Digital Healthcare and Organizational Learning: Enhancing Patient Care through Technology and Knowledge Management
Digital healthcare or digital health refers to an area of study that comprises the deployment of communication and information technologies to assist in addressing the challenges and health problems patients face. Alavi and Leidner say these technologies comprise software and hardware services and solutions. In general, digital healthcare is extremely concerned about establishing interconnected health systems to enhance the deployment of computational technologies, computational analysis techniques, smart devices, and communication media. These technologies assist healthcare patients and professionals in managing illnesses and health risks. Bell and Jackson have pointed out that digital healthcare is one of the multi-disciplinary areas of study involving several stakeholders, such as researchers, clinicians, scientists, management, health economics, public health, and engineering. This implies that this domain cannot be studied wholly at once because it is extremely wide. As a result, this paper narrows down to studying an information management aspect. The paper discusses organizational learning and knowledge management in strategic management within digital healthcare organizations.
Organizational Learning in Healthcare
Organizational learning refers to a domain of knowledge within the organizational theory, which studies theories and models concerning how organizations adapt and learn. Learning is an important characteristic of adaptive organizations. Innovation Norway has defined a learning organization as one that encompasses and integrates the major characteristics of organizational learning that, in turn, is built upon individual learning. According to Cerdan, Lopez–Nicolas and Sabater–Sanchez, a learning organization can sense changes in signals from both the external and internal environments and adapt appropriately. As a result, it is imperative to step back and examine the process of individual and organizational learning to understand the features of an adaptive healthcare organization. The respective processes are assessed separately since they are extremely linked yet different.
Nosta has defined learning as a process whereby knowledge is generated via experience transformation. As a result, learning involves two significant meanings. The first is acquiring expertise or skills, which implies the physical capability to produce action. The second one is the acquisition of know-why, which means the capability to articulate a conceptual understanding of experience. Nosta has argued that individual, organizational learning occurs only when the new knowledge is translated into a replicable behavior.
Consequently, the mechanisms of mental and memory models translate learning into the organization via the spiral of knowledge. The tacit knowledge buried in individual minds, embedded in habits and routines, is not visible directly to the outside world. The first step in acquiring organizational learning is to comprehend the individual implicit knowledge and interpret and share it across the organization via imitation, practice and observation. Consequently, implicit meanings should be transformed into explicit ones. This can be achieved via a shared understanding and coordinated action. This enables employees to integrate knowledge, operationalize it and deploy it to improve performance. Lastly, explicit knowledge has to be embedded and internalized within everyday routines at all levels of the hierarchy. Therefore, individual learning transforms into organizational learning.
Nevertheless, the mechanisms organizations deploy to learn differ greatly from those of individuals. According to West and Miller, organizations and their members might learn different things. In several cases, the organization needs to learn what each member knows. As a result, the association between organizational and individual learning is distorted.
Kim, Yu and Lee have identified three forms of organizational learning: single loop, double loop, and triple loop. In single-loop organizational learning, decisions are based exclusively on observation, leading to corrections of errors. In double-loop organizational learning, organizations involve themselves in critically rethinking the knowledge that has proven inadequate. Lastly, in triple-loop learning, organizations are forced to challenge the deep-rooted assumptions and norms which have previously been inaccessible. This is because they were either known or unknown but not discussable. As such, single-loop is concerned about doing completely similar things differently; double-loop is concerned about doing a completely varying thing. Meanwhile, triple-loop is about the way things are done.
Researchers agree that there is an agreed definition of organizational learning. This is because various academic studies are based on diverse theoretical presumptions. As a result, they emphasize various characteristics of organizational learning. The three significant characteristics witnessed in the digital age include:
- The changing and acquisition of meanings via collective actions.
- The reinforcement of improvements in actions, knowledge, behaviors, performances and actions.
- The capacity for collective acquisitions of ideas, knowledge, and insights via sharing experiences.
These characteristics of organizational learning can thrive within an environment that allows changes in the way individuals learn. According to Wickramasinghe and Silvers, a learning organization is such an environment promoting all forms of learning, with an emphasis on double and triple-loop learning.
Principles of Organizational Learning
Edmondson’s definition of learning organization integrates the major characteristics of organizational learning. He defines a learning organization as one skilled at creating, acquiring, and transferring knowledge and modifying its behavior to reflect new insights and knowledge. So far, studies have identified different learning organization characteristics supporting knowledge creation, acquisition, transfer and effective utilization. ROOO refers to five component technologies. Nosta has also identified five major components of organizational learning.
On the other hand, West and Miller have produced a framework comprising ten enabling factors of organizational learning. The identified characteristics of organizational learning can be classified into five groups that are the building blocks of organizational learning. The five principles include mission and learning, leadership, experimenting culture, knowledge transfer, teamwork and cooperation. However, these five principles can only be effective with two enabling foundations: organization design, employee competencies and skills.
Mission and Vision
Tucker and Edmondson have pointed out that a widely shared and understood mission enables the healthcare staff to develop their capabilities and skills, contribute to the organization’s performance, and takes responsibility. The mission and vision statement encourages healthcare professionals to acknowledge the gap between expectations and reality and offers incentives for learning and improvements in this digital age. This is possible when an actively involved and dynamic leadership considers employees a central competitive advantage of the healthcare organization. This leads to another significant principle referred to as leadership.
According to Cerdan, Lopez–Nicolas and Sabater–Sanchez, leadership in organizational learning empowers employees, rewards learning, encourages an experimenting culture, generates learning opportunities, and supports innovative suggestions. Healthcare managers are viewed as coaches, designers, facilitators, and stewards. Nevertheless, involved leadership, on its own, cannot accomplish its objectives unless there is a system of knowledge sharing and dissemination. This leads to another principle referred to as a transfer of knowledge.
Transfer of Knowledge
Knowledge and skills acquisition within healthcare employees is of limited importance unless they can be transferred. The transfer of knowledge energizes creative ideas in other healthcare departments or units. Critical reflection and thinking are needed to disseminate reliable and valid information. In addition, learning from past failures makes knowledge tacit and allows its transfer from the individual to the organizational level. However, effective knowledge transfer can only guarantee its utilization if there is teamwork in implementing some proposed solutions.
Teamwork and Cooperation
The diversity of knowledge of employees and backgrounds stimulates dialogue, team problem-solving, and brainstorming. Every individual in the learning healthcare organization is aware and enthusiastically accepts the responsibility of a learner and encourages and supports the learning of others. Nevertheless, these principles can only thrive with openness to encouragement to responsible risk-taking and willingness to acknowledge failures and learn from them. This leads to an experimenting culture, another building block.
A significant component of organizational learning is the capacity to create new knowledge and insights. According to West and Miller, this requires dialogue and open-mindedness that assist healthcare employees in discovering their hidden mental models and assumptions. Alavi and Leidner have pointed out that an experimenting culture sets aside resources for healthcare employees to engage in creative projects and develops rewarding mechanisms for individuals excelling in this area. If organizational learning comes from experience, then the more one can plan his or her guided experiences, the more he or she will learn. The principles of organizational learning can only learn with the two enabling foundations: organizational design and employees’ skills and competencies.
A learning healthcare organization requires a structure supporting downward and upward information circulation. Studies have indicated that learning capability is negatively linked to hierarchies and formalization, and positively linked to the depreciation of boundaries between informal networking, functions and dialogue. Nevertheless, communication mechanisms can only bolster organizational learning if healthcare employees have the appropriate skills and capabilities to promote triple- and double-loop learning.
Employee Competencies and Skills
Organizational learning also requires to be accompanied by life-long learning. Human resources practices or learning healthcare organizations focus on recruiting the individual for what they can learn, not what they already know. According to Ward and Aurum, organizational learning should also be based on new capabilities, such as reflective team building and thinking that equips nurses and doctors to search for interdependencies with various departmental functions and relate their learning to the learning of the organization as a whole.
Significance of Organization Learning in Healthcare
In relation to healthcare, organizational learning has been utilized in improving quality changes and patients’ safety in the healthcare environment. Learning practices also assist in improving the current knowledge and skills and offer some opportunities for discovering better ways of working together. According to Alavi and Leidner, local, middle and executive leadership is required to create a shared purpose. The shared vision and mission should assist in building efficient relationships, enable connections between reflection and action, and bolter the desirable elements of the healthcare culture while modifying obsolete procedures, assumptions, and structures. Bell and Jackson have cited organizational learning as an idea through which an organization evolves to respond to the changing healthcare environment. Being capable of adapting and hastily changing strategies and maintaining the patients’ quality in the healthcare industry enables an organization to be successful.
Healthcare organizations can improve all dimensions through Total Quality Management (TQM). The TQM is a subset of organizational learning developed to allow customers to define the quality of services or goods. Under the TQM, performance measures include service delivery, product reliability, and profitability. Generally, the TQM defines the process of making quality principles a component of the organization’s strategic objectives. It applies them to all aspects of operations, committing to continuous improvement and striving to satisfy the patient’s needs.
Knowledge Management in Digital Healthcare
Knowledge management is a management technique aimed at solving the present business challenges to increase the efficacy of a central business process while incorporating continuous innovation. Knowledge management is needed based on the paradigm shift in the business environment where knowledge is key to organizational performance. As medical science continues advancing and the applications of information and communications technologies (ICTs) to healthcare operations diffuse, more information permeates healthcare repositories and databases in this digital age. Nevertheless, given the huge nature of these disparate data assets, it is only possible for healthcare practitioners to process these data with the help of complex technologies and tools. The key goal of knowledge management in this digital age is to offer a decision-maker some necessary technologies, tools, processes, and, most importantly, strategies to turn the data and information into valuable knowledge assets.
Knowledge Management and Strategic Management
According to Alavi and Leidner, knowledge management is a discipline designed to offer a strategy, a process and technology to increase organizational learning. In addition, the strategy is a major plan to be undertaken and allocating resources to the organization. Alavi and Leidner have cited that an organization should assign a group of people to seize the responsibility for assessing new issues, such as knowledge management and developing responsive strategies. This is because knowledge management is gradually becoming an organization’s major resource center. The basic factors offer the changes for the organization’s competitive advantages whereby more knowledge is shaped. Knowledge is crucial in the present digital age. Organizations can exploit their intangible assets that have become more decisive than their capability to invest and manage their physical assets. Knowledge management’s strategies and goals need to reflect organizational strategies and goals. Alavi and Leidner have stated that knowledge drives strategy, and strategy drives knowledge management.
Strategic Management Perspective
Strategic management is the process where an organization formulates and implements a strategy. Topol, on the other hand, has defined strategic management from a wider perspective, comprising the formulation, implementation and controlling process. The organization needs to identify the precise process of leveraging and managing knowledge management in the digital age. The bottom line is that various conditions and situations require various strategic management processes to be applied in the organization. Developing an efficient and effective knowledge management strategy involves a formulation, implementation, and controlling stage. The framework for developing a strategic-management process is continuous and dynamic. A change in any stage might affect all other stages. Additionally, if the organization can link the overall strategic management, then it can manage knowledge well.
According to Cerdan, Lopez–Nicolas and Sabater–Sanchez, knowledge management has become the newest strategy for organizational competitiveness. In the modern era, knowledge management emphasizes developing new information technology applications. There is an association between a business strategy and knowledge. By executing the systematic process, organizations can ensure that knowledge management is an efficient strategy for acquiring the exact knowledge for the right individuals at the right time.
Knowledge Management and Strategy Formulation
Ward and Aurum have pointed out that strategy formulation comprises developing a mission and vision, identifying an environment analysis, generating alternative strategies, and selecting strategies to pursue accomplishment. According to Bell and Jackson, knowledge strategy formulation defines the way and actions to attain the goals. The flow chart below illustrates the knowledge strategy formulation. Generally, a mission and vision statement addresses the central beliefs and identifies the target markets and core services.
Developing the vision and mission statement is frequently considered an initial step in strategic healthcare planning. As a result, healthcare organizations need to have a link between a competitive advantage and knowledge assets. Bell and Jackson have affirmed that knowledge management is usually formed by a systematic process for creating, acquiring, disseminating, leveraging and deploying knowledge for a competitive advantage and to attain organizational objectives.
Incorporating external and internal resources requires the organization to match the internal weaknesses and strengths and external opportunities and threats. The organization must undertake knowledge management to comprehend what knowledge should be managed.
Knowledge Management and Strategy Implementation
Implementing a healthcare strategy in this digital age requires the organization to establish policies and objectives and allocate necessary resources. After the formulation of the strategy, they need to be implemented. This action requires the organization to develop a supportive culture, allocate budgets, link a reward to organizational performance, and maximize the information system. Nosta has defined strategy formulation as a process of deciding what to do. Various approaches have been established to guide organizations in employing and implementing knowledge competencies. In this digital age, the huge number of knowledge management instruments in organizational learning is the information and communication technological (ICTs) instruments. Technology is extremely significant in knowledge management to be implemented successfully.
Knowledge Management and Strategy Controlling
Strategy assessment is the last phase in strategic knowledge management. The management desperately needs to know which strategies are effective. Such information can only be obtained through a strategy analysis. Silberman has pointed out that strategy evaluation is increasingly becoming difficult in the present digital age. This is because of six trends. The first reason is a dramatic increase in the complexity of the modern business and healthcare environment. The second reason is the increasing difficulty of predicting the future with precision. Technology has resulted in some unforeseen events that affect the strategy assessment. The increasing number of variables is another cause of the difficulties involved in strategy evaluation. The fourth cause of the difficulty is the rapid rate of obsolescence of even the best strategies and plans. Technology changes extremely fast, making it hard for healthcare organizations to cope. As a result, best plans and strategies are becoming obsolete within a very short time. The fifth cause of the difficulty is the increase in the number of world and domestic events affecting organizations. The world has become more connected due to the rapid adoption of technology. This adoption has, in turn, increased the occurrence of both world and domestic events.
The Practice of Knowledge Management in the U.S. Healthcare
The healthcare industry in the U.S. is in a state of flux. According to Innovation Norway, the rate of increase in healthcare costs has been variable. The appalling increases witnessed in the last decade decreased in the middle of the 90s and early 2000s. However, there is no assurance that the costs will continue decreasing. In other industries, buyers appear to be more sensitive to the prices of the products or services. They undertake a cost-benefit analysis. In the medical market, users and buyers of healthcare services and technologies have been comparatively insensitive to the cost of services. The conventional reimbursement and financing policies of the healthcare industry are felt to be largely responsible for the insensitivity that inhibits the forces of competitive demand and supply economics. As such, there is increased pressure on healthcare providers to develop strategies for controlling and managing costs and increasing productivity without compromising quality. To stem the rising healthcare costs, managed care has emerged. Managed care is aimed at creating value via competition in order to combat the inefficient and wasteful system that has been bathed in cost-increasing incentives.
For healthcare providers to attain their strategies of offering high-quality treatment to patients suffering from various illnesses, various important factors must be addressed concerning practice management and clinical issues. Technologies of different forms play a significant role in enabling efficient and effective high-quality treatments at the center. The clinical technologies comprise radiology and laboratory facilities to enable the best possible detection of a specific health complaint and the technologies to support treating this complaint. On the management side, technologies comprise the hospital management information system (HMIS).
The Hospital Management Information System is an important tool in knowledge management in the digital age. It comprises the Hospital Information System (HIS), the Expert System (ES), the Case Management Systems (CMS), the Health Database Management Systems, and the Group Decision Support Systems (GDSS). The HIS offers integrative clinical and medical information support services using various computer services linked with high-speed networks. The ES offers expert consultation to a user to address specialized and complex health or management problems. The recent innovation of the CMS evolved from a growing trend of incorporating health service delivery horizontally and vertically. From a vertical perspective, the CMS coordinates clinical care across healthcare providers, such as surgeons and physical therapists. From a horizontal perspective, the CMS links the institution by offering the same form of treatment. According to Nosta, the CMS enables case mix applications. As a result, they offer flexibility and the capability of incorporating clinical and financial data. The HDBMS has been deployed massively in certain hospital settings. It refers to storing logically organized figures and data that query facilities. The automated patient record system is a typical example of HDBMS. These systems allow for data mining and other data analysis techniques to be deployed with the assistance of an online analytic process (OLAP). The GDSS involves interactive systems facilitating the search for solutions to unstructured and semi-structured problems shared by groups.
Digital healthcare generates considerable amounts of heterogeneous information daily. For instance, healthcare information might contain clinical information such as cholesterol levels and temperature and the physician’s interpretation. In addition to this massive data, the daily mountains of information accumulated from a healthcare administrative system demand a knowledge management system. Digital technologies play a crucial role in transforming raw information into knowledge. This is accomplished in various ways, such as applying data mining tools to offer a context and structure for apparently disparate data elements. This, in turn, supports crucial decision-making. Essential to any sound knowledge management strategy within the healthcare organization is transforming the information into knowledge. Nevertheless, to achieve this systematically and effectively, it is essential to have an organized, structured approach.
With the HMIS in place at healthcare organizations, administrators can address this problem by allowing the data to be transformed into knowledge and information. For instance, at the clinical level, the HMIS assists in the early discovery of diseases from historical databases of symptoms. The system, therefore, offers an early warning system resulting in a much more efficient quality treatment. At the hospital administration level, the HMIS assists in tracking certain anomalies that indicate areas that require improvement. The main reason for HMIS is to support the delivery of healthcare in a cost-effective way.,/p>
Digital healthcare information, therefore, not only enables healthcare providers to perform their work more efficiently but also offers them care parameters. According to Topol, this assists in enforcing practice guidelines. Additionally, it offers peer data on healthcare providers that allows benchmarking for particular treatments regarding the length of stay, cost and other important variables. According to Bell and Jackson, digital healthcare allows the sharing of knowledge, which enables a discussion and a discourse between physicians and management.
The paper has discussed organizational learning and knowledge management in strategic management at digital healthcare organizations. A learning organization is capable of sensing changes in signals from both the external and internal environments and adapting appropriately. There are three forms of organizational learning: single loop, double loop, and triple loop. The five principles of organizational learning include mission and learning, leadership, the experimenting culture, knowledge transfer, teamwork and cooperation. Concerning healthcare, organizational learning has been utilized in improving quality changes and patients’ safety in the healthcare environment. Learning practices also assist in improving the current knowledge and skills and offer opportunities for discovering better ways of working together. Knowledge management is a management technique aimed at solving the present business challenges to increase the efficacy of a central business process while incorporating continuous innovation. Knowledge management is a discipline designed to offer a strategy, a process and technology to increase organizational learning.
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