'Desktop knowledge': A new focus for medical education and decision support

Physicians today are faced with 'data overload' and, paradoxically, 'information underload'- the inhability to locate pertinent, needed knowledge in a sea of data with which they are inundated . Increasingly, the professional functions of the physician are becoming focused on the dekstop workstation, in terms of its ability to provide 'windows' into local databases and knowledge resources, and to serve as an access port to other networked resources. A challenge we now face is to develop means for structuring the vast potentially available knowledge resources in such a manner that access to pertinent knowledge can be facilitated, and to develop acceptable interfaces to the knowledge resources so that a user can effectively navigate through them. The complexity of this task is due to the nature of the knowledge resources-knowledge can be in a variety of forms, ranging from textual and pictorial material, to structured representations, to more dynamic embodiments in the form of procedures. In the Decision Systems Group we have focused on the development of a prototype desktop knowledge management environment known as Explorer-2, with the objective of providing a consistent interface for access to a wide variety of knowledge. Our accomplishments to date encompass the incorporation into the Explorer-2 environment of adaptations of textbook chapters and books, image data bases, simulations, and expert systems. Navigational aids are provided by a semantic net browser using both MeSH and augmented taxonomies and by a graphical overview map. User response to the predecessor system, Explorer-1, has been strongly positive. Our experience to data suggests a number of observations about the characteristics that knowledge management systems should possess, and the next steps for futher research and development.