A guideline-based co-operative work framework integrating medical knowledge management services for heart failure care delivery

Information and communication technology (ICT) represents a significant change agent in the medical community. The development and the integration of innovative ICT tools to effectively manage the Medical Knowledge (MK) is one of the more relevant challenges for near future. The development of innovative information technology tools can support the process of creating, sharing, disseminating and exploiting the MK among the different health care organisations. Guidelines (GLs) are one of the methods that try to solve the issue of transferring the results of the bio-medical research into the clinical practice, providing a series of recommendations based on scientific evidence that would constitute the best practice. However, the development of good GLs doesn’t ensure their use in practice. Several studies have shown that the compliance with the GL can be improved when GLs are integrated with an Electronic Medical Record so that patient-specific advices can be delivered at the right time and place, improving clinical performance. Moreover, it has been shown that organizational constraints, whose communication among hospital Health Care Professionals (HCPs) and between hospital specialists and General Practitioners (GPs) represents one of the more relevant aspects, can impair the implementation of GLs. The co-ordinated action of HCPs in patient care delivery is a key factor for an healthcare organization. Therefore, not only computerised GLs (establishing “what to do”), but also organisational aspects (establishing “how, by whom, and by what”) have to be taken in consideration. Workflow management systems could be a suitable tool to address organisational issues