead to rejection.
z Limit efforts to strategies likely to make the

most significant difference, such as key
processes.
Slide 56
Knowledge Management Technologies
z In Canada, the National Advisory Committee

on SARS and Public Health explained, “the
single largest impediment to dealing
successfully with future public health crises is
the lack of a collaborative framework and ethos
among different levels of government.”
National Advisory Committee on SARS and
Public Health, Learning from SARS: Renewal of
Public Health in Canada, October 2003.
Slide 57
Selected Vendors and Applications

z Online Discussion / Collaboration: Divine, Documentum eRoom,
Entopia, ePeople Teamwork, Hyperwave eKnowledge, iManage WorkSite,
Jive Software, Kamoon Connect, Knexa Tribute, Kubi, Lotus Workplace,
Nstein Work2gether, Open Text Livelink, Oracle, Silverorange, SiteScape,
Tomoye, and Vignette Business Workspaces.
z Weblogs (Blogs): Blogger, Drupal, MoveableType, Pebble, pMachine,

Radio, Roller, and Traction Software.
z Wiki (Collaborative Online Database): Confluence, pyWiki, PHPWiki,

SnipSnap, TikiWiki, and UseModWiki.
z Groupware (Project Specific) Applications: EDS Teamcenter, Groove,

Niku, Primavera, and Tacit ActiveNet,.
z Portal: IBM, Microsoft SharePoint, and Oracle.
z Data Mining: Hummingbird, iManage and Convera.

Slide 58
Online Resources
z Knowledge Management World

http://www.kmworld.com
z Column Two
http://www.steptwo.com.au/columntwo/
z KMNetwork
http://km.brint.com
z CIO Knowledge Management Research Center

http://www.cio.com/research/knowledge/
z KMTool
http://www.kmtool.net/
Slide 59

SARS Information, Communication and Knowledge Management

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SARS Information, Communication

and Knowledge Management

An Overview of Managing SARS Information

Carl Ditzler, Texas Department of Health

November 19, 2003

Information, Communication & Knowledge Management

Information and Communication

z A discussion about the types of information

z A look at how technical tools may assist with

What Is Known About SARS

The Experience of SARS

z Reviewing the Canadian response to SARS, the

z Having the right information and knowledge with

z Essential if we are to be effective in

Information and Knowledge

z Information: a description, definition or

z Knowledge: “the facts, feelings or experiences

Information and Knowledge

z Knowledge originates from information (“the

Types of Knowledge — Explicit

Two Types of Knowledge: Explicit and Tacit

z Explicit: Knowledge represented by an object,

z Generally, such information is organized or

Types of Knowledge — Tacit

z Tacit: Knowledge a knower knows

z Generally, such information is organized or

Knowledge Communicated — In Person

z Knowledge is not automatically stored, notes

z No central repository for the information

z No method to add to or modify the knowledge

z Advantage of in person communication

Knowledge Communicated — Conference Calls

z Knowledge is not stored and there is no

z Not all stakeholders receive same information

z “Effective but highly inefficient. Individuals

Knowledge Communicated — Conferences

z One time event and there is no method to add

z Difficult to reuse the knowledge shared ― Will

z Advantage of conferences compared with

Knowledge Communicated — E-Mail

z The management of the email inbox is

z Management of the inbox relies on a specific

z Eventually the IT Department reduces or limits

Knowledge Communicated — E-Mail

z The knowledge gained is, at best, known by a

z Cannot search through emails and

z Allows for distribution to users only specified

Knowledge Communicated — Network Drive

z Does not facilitate comments and discussions

z You do not know which files you have seen

Knowledge Communicated — Network Cont’d

z It is difficult to develop documents

z You have to search shared drives and your

z Generally, meant to facilitate storage and not

Knowledge Communicated — Online Messaging

z Examples include message boards and instant

z At a meeting or conference, the person

z Difficult to store and organize.

Knowledge Communicated — Online Messaging

z For successful online communication:

z An individual should identify when he or

z Individuals should maintain rapport and

“Knowledge management involves efficiently

Knowledge Management Should At Least Enable…