Knowledge Management Synopsis - Vanderbilt University Medical

Knowledge Management Synopsis
Knowledge Management (KM) at Vanderbilt University Medical Center (VUMC) provides high-level data and
knowledge organization skills to optimize innovative clinical, research, and educational initiatives.
Collaborating with clinicians and researchers, highly trained information specialists embed best practices in
organizing, structuring, and reusing the institution’s knowledge. The information specialists who constitute the
KM team, in addition to their unique expertise in library and information science, also hold deep knowledge and
expertise in the areas of adult learning, health literacy, public health, pharmacogenetics, neuroscience,
biosciences, and biostatistics. Current knowledge management services include expert genetics/biochemistry
information assistance to support biomedical research and in-depth clinical evidence to inform the development
of local and national patient care guidelines.
Evidence-based Practice Support. The Knowledge Management team employs a matrix of strategies to foster
evidence-based medicine (EBM) practice. Through the Digital Library, the team curates and provides
convenient access to critical evidence-based databases such as UpToDate and the Cochrane Library along with
globally accessible EBM resources such as the National Guideline Clearinghouse and Choosing Wisely. VUMC
students, staff, and faculty have access to key National Center for Biotechnology Information tools and
resources, including PubMed, Gene, and BLAST, and other useful databases, such as PharmGKB, Protein Data
Bank (PDB), UCSC Genome Browser, Database of Genomic Variants (DGV), OpenHelix, OMIM, and
TRANSFAC. Medical Center information systems, including the medical record system StarPanel, are also
accessible via the Digital Library.
Knowledge Management’s role in EBM practice extends well beyond the provision of resources. The team has
been an integral part of Vanderbilt's AHRQ-funded Evidence-based Practice Center (EPC) since its inception in
2007 to assess the feasibility and utility of topics for comparative effectiveness review and author systematic
reviews to evaluate evidence on various clinical issues. KM team members serve as essential participants in all
phases of the systematic review process, including authoring content in the final report and co-authoring peer
reviewed manuscripts.
The Knowledge Management team also actively supports clinical, research, and order set teams in responding to
complex patient care questions by searching and filtering the literature and delivering evidence summaries and
expert search strategies. Case-specific evidence can be requested by individual clinicians in selected units
through the EBM information basket in StarPanel, as well. Evidence summaries include syntheses of the overall
body of evidence, details and analysis from the best publications, and lists of relevant citations and search
strategies. Internally-developed online EBM databases house archived results from the Clinical Informatics
Consult Service, Outpatient Clinical Informatics Consult Service, Pathways/Order Set Support, and more,
facilitating around-the-clock access to filtered, evidence-based information and expert search strategies for the
entire VUMC community. All VUMC personnel may also request research assistance via SearchDoc,
BioSearchDoc, and general online request forms.
The Knowledge Management team works to advance the knowledge base and capacities of VUMC for its
personalized medicine missions. KM team members are heavily embedded in VUMC's multidisciplinary
Diagnostic Management Teams (DMTs), which are designed to provide laboratory test interpretations to help
VUMC clinicians understand results of complex diagnostic tests. With their knowledge of pharmacogenetics,
KM team members provide evidence-based support for coagulopathy and hematopathology interpretations;
preliminary work with the Breast DMT has also occurred. As contributors to the VUMC’s Clinical &
Translational Science Award project, KM information specialists aid in the integration of genetic information
into the electronic medical record, helping physicians match drugs and dosage to patients. The team provides
information directly to patients through the My Health at Vanderbilt portal to aid their understanding of lab data,
health condition information, and, most recently, the genetic information in their record. Evidence synthesized
by KM team members also plays an integral part in VUMC’s publicly available personalized cancer decision
support tool, My Cancer Genome.
Research and Education. Knowledge Management's research interests include integrating evidence into patient
care and research workflow using informatics applications; assessing various stakeholder groups' interactions
with health information; education, skills development, and leadership development of information
professionals; optimal selection and use of information resources; health literacy projects and interventions;
organizational knowledge management; and digital library development.
Two research grants from the Institute of Museum and Library Science have enabled the KM team to research
and implement pioneering patient education initiatives. The team conducted a series of studies to investigate
both the effectiveness and applicability of a new form of patient educational intervention that is centered on two
key elements: literacy and learning styles. Data collected from emergency medicine clinical trials validated the
approach in hypertensive patients. The team confirmed the model’s generalizability by replicating the
experiment with a different population in the Vine Hill Clinic for both hypertension and diabetes patients (IMLS
National Leadership Grant LG-06-10-0186-10 December 1, 2010 – November 30, 2012. “Using Patient Literacy
Levels and Learning Style Preferences to Optimize the Delivery of Health Information”). This research project
established an infrastructure for developing customized information prescriptions that can be broadly adapted
for use in varied care settings and with a range of health conditions.
The library was also awarded a two-year IMLS grant that started December 1, 2013 (IMLS National Leadership
Grant LG-06-13-0180-13 “Using Health Literacy and Learning Styles to Guide Oncology Patients through a
Pharmacogenetic Maze”). During this project the EBL team is partnering with My Cancer Genome to create
reusable consumer-friendly educational material of the site’s content to facilitate patient lifelong learning and to
maximize the impact of this national web-based tool for cancer genomics. This grant relies both on the
pharmacogenetics and health literacy expertise of the team and the long-standing collaboration among the
different departments working on personalized medicine.
Knowledge Management’s commitment to education is also reflected in its various training offerings.
Information specialists train VUMC personnel in pharmacogenetics and personalized medicine concepts and
resources. Group training and drop-in office hours are offered for VUMC practitioners, researchers, and students
to gain assistance in using in-depth genetics, biochemical, and structural resources and databases. As of the
2014/15 school year, each medical school class is assigned an information specialist who serves as the point
person for research assistance throughout all four years of the program. The quality of KM training was recently
validated by the accreditation of select training modules for Continuing Medical Education credit. All new KM
staff members also undertake extensive and rigorous training in medical librarianship and the biosciences to
ensure the maintenance and distribution of institutional expertise.