Health care institutions are always hotbeds of recordkeeping, or if one prefers, keeping up with records. Floor-walking doctors, clinicians, pharmacists, technicians, researchers, payers, regulators and administrators are all faced with information needs that today require technology infrastructure and a keen understanding of human goals and needs. To dive into one or two of these health care roles is instant education on the challenges faced today, so we'll approach this story from both the technical and practitioner points of view.

Children's Hospital Boston is a working and teaching 300-bed hospital that treats patients from New England and referrals from around the world. Danny Shaw was hired in 1998 with the then-fashionable title of chief knowledge officer, a role reporting to a CIO who wanted to start a knowledge management (KM) program enterprise-wide. This was Shaw's initial assignment eight years ago, much like the rest of his 30 years of IT work in data warehousing and project management on the fringes of KM.

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