Abstract
A health system has various knowledge structures enabling its knowledge resources to be efficiently applied. The literature has covered the management of clinical health information fairly extensively, but less is known about managerial knowledge flows. To address this knowledge gap, a regional health system in Finland is studied and managerial knowledge flows categorized in order to provide a better understanding of the inter-organizational knowledge networks of a health system. The paper contributes by illustrating and concretizing the knowledge dynamics of a health system. The empirical examination reveals the complexity of managerial knowledge flows and identifies three main categories of these: (1) national information steering, (2) regional information steering, and (3) internal control information. These categories are further elaborated with the data gathered through observation, interviews, and process modelling. A better understanding and management of knowledge flows is expected to have a positive effect on the performance of the health system.
Similar content being viewed by others
References
Albino V, Garavelli AC and Schiuma G (1999) Knowledge transfer and inter-firm relationships in industrial districts: the role of the leader firm. Technovation 19 (1), 53–63.
Alvesson M (1993) Organizations as rhetoric: knowledge-intensive firms and the struggle with ambiguity. Journal of Management Studies 30 (6), 997–1015.
Argote L and Ingram P (2000) Knowledge transfer: a basis for competitive advantage in firms. Organizational Behavior and Human Decision Processes 82 (1), 150–169.
Appleyard MM (1996) How does knowledge flow? Interfirm patterns in the semiconductor industry. Strategic Management Journal 17 (Winter Special Issue), 137–154.
Avillach P, Joubert M and Fieschi M (2008) Improving the quality of the coding of primary diagnosis in standardized discharge summaries. Health Care Management Science 11 (2), 147–151.
Bell G and Zaheer A (2007) Geography, networks, and knowledge flow. Organization Science 18 (6), 955–972.
Bender S and Fish A (2000) The transfer of knowledge and the retention of expertise: the continuing need for global assignments. Journal of Knowledge Management 4 (2), 125–137.
Berg M (2004) Health Information Management: Integrating Information Technology in Health Care Work. Routledge, New York.
Blackler F (1995) Knowledge, knowledge work and organizations: an overview and interpretation. Organization Studies 16 (6), 1021–1046.
Bontis N, Fearon M and Hishon M (2003) The e-flow audit: an evaluation of knowledge flow within and outside a high-tech firm. Journal of Knowledge Management 7 (1), 6–19.
Bose R (2003) Knowledge management-enabled health care management systems: capabilities, infrastructure, and decision-support. Expert Systems with Applications 24 (1), 59–71.
Cantwell JA and Mudambi R (2003) Multinational enterprises and competence-creating knowledge flows: a theoretical analysis. In Knowledge Flows, Governance and the Multinational Enterprise: Frontiers in International Management Research (Mahnke V and Pedersen T, Eds), pp 38–57, Palgrave Macmillan, New York.
Coff R, Coff D and Eastvold R (2006) The knowledge-leveraging paradox: how to achieve scale without making knowledge imitable. Academy of Management Review 31 (2), 1–13.
Cohen WM and Levinthal DA (1990) Absorptive capacity: a new perspective on learning and innovation. Administrative Science Quarterly 35 (1), 128–152.
Cruz NM, Pérez VM and Cantero CT (2009) The influence of employee motivation on knowledge transfer. Journal of Knowledge Management 13 (6), 478–490.
Cutler RS (1989) A comparison of Japanese and U.S. high-technology transfer practices. IEEE Transactions on Engineering Management 36 (1), 17–24.
Daft RL and Lengel RH (1986) Organizational information requirements, media richness and structural design. Management Science 32 (5), 554–571.
Delesie L and Croes L (2000) Operations research and knowledge discovery: a data mining method applied to health care management. International Transactions in Operational Research 7 (2), 159–170.
Dixon NM (2000) Common Knowledge. Harvard Business School Press, Boston, MA.
Dodgson M (1993) Learning, trust, and technological collaboration. Human Relations 46 (1), 77–95.
Easterby-Smith M, Lyles MA and Tsang EWK (2008) Inter-organizational knowledge transfer: current themes and future prospects. Journal of Management Studies 45 (4), 677–690.
Edwards JS, Hall MJ and Shaw D (2005) Proposing a systems vision of knowledge management in emergency care. Journal of the Operational Research Society 56 (2), 180–192.
Eisenhardt KM (1989) Building theories from case study research. Academy of Management Review 14 (4), 532–550.
Foss NJ and Pedersen T (2002) Transferring knowledge in MNCs: the role of sources of subsidiary knowledge and organizational context. Journal of International Management 8 (1), 49–67.
Grant RM (1996) Toward a knowledge-based theory of the firm. Strategic Management Journal 17 (Winter Special Issue), 109–122.
Gupta A and Govindarajan V (1991) Knowledge flows and the structure of control within multinational corporations. The Academy of Management Review 16 (4), 768–792.
Gupta A and Govindarajan V (2000) Knowledge flows within multinational corporations. Strategic Management Journal 21 (4), 473–496.
Hansen MT, Nohria N and Tierney T (1999) What’s your strategy for managing knowledge? Harvard Business Review 77 (2), 106–116.
Hendriks P (1999) Why share knowledge? The influence of ICT on the motivation for knowledge sharing. Knowledge and Process Management 6 (2), 91–100.
Hutzschenreuter T and Horstkotte J (2010) Knowledge transfer to partners: a firm level perspective. Journal of Knowledge Management 14 (3), 428–448.
Inkpen AC and Tsang EWK (2005) Social capital, networks, and knowledge transfer. Academy of Management Review 30 (1), 146–165.
Jasimuddin SM (2005) Storage of transferred knowledge of transfer of stored knowledge: which direction? If both, then how? Proceedings of the 38th Hawaii International Conference on System Sciences, 1, 27a.
Jensen JL and Rodgers R (2001) Cumulating the intellectual gold of case study research. Public Administrative Review 61 (2), 235–246.
Kalling T (2003) Organization-internal transfer of knowledge and the role of motivation: a qualitative case study. Knowledge and Process Management 10 (2), 115–126.
Käpylä J, Laihonen H, Lönnqvist A and Carlucci D (2011) Knowledge-intensity as an organisational characteristic. Knowledge Management Research & Practice 9 (4), 315–326.
Khamseh HM and Jolly DR (2008) Knowledge transfer in alliances: determinant factors. Journal of Knowledge Management 12 (1), 37–50.
King WR (2006) Knowledge sharing. In The Encyclopedia of Knowledge Management (Schwartz DG, Ed), pp 493–498, Idea Group Publishing, Hershey, PA.
Ko DG, Kirsch LJ and King WR (2005) Antecedents of knowledge transfer from consultants to clients in enterprise system implementations. MIS Quarterly 29 (1), 59–85.
Kumar JA and Ganesh LS (2009) Research on knowledge transfer in organizations: a morphology. Journal of Knowledge Management 13 (4), 161–174.
Laihonen H (2006) Knowledge flows in self-organizing processes. Journal of Knowledge Management 10 (4), 127–135.
Laihonen H (2012) Knowledge structures of a health ecosystem. Journal of Health Organization and Management 26 (4), 542–558.
Laihonen H and Lönnqvist A (2010) Knowledge-based value creation: grasping the intangibility of service operations in Finland. International Journal of Knowledge-Based Development 1 (4), 331–345.
Lemire M (2010) What can be expected of information and communication technologies in terms of patient empowerment in health? Journal of Health Organization and Management 24 (2), 167–181.
Lloyd-Bostock S (2010) The creation of risk-related information: the UK General Medical Council’s electronic database. Journal of Health Organization and Management 24 (6), 584–596.
Lönnqvist A and Laihonen H (2012) Welfare service system productivity: the concept and its application. International Journal of Productivity and Performance Management 61 (2), 128–141.
Løwendahl B, Revang Ø and Fosstenløkken S (2001) Knowledge and value creation in professional service firms: A framework for analysis. Human Relations 54 (7), 911–931.
McEvily SK and Chakravarthy B (2002) The persistence of knowledge-based advantage: an empirical test for product performance and technological knowledge. Strategic Management Journal 23 (4), 285–305.
Meier M (2011) Knowledge management in strategic alliances: a review of empirical evidence. International Journal of Management Reviews 13 (1), 1–23.
Miles I et al (1995) Knowledge-Intensive Business Services: Users, Carriers and Sources of Innovation, European Innovation Monitoring System (EIMS). EIMS Publication No. 15 Luxembourg.
Mu J, Peng G and Love E (2008) Interfirm networks, social capital, and knowledge flow. Journal of Knowledge Management 12 (4), 86–100.
Nissen M (2006) Harnessing Knowledge Dynamics: Principled Organizational Knowing & Learning. IRM Press, Hershey, PA.
Nissen M and Levitt R (2002) Dynamic models of knowledge-flow dynamics. CIFE Working Paper No. 76. Stanford University, Stanford, CA.
Nonaka I, Toyama R and Hirata T (2008) Managing Flow: A Process Theory of the Knowledge-Based Firm. Palgrave Macmillan, Basingstoke, UK.
Nonaka I (1994) A dynamic theory of organizational knowledge creation. Organization Science 5 (1), 14–37.
Nonaka I and Takeuchi H (1995) The Knowledge Creating Company: How Japanese Companies Create the Dynamics of Innovation. Oxford University Press, New York.
Nordgren L (2009) Value creation in health care services – developing service productivity: experiences from Sweden. International Journal of Public Sector Management 22 (2), 114–127.
Pentland D et al (2011) Key characteristics of knowledge transfer and exchange in healthcare: integrative literature review. Journal of Advanced Nursing 67 (7), 1408–1425.
Phelps C, Heidl R and Wadhwa A (2012) Knowledge, networks, and knowledge networks: a review and research agenda. Journal of Management 38 (4), 1115–1166.
Porter M and Teisberg E (2006) Redefining Health Care: Creating Value-Based Competition on Results. Harvard Business School Publishing, Boston, MA.
Preiss K (1999) Modelling of knowledge flows and their impact. Journal of Knowledge Management 3 (1), 36–46.
Riege A (2007) Actions to overcome knowledge transfer barriers in MNCs. Journal of Knowledge Management 11 (1), 48–67.
Schiuma G (2009) The managerial foundations of knowledge assets dynamics. Knowledge Management Research & Practice 7 (4), 290–299.
Schiuma G, Ordóñez de Pablos P and Spender JC (2007) Intellectual capital and company’s value creation dynamics. International Journal of Learning and Intellectual Capital 4 (4), 331–341.
Simonin BL (1999) Ambiguity and the process of knowledge transfer in strategic alliances. Strategic Management Journal 20 (7), 595–623.
Simonin BL (2004) An empirical investigation of the process of knowledge transfer in international strategic alliances. Journal of International Business Studies 35 (5), 407–427.
Snider KF and Nissen ME (2003) Beyond the body of knowledge: a knowledge-flow approach to project management theory and practice. Project Management Journal 34 (2), 4–12.
Spencer JW (2000) Knowledge flows in the global innovation system: do US firms share more scientific knowledge than their Japanese rivals? Journal of International Business Studies 31 (3), 521–530.
Stake RE (1994) Case studies. In Handbook of Qualitative Research (Denzin NK and Lincoln YS, Eds), pp 236–247, Sage Publications, Thousand Oaks, CA.
Stein J and Ridderstrale J (2001) Managing the dissemination of competences, in knowledge management and organizational competence. In Knowledge Management and Organizational Competence (Sanchez R, Ed), pp 63–76, Oxford University Press, Oxford.
Szulanski G (1996) Exploring internal stickiness: impediments to the transfer of best practice within the firm. Strategic Management Journal 17 (Winter Special Issue), 27–43.
Szulanski G (2000) The process of knowledge transfer: a diachronic analysis of stickiness. Organizational Behavior and Human Decision Processes 82 (1), 9–27.
Sveiby KE (2007) Disabling the context for knowledge work: the role of managers’ behaviours. Management Decision 45 (10), 1636–1655.
Swap W, Leonard D, Shields M and Abrams L (2001) Using mentoring and storytelling to transfer knowledge in the workplace. Journal of Management Information Systems 18 (1), 95–114.
Syväjärvi A, Stenvall J and Harisalo R (2007) Information steering to create innovative actions in local public administration. In Proceedings of the Eleventh International Research Symposium on Public Management, pp 2–4. Potsdam University, Germany, April.
Tsai W (2000) Social capital, strategic relatedness and the formation of intraorganizational linkages. Strategic Management Journal 21 (9), 925–939.
Van Wijk R, Jansen JP and Lyles MA (2008) Inter- and intra-organizational knowledge transfer: a meta-analytic review and assessment of its antecedents and consequences. Journal of Management Studies 45 (4), 815–838.
Vedung E and van der Doelen F (1998) The sermon: information programs in the public policy process – choice, effects, and evaluation. In Carrots, Sticks & Sermons (Bemelmans-Videc R and Vedung E, Eds), pp 103–128, Transaction Publishers, New Brunswick, Canada.
von Hippel E (1994) ‘Sticky information’ and the locus of problem solving: implications for innovation. Management Science 40 (4), 429–439.
Wathne K, Roos J and von Krogh G (1996) Towards a theory of knowledge transfer in a cooperative context. In Managing Knowledge – Perspectives on Cooperation and Competition (von Krogh G and Roos J, Eds), pp 55–81, Sage Publications, London.
Williams K, Robinson K and Toth A (2006) Data quality maintenance of the patient master index (PMI): a ‘snap-shot’ of public healthcare facility PMI data quality and linkage activities. Health Information Management Journal 35 (1), 10–26.
Yin RK (1994) Case Study Research: Design and Methods. Sage Publications, Newbury Park, CA.
Zander U and Kogut B (1995) Knowledge and the speed of transfer and imitation of organizational capabilities: an empirical test. Organization Science 6 (1), 76–92.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Laihonen, H. A managerial view of the knowledge flows of a health-care system. Knowl Manage Res Pract 13, 475–485 (2015). https://doi.org/10.1057/kmrp.2014.3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1057/kmrp.2014.3