Applying the Practice Theoretical Perspective to Healthcare Knowledge Management

  • Obinna Anya
  • Hissam Tawfik
  • Raouf N. G. NaguibEmail author
Part of the Healthcare Delivery in the Information Age book series (Healthcare Delivery Inform. Age)


A primary focus of healthcare knowledge management is to provide clinical practitioners with appropriate knowledge resources for making the best patient care decisions. Over the years, advances in information technology have enabled a knowledge-rich healthcare system with accessible databases and repositories. However, healthcare knowledge remains largely underutilized, and often wrongly utilized, in patient care decision-making. As greater considerations of social and organizational contexts began to emerge, concepts and techniques of the practice theoretical perspective have gained relevance as a tool for providing a rich set of findings required to making sense of how healthcare knowledge is utilized at the point of care and for designing systems to support that use. In this chapter, we describe a research effort at developing an e-health system for clinical decision support and knowledge sharing across organizational and geographical boundaries using the practice theoretical approach. The chapter concludes with a roadmap for the critical goal of designing healthcare knowledge management systems and user interfaces that meet the information, collaboration and workflow needs of healthcare professionals at the point of care.


Health information systems Practice theory Healthcare knowledge management Clinical decision support 


  1. Abidi, S. S. R. (2006). Healthcare knowledge sharing: Purpose, practices and prospects. In R. Bali & A. Dwivedi (Eds.), Healthcare knowledge management: Issues, advances and successes (pp. 65–86). New York: Springer.Google Scholar
  2. Abidi, S. S. R. (2008). Healthcare knowledge management: The art of the possible. In D. Riaño (Ed.), Knowledge management for health care procedures, Lecture notes in computer science (Vol. 4924). Berlin: Springer.CrossRefGoogle Scholar
  3. Allert, H., & Richter, C. (2008, April 1–2). Practices, systems, and context working as core concepts in modeling socio-technical systems. In M. Möller, T. Roth-Berghofer, & W. Neuser (Eds.), Proceedings of the fifth international workshop on philosophy and informatics, WSPI 2008, Kaiserslautern.Google Scholar
  4. Anya, O., & Tawfik, H. (2016). Designing for practice-based context-awareness in ubiquitous e-health environments. Computers & Electrical Engineering, 61, 312–326. Retrieved August 24, 2016, from CrossRefGoogle Scholar
  5. Anya, O., Tawfik, H., Amin, S., Nagar, A., & Shaalan, K. (2010). Context-aware knowledge modelling for decision support in e-health. In International joint conference on neural networks (IJCNN) (pp. 1–7).Google Scholar
  6. Bødker, S. (1991). Activity theory as a challenge to systems design. In H.-E. Nissen, H. K. Klein, & R. Hirschheim (Eds.), Information systems research: Contemporary approaches and emergent traditions. Amsterdam: North Holland.Google Scholar
  7. Brézillon, P. (2011). Context-based management of practices. In International workshop on modeling and reasoning in context, Karlsruhe, Germany. Berlin, Germany: Springer.Google Scholar
  8. Bricon-Soufa, N., & Newman, C. R. (2007). Context awareness in health care: A review. International Journal of Medical Informatics, 76, 2–12.CrossRefGoogle Scholar
  9. Büscher, M., Gill, S., Mogensen, P., & Shapiro, D. (2001). Landscapes of practice: Bricolage as a method for situated design. CSCW, 10, 1–28.Google Scholar
  10. Button, G., & Harper, R. (1996). The relevance of ‘work-practice’ for design. CSCW, 4(4), 263–280.Google Scholar
  11. Chaiklin, S. (2011). The role of practice in cultural-historical science. In M. Kontopodis, C. Wulf, & B. Fichtner (Eds.), Children, development and education: Cultural, historical, anthropological perspectives (pp. 227–246). Dordrecht: Springer.CrossRefGoogle Scholar
  12. Coutaz, J., Crowley, J. L., Dobson, S., & Garlan, D. (2005). Context is key. Communications of the ACM, 48, 49–53.CrossRefGoogle Scholar
  13. Davenport, T., & Prusak, L. (1998). Working knowledge: How organizations manage what they know. Boston: Harvard Business School Press.Google Scholar
  14. Dey, A. K. (2001). Understanding and using context. Personal and Ubiquitous Computing, 5, 4–7.CrossRefGoogle Scholar
  15. Dourish, P. (2004). What we talk about when we talk about context. Personal and Ubiquitous Computing, 8(1), 19–30.CrossRefGoogle Scholar
  16. Endsley, M. R. (1995). Toward a theory of situation awareness in dynamic systems. Human Factors, 37(1), 32–64.CrossRefGoogle Scholar
  17. Fitzpatrick, G., & Ellingsen, G. (2013). A review of 25 years of CSCW research in healthcare: Contributions, challenges and future agendas. Journal of CSCW, 22, 609–665.Google Scholar
  18. Foot, K. A. (2014). Cultural-historical activity theory: Exploring a theory to inform practice and research. Journal of Human Behavior in Social Environment, 24(3), 329–347.CrossRefGoogle Scholar
  19. Gabbay, J., & le May, A. (2011). Practice-based evidence for healthcare: Clinical mindlines. London: Routledge.Google Scholar
  20. Harrison, M. B., Légaré, F., Graham, I. D., & Fervers, B. (2010). Adapting clinical practice guidelines to local context and assessing barriers to their use. Canadian Medical Association Journal, 182(2), E78–E84.CrossRefPubMedGoogle Scholar
  21. Hopwood, N. (2010). Dwelling in complexity: Relational-ecological understandings of context, space, place, and the body in professional practice. Presented at the AARE international research in education conference, Melbourne.Google Scholar
  22. Kaenampornpan, M., & O’Neill, E. (2005). Integrating history and activity theory in context aware system design. In International workshop on exploiting context histories in smart environments, pervasive ‘05, Munich, Germany.Google Scholar
  23. Kirsh, D. (2001). The context of work. Human Computer Interaction, 16(2–4), 305–322.CrossRefGoogle Scholar
  24. Kofod-Petersen, A., & Aamodt, A. (2009). Case-based reasoning for situation-aware ambient intelligence: A hospital ward evaluation study. In International conference on case-based reasoning ICCBR’09 (pp. 450–464). Berlin, Germany: Springer.CrossRefGoogle Scholar
  25. Kuziemsky, C.E., & Varpio, L. (2010). Describing the clinical communication space through a model of common ground–you don’t know what you don’t know. AMIA Annual Symposium (pp. 407–411).Google Scholar
  26. Leidner, D., Alavi, M., & Kayworth, T. (2006). The role of culture in knowledge management: A case study of two global firms. International Journal of e-Collaboration, 2(1), 17–40.CrossRefGoogle Scholar
  27. Mejia, D. A., Favela, J., & Morán, A. L. (2010). Understanding and supporting lightweight communication in hospital work. IEEE Transactions on Information Technology in Biomedicine, 14(1), 140–146.CrossRefPubMedGoogle Scholar
  28. Nardi, B. (1996). Context and consciousness: Activity theory and human-computer interaction. Cambridge, MA: MIT Press.Google Scholar
  29. Newell, A. (1981). The knowledge level. AI Magazine, 33, 1–20.Google Scholar
  30. Nicolini, D. (2008). Managing knowledge in the healthcare sector: A review. International Journal of Management Review, 10(3), 245–263.CrossRefGoogle Scholar
  31. Reckwitz, A. (2002). Towards a theory of social practices: A development in culturalist theorizing. European Journal of Social Theory, 5(2), 243–263.CrossRefGoogle Scholar
  32. Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). New York: Churchill Livingstone.Google Scholar
  33. Saltmarsh, S. (2009). Researching context as a ‘practiced place’. In B. Green (Ed.), Understanding and researching professional practice (pp. 153–163). Rotterdam: Sense Publishers.Google Scholar
  34. Schatzki, T. R. (2012). A primer on practices: Theory and research. In Practice-based education, Practice, education, work and society series (Vol. 6, pp. 13–26).CrossRefGoogle Scholar
  35. Simon, H. (1991). Bounded rationality and organizational learning. Organization Science, 2(1), 125–134.CrossRefGoogle Scholar
  36. Szymanski, M. H., & Whalen, J. (Eds.). (2011). Making work visible: Ethnographically grounded case studies of work practice. Cambridge, UK: Cambridge University Press.Google Scholar
  37. Tawfik, H., Anya, O., & Nagar, A. K. (2012). Understanding clinical work practices for cross-boundary decision support in e-health. IEEE Transactions on Information Technology in Biomedicine, 16(4), 530–541.CrossRefPubMedGoogle Scholar
  38. Wenger, E. (1998). Communities of practice: Learning, meaning and identity. Cambridge, UK: Cambridge University Press.CrossRefGoogle Scholar
  39. Whittaker, S., Frohlich, D., & Daly-Jones, O. (1994). Informal workplace communication: What is it like and how might we support it? In Proceedings of the SIGCHI conference on human factors in computing systems: Celebrating Interdependence (CHI 1994) (pp. 131–137), Boston, MA.Google Scholar
  40. Wickramasinghe, N. (2009). Healthcare knowledge management: Incorporating the tools, technologies, strategies, and process of knowledge management to effect superior healthcare delivery. In R. Bali, & A. Dwivedi (ed.) Healthcare knowledge management: issues, advances, and successes, (pp. 87–103). Berlin: Springer.CrossRefGoogle Scholar
  41. Wickramasinghe, N., & Davison, G. (2004). Making explicit the implicit knowledge assets in healthcare: The case of multidisciplinary teams in care and cure environments. Health Care Management Science, 7(3), 185–195.CrossRefPubMedGoogle Scholar
  42. Wilson, T. D. (2006). A re-examination of information seeking behaviour in the context of activity theory. Information Research, 11(4), 11–14.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Obinna Anya
    • 1
  • Hissam Tawfik
    • 2
  • Raouf N. G. Naguib
    • 3
    • 4
    Email author
  1. 1.IBM Research-AlmadenSan JoseUSA
  2. 2.Leeds Beckett UniversityLeedsUK
  3. 3.Liverpool Hope UniversityLiverpoolUK
  4. 4.BIOCORE Research & Consultancy LtdLiverpoolUK

Personalised recommendations