Knowledge Management in healthcare covers a number of diverse practice activity areas that range from admission and accounting to preventive health programmes. From among these areas, clinical knowledge management represents a specific category that poses differentiated problems and requires specific management support. Clinical knowledge as practiced today mixes formally assessed scientific knowledge with a person-culture in which the expertise of the clinician is the key element. When considering standard Knowledge Management life cycles, this entails that the required processes of creation, assessment and dissemination of clinical knowledge assets diverge from other kind of activities in how different kinds of knowledge are handled. Further, the Information Technology support required for clinical knowledge assets is complex and multi-perspective, thus requiring schemas that integrate formally gathered evidence and subjective practical knowledge. This paper Sicilia deals with those differences from the viewpoint of formal ontology as a tool to model the specificities of clinical knowledge. An epistemological account of such knowledge is first provided, which serves to delineate how clinical processes and clinical knowledge management could be aligned. The problems of claim evaluation and representation are then approached from that framework, resulting in a realistic integrated set of design guidelines for clinical knowledge management prepared for use in ontology-based Information Systems.
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