The Electronic Journal of Knowledge Management publishes original articles on topics relevant to studying, implementing, measuring and managing knowledge management and intellectual capital.

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Journal Article

Knowledge Management for Virtual Reality Applications in a Home Rehabilitation Virtual Network  pp477-486

Emil Scarlat, Virginia Maracine, Adriana Nica

© Jan 2008 Volume 5 Issue 4, Editor: Charles Despres, pp347 - 550

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This paper describes the reference architecture to support a multi‑user virtual healthcare network that enables rehabilitation and social reintegration of people with disabilities. The network, based on a virtual collaborative environment supported by the www, includes collaboration and interpersonal communication devices and data collection mechanisms that provide knowledge management for the system and effectiveness evaluation. The Virtual Network (VN) allows the rehabilitation patients spread in geographically dispersed areas, a very frequent reality in the considered context, to access a distributed virtual platform able to offer communication and shared knowledge with doctors, nurses, therapists, social workers and other people involved in the process of rehabilitation. VN solutions allow building a virtual shared space, a context of understanding and knowledge where the "real world" knowledge affects virtual interaction and virtual interaction modifies "real world" therapies. The main aim of the VN is to achieve a higher quality of life for the people with disabilities and, in the long term, from the economic point of view, to produce important savingsprofits and bring about feasible ways to improvingre‑organizing health care services. The present paper illustrates our team's first steps in building such a network in Romania. The first section establishes the link between the virtual reality and the medical rehabilitation as an important branch of the healthcare system. Several applications in the field are presented here. The second section focuses on two main aspects: on the one hand, the current Romanian reality of medical rehabilitation and, on the other hand, the existing possibilities to build a VN for rehabilitation as a solution to the main problems Romania has in this field. The third section is a technical preamble to the knowledge sharing process particularized for a healthcare VN in section number four. The last part of the paper includes both pro and cons arguments for the designing of a VN as a solution to the discrepancy between the demand and the real current hospitals' supply of medical rehabilitation in Romania.


Keywords: home rehabilitation, virtual reality, virtual healthcare network, virtual organization, knowledge sharing models, information broker agent, personal healthcare agent


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Journal Article

Dynamic Knowledge and Healthcare Knowledge Ecosystems  pp99-110

Virginia Maracine, Emil Scarlat

© Apr 2009 Volume 7 Issue 1, ECKM 2008, Editor: Roy Williams, pp1 - 198

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The concept of Knowledge Ecosystem (KE) is used to define a community of practice that builds knowledge in a bottom‑up, networked and dynamic fashion. These features define a new kind of digital ecosystem that is domain specific and operate in an open (virtual or real) world. The openness is an ideal situation that needs to apply the unified standards, for instance the Semantic Web Standards and Rules and Web 3.0 that help the building, growth, sharing and forgetting of knowledge across the Knowledge Ecosystems. What makes the KE different from the "classic" view upon the digital ecosystem is an active and dynamic process that involves: the creation of knowledge; the intentional elicitation of knowledge; the ability of share knowledge across the entities; and the possibility to depreciate and forget knowledge. How does the dynamic nature of knowledge influence the nature of knowledge ecosystems? What are the general principles that can be applied to design the sound and enduring knowledge ecosystems? These are some of the questions will try to get answers in our paper work. First of all, we will show that the dynamic evolution of knowledge and the dynamic character of the flows of knowledge are essential for the transition from digital ecosystems to knowledge ecosystems. Having a static collection of pieces of knowledge, processing them and placing them in a digital ecosystem are not really enough for this one to becomes a knowledge ecosystem. Continuous knowledge creation is responsible for transforming the digital ecosystem in a knowledge one. The process of dynamic knowledge building occurs when internal (tacit) knowledge becomes external (explicit). The continuously feedbacks that operate between internal and external knowledge are producing new knowledge among entities and create the energy and permanent innovation that characterizes a knowledge ecosystem. In the second part of the paper we have draw some general principles of accelerating the appearance of new knowledge ecosystems, while in the third section we define the main features of the knowledge healthcare ecosystem design for the home rehabilitation of people with motor disabilities. In order to do so, we are going to extract from these general principles the specific in‑rules that make the agents involved in home health rehabilitation act as a knowledge ecosystem. Alongside the theoretical approach to our paper (that refers to the principles' establishing), there is also the practical one. We conclude the paper work with some remarks on the KE's role and importance in healthcare, and in particular in home rehabilitation field.


Keywords: digital ecosystem, healthcare knowledge ecosystem, dynamic knowledge, flows of knowledge, home health rehabilitation, virtual network for home health rehabilitation


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Journal Article

Knowledge use and Sharing into a Medical Community of Practice; the Role of Virtual Agents (Knowbots)  pp64-81

Virginia Maracine, Luca Iandoli, Emil Scarlat, Adriana Sarah Nica

© Jan 2012 Volume 10 Issue 1, ECKM 2011, Editor: Franz Lehner, pp1 - 109

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Knowledge‑oriented organizations are bricks for the knowledge‑based society construction. Building knowledge‑based society and economy suppose challenging transition processes from the classical structure of an organization to new organizational forms that help to fill the gap between actual society and the future knowledge‑based society and economy. This transition generates new issues in knowledge creation and sharing processes, related to the particularities of the new organizational forms. Therefore, in the last few years, our researches are oriented to developing and testing a number of forms of organization designed to facilitate an efficient and effective transition toward the knowledge‑based society, like communities of practice, (virtual) networks of professionals or knowledge ecosystems (KE). Under this general frame, this paper presents the results of our research aiming to capture the necessary changes that a medical organization specialized in rehabilitation (the National Institute of Rehabilitation and Physical Medicine from Bucharest, Romania ‑ INRMFB) has to undertake for converting its classical structure into a new knowledge‑oriented one, possible and easily to being integrated into a Virtual Network for Home Health Rehabilitation of the impaired people – the meta goal of our research in recent years. Specifically, within its five sections, the paper outlines: 1. An introduction in the macro and micro‑level empirical setting in which the study is carried out; 2. The methodological approach based on Social Network Analysis (SNA). Although quit often used in the medical field, as we will see in the second section of the paper, the SNA methods and models aren’t used yet in the particular area of health rehabilitation; 3. The objectives of the empirical study that can be summarized as follows: Mapping of the knowledge flows & needs in the target community of practice. The aim of this step is to produce an accurate picture of the knowledge flows that the target community identified at the INRMFB actually enacts in the accomplishment of its organizational objectives. Analysis & Diagnosis: Identification of critical aspects and areas of improvements (e.g. knowledge needs, knowledge bottlenecks, structural determinants of inefficiency or of poor performance). Design: definition of the functional specifications for redesigning the agents, network and of the functionalities of Knowbots. 4. The survey we have designed for data collection. According with the particularities of the macro and micro‑level in which our study is carried out, we have designed a survey that will help us both for diagnosing the knowledge‑sharing‑structure of INRMFB, and for finding adequate solutions for potential critical aspects identified in this medical facility.; 5. A set of conclusions and recommendations for the new knowledge‑oriented organizational structure to be created within the INRMFB. Alongside with performing SNA in the health rehabilitation field, an important output of our study is to find answer to the following questions: Cans the classical organizational structure of the INRMFB be transformed into a knowledge‑based one, by reengineering the knowledge flows and agent’s roles? If and where within the actual structure a virtual knowledge agent (knowbot) can and should be integrated? Our paper is a consequent continuation of our work in the KE area, contributing to the completion of an integrate vision over the role of the KM techniques, human and virtual agents in the emerging of knowledge‑based society. It presents a work still in progress, the final results of our study going to be presented within the ECKM2011 conference.


Keywords: community of practice, healthcare knowledge ecosystems, social network analysis, knowledge agent, Knowbot, collective learning, knowledge-based organization.


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Journal Article

Knowledge Management Practices and Healthcare Delivery: A Contingency Framework  pp110-120

Prantik Bordoloi, Nazrul Islam

© Mar 2012 Volume 10 Issue 2, ICICKM 2011, Editor: Vincent Ribière, pp110 - 207

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Being a knowledge driven process, healthcare delivery provides opportunity to incorporate knowledge management practices to improve processes. But it has also been noted that knowledge management is systematically more complex in healthcare and minimal research exist to guide academic and organizational stakeholders. The purpose of this paper is to investigate the application and impact of knowledge management practices in healthcare delivery. The paper is conceptual in its nature and aims to propose a contingency‑based framework to drive further empirical research. The paper is primarily based on a literature review of the healthcare knowledge management and associated information sciences research streams. The fundamental research questions are: ‘‘what and how do the various knowledge management practices affect the performance of healthcare delivery?’’ and ‘‘what are the contingent and contextual factors that needs to be considered when exploring the relationship between knowledge management practices and performance of healthcare delivery?’’ We first discuss facets of performance in healthcare delivery but thereafter focus on the technical and interpersonal care aspects of healthcare delivery. We investigate knowledge management practices in the areas of (i) knowledge acquisition and sharing, (ii) knowledge assimilation and application. In our paper we explore how the different knowledge management practices affect the performance of healthcare delivery through technical and interpersonal care. Thereafter we explore the factors of physician characteristic, ailment characteristics, organizational IT infrastructure and organization processes, on which the conceptual framework will be contingent on. We thereafter evaluate the conceptual framework with a case study. From an academic perspective our paper identifies some key knowledge management practices and explores their linkages with technical and interpersonal care, while from a practical point of view it provides implications for administrators and practitioners in healthcare delivery on the management of contingency factors so that the knowledge management practices can be properly implemented.


Keywords: healthcare knowledge management, healthcare delivery performance, electronic medical records, clinical decision support, evidence based medicine


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Journal Article

Knowledge Management and the Effectiveness of Innovation Outcomes: The Role of Cultural Barriers  pp62-71

Antonio Leal-Rodríguez, Antonio Leal-Millán, José Luis Roldán-Salgueiro, Jaime Ortega-Gutiérrez

© Jan 2013 Volume 11 Issue 1, ECKM 2012, Editor: Dr Juan Gabriel Cegarra and Dr María Eugenia Sánchez, pp1 - 115

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In this paper we propose a conceptual model to test the moderating effect of cultural barriers on the link between knowledge strategies and innovation using healthcare organizations. In order to study the tie (knowledge‑innovation) and the effects of the


Keywords: knowledge base, innovation outcome, cultural barriers, healthcare organizations


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Journal Article

Intellectual Capital and Innovation: A Case Study of a Public Healthcare organisation in Europe  pp361-372

Helena Santos-Rodrigues

© Nov 2013 Volume 11 Issue 4, ECIC 2013, Editor: Lidia Garcia Zambrano, pp280 - 392

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Abstract: This research study focuses on innovation and the Human, Structural, and Relational components of Intellectual Capital, using Santos‑Rodrigues et al. (2011) research proposal as a framework. It aims to investigate the influence of Intellectua l Capital on a public Healthcare organisations capability for innovation. Sixty five of the sixty eight questionnaires administered to hospital managers and leaders between July and August of 2011, were used in the research. The study suggests that a rel ationship exists between the incentives to innovate (a dimension of Human Capital) and the innovation created, with trust being the only Structural Capital dimension related with the innovation adopted. It was found that networks and alliances (a dime nsion of Relational Capital), is the only dimension simultaneously related with the innovation created and adopted constructs, hence, Relational Capital being the only Intellectual Capital construct related simultaneously with both innovation creation an d adoption. The research further suggests that there is a direct relation between Human Capital and innovation, principally with the innovation created. The Structural Capital construct was found to be partly related with the Innovation Adoption construct .


Keywords: Keywords: Intellectual Capital, Innovativeness, Healthcare, Human Capital, Structural Capital, Relational Capital


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Journal Article

Intellectual Capital and BI‑tools in Private Healthcare Value Creation  pp143-154

Milla Ratia

© Sep 2018 Volume 16 Issue 2, The Management of IC and Knowledge “in action”, Editor: Dr Maria Serena Chiucchi and Dr Susanne Durst, pp73 - 154

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The demand for data‑driven decision making in the healthcare sector has increased, not only on the clinical side, but also from the managerial perspective; this is especially true in the private healthcare sector. Utilisation of internal and external data requires certain capabilities, such as intellectual capital (IC), as different data sources (structural capital) and organisational competences (human capital) can become organisational value. We study the utilisation of business intelligence (BI) tools and IC dimensions in creating value in the Finnish private healthcare sector. IC components and a modified value creation capabilities model are used as a framework for considering data utilisation and BI tools’ role in value creation. Our study includes private healthcare organisations in Finland and management and BI technology consulting representatives. Thematic interviews of key personnel responsible for BI were conducted to elucidate the value creation capabilities, IC components and BI tool utilisation in the Finnish private healthcare industry. Data‑driven decision making is currently one of the most discussed topics in private healthcare sector organisations. By analysing the current data source utilisation and organisational competences in data utilisation, we gain a better understanding of IC and BI tool–enabled value creation in private healthcare organisations. The study’s outcomes will provide valuable information and a deep understanding concerning the influence of BI tools and IC dimensions on value creation in private health care in Finland. In addition, it will provide insight into future‑oriented value creation factors that can enable new business concepts for private healthcare companies. Advanced capability of data utilisation will increase the value creation ability in private healthcare sector companies. However, in addition to the technology and data, human capital or capability of BI tool utilisation and data‑driven decision making are crucial.


Keywords: Private healthcare, business intelligence, intellectual capital, value creation, external data sources


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Journal Issue

Volume 7 Issue 1, ECKM 2008 / Apr 2009  pp1‑198

Editor: Roy Williams

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This special edition of the journal is a selection of the best papers from the recent European Conference on Knowledge Management, held at Southampton Solent University in 2008. Several of the papers addressed the shift to what is increasingly being called knowledge ecologies, within the more general field of digital ecologies (see IEEE 2009)

Vanessa Lawrence's keynote speech on Ordnance Survey: underpinning Great Britain with geographic information set the tone for the conference, and set the standard for key aspects of knowledge management and knowledge ecologies. The Ordnance Survey (OS) is an exemplary case study of how to create well mapped data and maximise its use in today's digital ecologies. This case study combines the best aspects of interoperability at the level of data with the best aspects of dynamic, complex and even open systems at the level of information and knowledge creation and exchange. Intelligently mapped data is at the heart of the OS topological information system, creating uniquely identified data objects which are the building blocks for the four layers of the Master Map: topography, address, integrated transport, and imagery.

More importantly from a knowledge management point of view, this integrated Master Map crosses seamlessly from data base management, to information systems, to traditional knowledge management and into knowledge ecologies. A range of commercial and community organisations can build on the Master Map, using elements from it, to create their own maps from their own perspectives, such as housing, health care, flood management, or policing. These different, user‑generated derivative maps create a knowledge ecology, which is a dynamic, flexible, and adaptable set of meta‑mappings (literally and figuratively) or what might be called 'map‑ups', which people can read, write and contribute to, link to, and mash‑up with their own data.

The intelligent data is itself dynamic and changing, and in a ""mobile, transient society and economy where location is a dynamic resource within business"" (Lawrence op. cit.), the data has to be accurate and constantly updated. The figures are impressive: 460M data fields, 1.8M changes per annum, 0.5M updates per annum, of which 99.9% are updated or added within 6 months of completion on the ground, and a potential resolution of 20mm for information on reticulation.

The Open Space initiative, for non‑commercial use only, provides a base and a framework for social mapping or map‑ups. In the first year it involved 900 developers and 156k visitors. The Explore programme allows people to create routes, tag points of interest, and share pictures, news and events.

Lawrence summed up the Ordnance Survey approach as the challenge to ""establish principles to make information sources accessible and connectable"", an elegantly simple framework for knowledge management in the service of knowledge ecologies.

Maracine et al describe knowledge ecosystems (KE) as a new kind of digital ecosystem which is an ""active and dynamic process, that … helps the building, growth, sharing and forgetting of knowledge"". They explore this in healthcare systems for home rehabilitation, which differ from other KEs because of the role and importance of the patient: in practice the entire ""life"" of the ecosystem gravitates around the patient and their personal rehabilitation chain.

Managing Intellectual Capital is now central to the EU strategy, so small and medium sized companies (SME's) must play their part in this. Mertins, Wang and Will's study analyses the different rankings of IC factors across 5 major economic sectors, and leads to some interesting conclusions, for instance that ""the traditional distinction between Industry and Services is improper for researching the strategic impact of IC. Rather companies should be classified by comparing the actual business models"".

Third sector organisations are also applying KM. In this case study, Reilly describes the way resource priorities, programme funding and dispersed Authority inhibit successful KM. There is widespread support for the discovery of knowledge, but it is subject to diverse interpretation, and consensus on how to apply it is difficult to achieve. Reilly proposes a relational knowledge domain to promote a more holistic approach in value driven organisations, to integrate and optimise KM. There seems to be similar issues in the corporate sector too, as Brännström and Giuliani have found, namely that one of the difficulties in IC reporting is that ""goodwill is substantially based not on particular components of IC, but on the synergies between them"". Another problem with IC reporting, and with FRS IFRS3 in particular is that some firms deliberately ""want to continue to use goodwill as a 'blackbox' to avoid disclosing some items to analytic scrutiny by outsiders"".

The link between descriptions and analyses of real business situations and personal experience can be used to build a real consensus. The Socratic Dialogue (Remenyi & Griffiths) involves much more than a simple verbal agreement. Participants try to clarify the meaning of what has just been said by testing it against their own experiences. In this way the limitations of individual experience which stand in the way of a clear understanding can be made conscious, and these limitations can hopefully be transcended.

Garcia‑Perez & Ayres's paper outlines an approach where elicitation and transfer, and possibly also creation, are carried out in one process. This involves identifying key experts and stakeholders, who then work together to develop a representation of the experts' domain knowledge. They conclude that ""communicational problems are minimised because the main interaction will take place between domain experts and their stakeholders. Also, discussion of their own experience with colleagues through a process of modelling their expertise significantly increases experts' motivation to share knowledge"".

Begley et al outline their 'new' theory of the firm, its relationship to networked society, and to other theories of the firm, within KM. They see the firm as a 'connected temporary coalition' perspective (based on Taylor, 1999; 2006), within an interactive model of the firm, containing diverse types of relationships, collections of both closely coupled and loosely coupled systems that configure, dissolve and reconfigure over time, forming a distinct capability in leveraging collective knowledge assets.

A new approach to systems development for KM is presented by Moteleb & Woodman, which is based in action research and Grounded Theory, using a number of business problems experienced by organizations. The KMSD approach is highly participatory, requiring full involvement of members of an organization, in three interacting aspects: envisioning knowledge work behaviour, design of knowledge management system (KMS), and identifying technology options. The KMS design integrates organizational, social and technological aspects of the system.

Landwitch et al have developed a more interactive and dynamic process for Information Retrieval in which the IR systems explicitly support the user's query requirements, but also their cognitive abilities, to realize a dynamic dialogue between the user and the system. This is aimed at satisfying both the information needs of the users, and the innovation‑process. Smith deals with the specifically human elements of what could also be called knowledge ecology, integrating cultural and process issues, and ""issues of organisational adaptation, survival and competence in and increasingly discontinuous environment. Rather than being a process problem, poor knowledge emergence from a new system is more likely to be a communication and learning problem where there is a failure to engage with the individuals who are within the system"".

Vedteramo & de Carolis advocate a community‑based approach to KM in the growing sector of project‑based organizations. Projects are typically temporary, and much learning may be lost when they disband, the storage of lessons learned is not effective, the databases are not widely used and the people are too engaged in their projects to share knowledge or help other people cope with similar problems. Vedteramo suggests the adoption of McDermott (1999)'s ""double knit organisation"", integrating project teams and communities of practice.

Webb uses open ended diaries and strategically resourced reflection on the diaries, and provides material on management and complexity theory for managers to use, to reflect on and make sense of their practice and learn from it. This provides ""multiple first person accounts and opened up new avenues of exploration and … [suggests that is could also be used for] the stimulation, initiation and development of knowledge transfer activities on particular themes.

Koolmees et al have developed and tested a new Knowledge Management Scan which assesses six basic KM abilities in an organisation , based on a survey of 15 statements per ability, and is based on work on value based KM, and different organisational learning types. The abilities are: to produce, anticipate, respond, learn, create and to last. The Scan produces an understanding of the organisation's overall learning ability, in terms of single, double and triple loop learning.

Harorimana's case studies describe how knowledge gatekeepers contribute to the benefits of the firm's internal capabilities, without being paid for their role. However, the informal nature of people's roles as gatekeepers makes their job difficult to recognize, and therefore requires some form or rewards.

Evans and Wensley's research on network structure and trust explores the extent to which network principles determine the level of trust in Communities of Practice. They provide a detailed analysis of the how trust is established and how it functions in CoP: in self‑directed teams, mutual trust takes the place of supervision, and this has a positive impact on knowledge sharing and on innovation.

Rees and Protheroe recommend the joint development of KM and kaizen practices (continuous improvement), embedded into the redevelopment of an existing strategy set, to facilitate the development of knowledge value, and show how this is implemented in the higher education sector.

Aidemark points out the ongoing confusion in the theoretical base of KM, and specifically highlights the complexity and paradoxes that arise between knowledge as information on the one hand, and as competence (or know‑how) on the other hand, and provides models which should improve our awareness of these problems, and help us in developing strategy.

And finally, Devane and Wison, in their paper on Non‑managed Knowledge, provide an interesting critique of traditional approaches to knowledge 'management' and knowledge transfer, and suggests that Coverdale's focus on the development of skills is a better foundation for a company's success. They argue that knowledge should not be seen as something extrinsic, and external that can be managed 'for' individuals, but rather as something intrinsic, in which case the best approach is to allow individuals to manage it themselves.


The papers in this special edition provide new ideas, new critiques, and new research on KM. Most of them in some way also address the very welcome shift from 'management' to 'ecologies', which adds more emphasis on personal roles and at the same time, more emphasis on networking, content and knowledge creation beyond the confines of the traditional Weberian institution. Lawrence's approach is an interesting exemplar of how this can be done, as it integrates well mapped data and basic information structures with flexible, customisable and personalisable knowledge creation and sharing. Perhaps this could be called 'connectable interoperability'?


Keywords: action research, agency, assessment, learning organisation, brokerage, case study, certification, closure, communities of practice, cultural memes, culture, digital ecosystem, dynamic knowledge, enterprise renewal, financial accounting, flows of knowledge, goodwill, grounded theory, groups design, healthcare knowledge ecosystem, home health rehabilitation, homophily, information retrieval, information visualisation, innovation intellectual capital, innovation-process, intellectual capital statement audit, interactive systems, kaizen, knowledge audit, knowledge communities, knowledge creation, knowledge elicitation, knowledge gatekeeper, knowledge management frameworks, knowledge management in higher education, knowledge management scan, knowledge management systems, knowledge management systems development, knowledge sharing, knowledge strategy, knowledge transfer, leading firms, network structure, nonprofit organizations, organisational form, organisational learning knowledge, organiz


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