Nitya Ahilandam Kamalanathan, Alan Eardley, Caroline Chibelushi, Tim Collins

Show more
Faculty of Computing Engineering and Sciences, Staffordshire University, Stafford, UK.
Show less

Abstract: The UK National Health Service (NHS) is faced with problems of managing patient discharge and preventing the problems that result from it such as frequent readmissions, delayed discharge, long waiting lists, bed blocking and other such consequences. The problem is exacerbated by the growth in size, complexity and the number of chronic diseases in the NHS. In addition, there is an increase in demand for high quality care, processes and planning. Effective Discharge Planning (DP) requires practitioners to have appropriate, patient personalised and updated knowledge in order to be able to make informed and holistic decisions about a patients’ discharge. This paper examines the role of Knowledge Management (KM) in both sharing knowledge and using tacit knowledge to create appropriate patient discharge pathways. The paper details the factors resulting in inadequate DP, and demonstrates the use of Internet of Things (IoT) and Machine2Machine (M2M) as candidate technologies and possible solutions which can help reduce the problem. The use of devices that a patient can take home and devices which are perused in the hospital generate information, which can serve useful when presented to the right person at the right time, thus harvesting knowledge. The knowledge when fed back can support practitioners in making holistic decisions with regards to a patients’ discharge.

Keywords: National Health Service (NHS); Knowledge Management (KM); Discharge Planning (DP); Internet of Things (IoT); Machine2Machine (M2M)

Cite this paper: N. Kamalanathan, A. Eardley, C. Chibelushi and T. Collins, "Improving the Patient Discharge Planning Process through Knowledge Management by Using the Internet of Things," Advances in Internet of Things, Vol. 3 No. 2, 2013, pp. 16-26. doi: 10.4236/ait.2013.32A003.

References

[1]   NHS, “About the NHS,” 2012. http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx

[2]   P. Ashmos and P. Huber, “The Systems Paradigm in Organization Theory: Correcting the Record and Suggesting the Future,” JSTOR: The Academy of Management Review, Vol. 12, No. 4, 1987, pp. 607-621. http://jaylee.business.ku.edu/MGMT916/PDF/AshmosHuber 1987 AMR.pdf

[3]   L. Ervin, “The Systems View of the World,” Hampton Press, New Jersey, 1996.

[4]   A. D. Chetty, V. K. Kartha, A. McKenna, K. DePaoli, M. R. B. Jack, “Re-Engineering the Hospital Discharge: An Example of a Multifaceted Process Evaluation,” Advances in Patient Safety: From Research to Implementation, Vol. 1-4, Agency for Healthcare Research and Quality, Rockville, 2005. http://www.ahrq.gov/qual/advances/

[5]   I. Reychav and J. Weisberg, “Bridging Intention and Behaviour of Knowledge Sharing,” Journal of Knowledge Management, Vol. 14, No. 2, 2010, pp. 285-300. http://www.emeraldinsight.com/10.1108/13673271011032418.

[6]   M. Fontaine and E. Lesser, “Challenges in Managing Organizational Knowledge,” 2002. http://www-935.ibm.com/services/us/imc/pdf/g510-3234-00-esr-managing-organizational-knowledge.pdf

[7]   A. Hannan, “Opportunities and Challenges of Using Electronic Health Records to Enhance Patient Care,” 2010. http://www.bcs.org/upload/pdf/assist-140910-ahannan.pdf

[8]   M. Polanyi, “Tacit Knowing,” In: M. Polanyi, Ed., The Tacit Dimension, Doubleday & Company, New York, 1966, pp. 3-25.

[9]   H. J. Levenstein, C. E. McCracken, M. R. Ian, A. M. Stewart and B. J. Brown, “The Patient-Centred Clinical Method,” Family Practice, Vol. 3, No. 1, 1986, pp. 24-30. http://fampra.oxfordjournals.org/content/3/1/24.full.pdf+html

[10]   A. Eardley and A. Czerwinski, “Knowledge Management for Primary Healthcare Services,” In: R. Bali and A. Dwivedi, Eds., Knowledge Management: Issues, Advances and Successes, Springer Science + Business Media, New York, 2007.

[11]   R. K. Bali, A. Dwivedi, A. E. James, R. N. G. Naguib and D. Johnston, “Towards a Holistic Knowledge Management Framework for Healthcare Institutions,” Proceedings of the Second Joint EMBSBMES Conference, Houston, 2002, pp. 1894-1895. http://ieeexplore.ieee.org/stamp/stamp.jsp?arnumber=01053081

[12]   N. Kamalanathan, A. Eardley, C. Chibelushi and P. Kingston, “The Discharge Planning Dilemma in the UK NHS: The Role of Knowledge Management,” In: G. Huang, et al., Ed., Health Informations Systems, Springer-Verlag, Berlin Heidelberg, 2013, pp. 172-185.

[13]   Sg2 Healthcare Intelligence, “Reducing 30-Day Emergency Readmissions,” 2011, pp. 1-28. http://www.hsj.co.uk/Journals/2/Files/2011/6/15/Sg2_Service Kit_Reducing30-DayReadmissions.pdf

[14]   K. Ishikawa, “Introduction to Quality Control,” 3A Corporation, Tokyo, 1990.

[15]   Social Care Institute for Excellence, “SCIE Research Briefing 12: Involving Individual Older Patients and Their Carers in the Discharge Process from Acute to Community Care: Implications for Intermediate Care.” http://www.scie.org.uk/publications/briefings/briefing12

[16]   Institute for Healthcare Improvement, “Improving Patient Flow at Bon Secours Venice Hospital,” 2011. http://www.ihi.org/knowledge/Pages/ImprovementStories/ImprovingPatientFlowBonSecoursVeniceHospital.aspx

[17]   N. Triggle, “Organise Urgent Care Better, NHS Told,” BBC News, 2012. http://www.bbc.co.uk/news/health-19181905

[18]   R. Ramesh, “One in Four Hospital Patients Could Be Recovering at Home,” The Guardian, 2011. http://www.guardian.co.uk/society/2011/dec/29/hospital-patients-discharge-bed-blocking

[19]   S. Adams, “‘Intolerable’ Bed-Blocking Crisis Threatens NHS,” The Telegraph, 2011. http://www.telegraph.co.uk/health/healthnews/8343879/Intolerable-bed-blocking-crisis-threatens-NHS.html

[20]   R. Winnett, “Scandal of NHS ‘Production Line’ as Read- missions Soar,” The Telegraph, 2011. http://www.telegraph.co.uk/health/healthnews/8983505/Scandal-of-NHS-production-line-as-readmissions-soar.html

[21]   T. Chunsheng, “The Research on Knowledge Management and Knowledge Portal Framework Based on Agent Mechanism,” IEEE (Vol. 00, pp. 263-267), Hefei, China. 3rd World Congress on Intelligent Control and Automation. http://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=859962

[22]   T. M. Hansen, N. Nohria and T. Tierney, “What’s Your Strategy for Managing Knowledge?” Harvard Business Review, 1999, pp. 1-11. http://consulting-ideas.com/wp-content/uploads/Whats-your-strat-art.pdf

[23]   S. Liao, “Problem Solving and Knowledge Inertia,” Expert Systems with Applications, Vol. 22, No. 1, 2002, pp. 21-31. http://linkinghub.elsevier.com/retrieve/pii/S095741740100046X

[24]   A. M. Mills and T. A. Smith, “Knowledge Management and Organizational Performance: A Decomposed View,” Journal of Knowledge Management, Vol. 15, No. 1, 2011, pp. 156-171. http://www.emeraldinsight.com/10.1108/13673271111108756

[25]   P. J. Sharp, W. A. Eardley and H. Shah, “Visual Tools within MakE: A Knowledge Management Method, Electronic,” Journal of Knowledge Management, Vol. 1, No. 2, 2003, pp. 177-186.

[26]   A. Copper, “We Haven’t Got a Plan, So What Can Go Wrong? Where Is the NHS Coming from?” In: R. K. Bali and A. Dwivedi, Eds., Healthcare Knowledge Management, Springer Science + Business Media, New York, 2007, pp. 221-232.

[27]   S. Shepperd, J. McClaran, C. Phillips, N. Lannin, L. Clemson, A. McCluskey, I. Cameron and S. Barras, “Discharge Planning from Hospital to Home,” The Cochrane Library, Vol. 1, 2010, pp. 1-75. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000313.pub3/pdf

[28]   NHS, “Leaving Hospital,” 2012. http://www.nhs.uk/nhsengland/aboutnhsservices/nhshospitals/pages/leaving-hospital.aspx

[29]   Theinternetofthings.eu, “Russian Research Center on the Internet of Things Is Official Partner for the Internet of Thing Council: The Internet of Things.” http://theinternetofthings.eu/russian-research-center-internet-things-official-partner-internet-thing-council

[30]   D. Evans, “The Internet of Things: How the Next Evolution of the Internet Is Changing Everything,” 2012. http://www.cisco.com/web/about/ac79/docs/innov/IoT_IB SG_0411FINAL.pdf

[31]   C. Pfister, “Getting Started with the Internet of Things,” O’Reilly Media, Inc., Sebastapool, 2011.

[32]   M. R. McGee-Lennon and P. D. Gray, “Including Stakeholders in the Design of Home Care Systems: Identifica- tion and Categorization of Complex User Requirements,” INCLUDE Conference, London, April 2007.

[33]   H. Ning, “Future Internet of Things Architecture: Like Mankind Neural System or Social Organization Framework?” IEEE Communications Letters, Vol. 15, No. 4, 2011, pp. 461-463.

[34]   I. F. Akyilidiz, T. Melodia and K. Chowdhury, “A Survey on Wireless Multimedia Sensor Networks,” Journal of Computer Networks, Vol. 51, No. 4, 2007, pp. 921-960. doi:10.1016/j.comnet.2006.10.002

[35]   J. Hurwitz, “Cloud Computing for Dummies,” Wiley Publication. Hoboken, 2010.

[36]   Exelanz, “Cloud vs. Traditional Hosting,” 2012. http://www.exelanz.com/cloud-vs-traditional-hosting/

[37]   Fasthosts, “The Myth behind the Extinction of IT Departments,” 2012. http://blogs.fasthosts.co.uk/cloud-computing/the-myth-behind-the-extinction-of-it-departments/?goback=%2Egde_45151_member_191264989

[38]   D. B. Lange and M. Oshimma, “Ten Good Reasons for Mobile Agents,” Communications of the ACM, Vol. 42, No. 3, 1998, pp. 88-89. doi:10.1145/295685.298136

[39]   M. Satyanarayanan, “Pervasive Computing: Vision and Challenges,” IEEE Personal Communications, Vol. 8, No. 4, 2001, pp. 10-17. http://www.cs.cmu.edu/~aura/docdir/pcs01.pdf

[40]   D. J. Cook, M. M. Youngblood, E. O. Heiermann, K. Gopalratnam, S. Rao, A. Litvin and F. Khawaja, “Mavhome: An Agent-Bqased Smart Home,” Proceedings of the First IEEE International Conference on Pervasive Computing and Communications, Fort Worth, 26 March 2003, pp. 521-524.

[41]   S. Poslad, “Ubiquitous Computing: Smart Devices, Environments and Interactions,” John Wiley and Sons, London, 2011.

[42]   K. M. Dombroviak and R. Ramnath, “A Taxonomy of Mobile and Pervasive Applications,” Proceedings of the 2007 ACM Symposium on Applied Computing, Seoul, 11-15 March 2007, pp. 1609-1615.

[43]   D. Chaffey, “Internet Marketing: Strategy, Implementation, and Practice,” Financial Times, Prentice Hall, Harlow, 2000.