Connecting medical devices in remote and resource poor settings plays a critical role in effectively supporting decentralised healthcare.
Connectivity facilitates the evolution of data from information to actionable, empowering knowledge. But, can the current paradigm of data management keep up with the needs of knowledge management? This article explores the current Who, Where, What, and How paradigm of data management and the shift to knowledge management that is needed to strengthen healthcare systems.
The relationship between Data, Information and Knowledge is well described. Data on its own is not useful until it is collected, collated, organised and referenced in a retrievable structure. It then becomes information. Information becomes useful when it is internalised, shared and is made actionable. At this point, it becomes knowledge, and knowledge is empowering.
Point of care is embracing connectivity. The ability to connect remote devices to a data management platform is considered an essential part of any point-of-care deployment. This is especially true in resource poor settings. Without connectivity, vast amounts of data are generated, but may never become useful or actionable. A suitable knowledge management approach must be created to fully utilise that data.
Without connectivity, vast amounts of data are generated, but may never become useful or actionable.
The common paradigm encountered in connectivity installations is the “Who, Where, How and What” of data management. Who has access to my data? Where is my data housed? How do I connect my instrument to a data platform? What is my data used for? A shift from this mechanistic paradigm towards a knowledge-based paradigm is needed to enhance point of care programs
- Who has access to my data? should become how can we ensure that the correct person has the appropriate level of access to the data
- Where is my data being housed? should be replaced with how do we address the complex requirements of data security while ensuring that data flows freely across multiple integrated systems
- How can I connect my instrument to my server? should be replaced with how can we create clinic level integration across multiple information platforms and instruments to strengthen health systems?
- What is my data being used for? should become how can we ensure that actionable knowledge is being created from access to the information?
Allowing scaled access to data to different role players within the point-of-care value chain means that those players will enhance their contribution to that value chain. Technical support can become more proactive. The post-market vigilance and the reporting chain can be improved. Instrument downtime can be decreased. User errors can be detected and addressed. Quality improvement programs such as External Quality Assurance and Internal Quality Control can be implemented and monitored.
Warehousing data is a complex process made more difficult by the constantly changing threat environment. This was well illustrated by the recent “Wannacry” ransomware attack that crippled many systems worldwide. The complexity of this problem should not mean that access to data should be denied. Systems should be created that adequately address the needs for data security and that meet the need for legal and regulatory compliance. At the same time, these systems should allow data to flow freely to those systems and users that need access. No one system or organisation can address these needs. Partnerships, and cooperation between manufacturers, service providers, ministries of health, and the end users of point of care as well as other diagnostic technologies are essential.
Point of care is capable of driving a revolution in healthcare, especially in resource poor settings. Connectivity has the potential to integrate and improve information flow. Adding a knowledge management component will strengthening health systems and that will ultimately benefit the people who depend on those systems.