This piece is the first installment of a five-part series called “The Missing Pieces: How Better Knowledge Management (KM) Can Complete the Public Health Puzzle.”

Public health is constantly changing. Those in public health are called upon to protect, inform, and advise the public on emerging threats as well as ever-present issues that affect health and well-being on a large scale. Their myriad challenges include managing and containing outbreaks of infectious diseases to motivating individuals in all racial, ethnic, and socioeconomic groups to adopt healthy lifestyles. Its professionals are as diverse as they are dynamic: clinicians must work together with pharmacists, epidemiologists, advocates, and researchers to reach as wide an audience as possible.

Lately, however, many public health budgets are shrinking as demands increase and become more complex, and public health agencies are increasingly called upon to do more with less. It is at this intersection of responsibilities and resources that good knowledge management can enable public health professionals to do their best work. Digital communication allows us to connect with anyone in the world at any time and makes a wealth of information instantly available– if professionals know where and how to find it, and if those who have come before have saved it so that it can be found. Knowledge management is a practice that is devoted to making that happen.

How has Knowledge Management in Public Health Helped?

The ongoing Ebola outbreak is a perfect example of public health need at its most demanding. While internationally-regarded public health bodies such as the World Health Organization and the US Centers for Disease Control and Prevention are working around the clock to provide the most up-to-date information on the outbreak, doctors and nurses in areas struck by the virus need to know how best to treat their patients while protecting themselves from getting sick. Government officials in Guinea, Liberia, Sierra Leone, and now Nigeria are struggling to keep the population calm and to contain the outbreak as it continues to cross borders. Scientists are working to discover where the virus comes from and how it is initially transmitted to humans from a still-unknown animal reservoir. Now, public health agencies around the world – including the US – are trying to prepare hospitals for the possibility of receiving and treating patients if the virus continues to spread as officials contemplate travel bans. And on top of it all, medical ethicists are debating the implications of administering untested experimental treatments to hundreds of patients fighting for their lives.

Information, research, quarantines, clinical care, and ethics are just a few of the many areas that public health must navigate. In order to perform to their full capacity, public health workers need access to well-organized information resources – and they must know how to find exactly what they need as quickly as possible. Unfortunately, there are several challenges that the field of public health faces if it is to move toward good knowledge management practices.

History of Knowledge Management

First, knowledge management is a fairly new discipline in its own right. Formally recognized in 1991, it was primarily used in the consulting field as a tool for corporations to improve their efficiency. Because it has been used primarily as a strategy to increase profits, its value is not yet widely recognized in the public sector. However, its potential has not gone unnoticed: the Association of State and Territorial Health Officials, the University of Washington, and Canadian public health agencies have all published guidance on developing knowledge management practices for public health. They, along with others, are beginning to recognize its ability to positively impact public health outcomes by creating organizations that, with minimal cost, also become virtual public health practice libraries, leveraging institutional knowledge to improve efficiency and response. There are also immediate benefits to agencies themselves, such as better succession management and continuity of operations, being able to more easily respond to freedom of information requests, and more effective team collaboration.

Second, US public health is somewhat fragmented, with different organizations and agencies operating largely independently of one another. More collaboration is needed. This “silo model” is well known in public health, but it is difficult to overcome, particularly with so many different types of professionals and budget constraints that narrowly define their roles. Additionally, each organization has its own processes and unique culture, and there are no widely recognized knowledge management practices.

Third, public health agencies are straining under the burden of increasing responsibilities as their funds dwindle. The number of unfunded mandates placed on state and local health departments continues to increase, while budget cuts result in staff cuts, downsized programs, and generally having to do more with less. Any funding that does go toward technological infrastructure is focused on making sure it is current and secure, rather than organizing and disseminating content generated by the organization. As agencies struggle to keep up with rapidly advancing technology and comply with increasingly stringent security standards, it is difficult to find the funding to establish and maintain good knowledge management systems.

These obstacles are daunting, but they are by no means insurmountable. In this series, we will discuss the importance of good knowledge management practices and how these are critical to the mission of public health. We will also examine how the field can address the challenges to developing a culture of dedication to knowledge management. We will build a vision of public health practice seamlessly integrated with and informed by a sound knowledge management infrastructure.  Good knowledge management practices can improve public health practice, conserve resources, and save lives.

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