A session about the importance of knowledge management from Dr Madhukar. This was presented in the Whatfix Inspire series where external experts are invited to speak about an impactful topic.

1. Shaping
Serendipity
Madhukar Kalsapura
madhukar@Knowurture.com

2. Shaping Serendipity
Serendipity means “fortuitous happenstance” or “pleasant surprise”. For
serendipity to shape up, most important is the need to be sagacious enough
to link together apparently innocuous facts in order to come to a valuable
conclusion.
Organizations need to build a culture of shaping serendipity not by
processing information but rather by tapping the tacit and often highly
subjective insights, intuitions, and hunches of experts and making those
insights available. There is a need to develop intimate and seamless
relationships with customers, intermediaries, beneficiaries, vendors,
employees, partners and other stakeholders to be prepared in many other
ways to harness serendipity and make discoveries.

3. “Serendipity is looking in a haystack for
a needle and discovering a farmer's
daughter”
- Julius Comroe, Jr

4. Managing…
Knowledge Collaboration Innovation Entrepreneurship
Organizational
Structure

5. Managing…
Knowledge
People Process Technology Culture

6. The Cost of
Lost
Knowledge

7. Once upon
time we
put a man
on the
moon

8. We forgot
how !

9. Documents

10. Why Manage Knowledge?
“Other resources, money or physical equipment, for instance, do not confer any
distinction. What does make a business distinct and what is its peculiar resource is
its ability to use knowledge of all kinds – from scientific and technical knowledge to
social, economic, and managerial knowledge. It is only in respect to knowledge
that a business can be distinct, can therefore produce something that has a value in
the marketplace.”
--- Peter F. Drucker, Managing for Results (1964), p. 5(quoted in Morton F. Meltzer,
Information: The Ultimate Management Resource, 1981, p. 4)

11. Everything that can be
converted from an atom
to a bit, will be
Twenty-first-century free is different from
twentieth-century free. Somewhere in the
transition from atoms to bits, a phenomenon
that we thought we understood was
transformed. Those who understand the new
free will command tomorrow‘s markets and
disrupt today‘s—indeed, they‘re already
doing it.

12. Data
Information
Knowledge
Wisdom
Manage What?

13. Shape of Knowledge
• I have a box.
• The box is 3' wide, 3' deep, and 6' high.
• The box is very heavy.
• The box has a door on the front of it.
• It is colder inside the box than it is outside.
• You usually find the box in the kitchen.
• When you open the door, the light comes on.
• Junk has a real habit of collecting on top of this
box.

14. Knowledge is experience
everything else is information

15. Inspiration
Lead
Manage
Administer
Do
Wisdom
Knowledge
Information
Data
Judgment
Competence
Skills
A new look at our World…
Intuitive
Trust
Integrity
Trust
Competence
Trust

16. Method in madness

17. Identify

18. What do we DO when we don’t know?
Co-located
colleagues
Intranet
Non-electronic
documents
Internal
electronic
networks
Contacts in
other offices
Firm
boun
dary
External
electronic
networks
Internet
Non-electronic
documents
Other
contacts

19. Align KM to Organizational Strategy
Delivering the best products and
service-offerings that push
performance boundaries
Delivering solid products
and services at the best
price and with the least
inconvenience
Cultivating relationships to gain
customer knowledge
Delivering what specific
stakeholders want
Employee Capability
Operational Excellence Product/Service Leadership
Customer Intimacy
Leveraging human
intellectual capital in
service design and
delivery

20. The Four Value Propositions are Built Around
Entirely Different Operating Models
Product Leadership
• Concept invention, product
development, market
exploitation
• Ad hoc, organic, loosely
knit, and ever-changing
• High skills abound in loose-
knit structures
• Rewarding individuals'
innovative capacity and new
product success
• Managing risk
• Concept push
• Experimentation and "out-
of-the-box" mindset
• Emphasize breakthroughs
Customer Intimacy
• Solution development, results
management, relationship
management
• Empowerment close to
customer contact
• High skills at boundary of the
organization
• Customer equity measures like
lifetime value and share-of
client
• Managing outcomes
• Relationship push
• Flexibility and "have it your
way" mindset
• Emphasize complete solutions
Organization
and structure
Management
systems
Culture:
mindsets and
behavior
Operational Excellence
• Product supply, basic
service, demand
management
• Central authority, finite
level of empowerment
• High skills at the core of
the organization
• “Command and control”,
standard operating
procedures
• Managing total quality
• Process push
• Conformance, "one size
fits all" mindset
• Emphasize efficiency and
dependability
Core business
processes
Employee Capability
• People development,
expertise enhancement,
performance management
• Empowerment on work teams
• High skills at all levels
• Rewarding demonstrated
applications of individual
and team expertise
• Managing learning and
development
• Learning push
• Resilience and growth mindset
• Emphasize development

21. Categorize -
Tacit or Explicit
• ‘How to boil an egg’ is placed in the top-left as it
is a simple task that can easily be explained.
• ‘How to tie a shoelace’ is in the top-right because
it is a task that is almost impossible to explain
without doing it and commentating as you do it.
• ‘E=mc2’ is placed in the bottom left as it is a basic
relationship between concepts.
• ‘The position of the keys on a keyboard’ is
something many people know subconsciously (i.e.
those who regularly type into computers) but
very few know consciously (can you say which
keys are to the left and right of the letter B?).

22. interchange

23. Codification Vs Personalization
Codification:
• More focused on technology that enables
storage, indexing, retrieval, and reuse.
• Suited companies that repeatedly deal with
similar problem and decision.
Personalization:
• Focused on connecting knowledge workers
through networks.
• Better suited to companies that face “one-
off” problems and depend more on tacit
knowledge and expertise than on codified
knowledge

24. 9 connects and 4 levers
Individual to
Internal structure
Individual to
External structure
External structure
To Individual
External structure
To Internal
Structure
Internal structure
to Individual
Internal structure to
External structure
Individual to
Individual
External to
External
Internal to
Internal
Process
Technology
Culture
People

25. Managing Context
A newspaper is better than a magazine. A seashore is a better place
than a street. At first it is better to run than to walk. You may have to
try several times. It takes some skill, but it is easy to learn. Even young
children can enjoy it. Once successful, complications are minimal. Birds
seldom get too close. Rain, however, soaks in very fast. Too many
people doing the same thing can also cause problems. One needs lots
of room. If there are no complications it can be very peaceful. A rock
will serve as an anchor. If things break loose from it, however, you will
not get a second chance………
Do most of our corporate documents look like this?

26. Now again…
A newspaper is better than a magazine. A seashore is a better
place than a street. At first it is better to run than to walk. You
may have to try several times. It takes some skill, but it is easy to
learn. Even young children can enjoy it. Once successful,
complications are minimal. Birds seldom get too close. Rain,
however, soaks in very fast. Too many people doing the same
thing can also cause problems. One needs lots of room. If there
are no complications it can be very peaceful. A rock will serve as
an anchor. If things break loose from it, however, you will not get
a second chance………

27. Managing…
Collaboration

28. Not Small numbers for Long periods but
Large Number for Short periods

29. Communities
https://www.facebook.com/groups/urinarytractinfections

30. Managing…
Innovation

31. Innovation happens
on the next curve
31

32. Harvester
1.0
32
Ice

33. Factory
2.0
33
Ice

34. Refrigerator
34
3.0
Ice
34

35. Managing…
Entrepreneurship

36. Serendipity occurs in chaotic processes that take
time, it needs an Entrepreneurial mindset
The irony of this principle is that it demands two things we don't have: a tolerance
for messy, non-linear processes, and time. But creativity is only available when we
become confused and overwhelmed, when we get so frustrated that we admit we
don't know. And then, miraculously, a perfect insight appears suddenly. This is how
great scientists achieve breakthrough discoveries, how teams and individuals
discover transforming solutions. Great insights never appear at the end of a series
of incremental steps. Nor can they be commanded to appear on schedule, no
matter how desperately we need them. They present themselves only after a lot of
work that culminates in so much frustration that we surrender. Only then are we
humble enough and tired enough to open ourselves to entirely new solutions. They
leap into view suddenly (the "Aha" experience,) always born in messy processes
that take time.

37. Dissatisfied
presence
Vision for
the future
First few
steps
E(I)ntrapreneurship

38. Nurture

39. Managing…
Organizational Structure

40. Human conscious or organization conscious evolves in stages. We are not like trees that grow continuously. We evolve by sudden
transformations, like a caterpillar that becomes a butterfly, or a tadpole a frog.

42. RED ORGANIZATIONS (impulsive)

43. AMBER ORGANIZATIONS ( Conformist)

44. ORANGE ORGANIZATIONS ( Achiever)

45. GREEN ORGANIZATIONS ( Pluralistic)

46. TEAL ORGANIZATIONS ( Evolutionary)

47. Knowurture Journey – case study

48. Patient/Caretakers face uncertainties in a medical situation
Are the
symptoms
serious?
Prognosis?
Which
Doctor?
Treatment
options?
Drug side-
effects?

49. Patients and caretakers are
desperately trying to find
answers
80%
56%
80% search for health
information on the net.
Google's total daily health-
related searches amount to
70,000 each minute, which is 1
Billion in a day.
56% are seeking 2nd Opinions
49% individuals have posted or
shared a personal story or
content in online communities
seeking help and advice
Need
49%

50. Probe - Sense - Respond
Complex Complicated
Sense - Analyse - Respond
Emergencies Self Limiting
Sense - Categorise - Respond
Act - Sense - Respond
Undiagnosed
Conditions
Rare Diseases

51. © K n o w u r t u r e 2 0 1 9 . A L L R I G H T S
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51
Misdiagnosis
(missed, wrong and delayed)
Without a diagnosis, patients often
will not qualify for needed benefits
or receive proper and compassionate
healthcare. All they can do is to exist
from day to day, feeling like they are
drowning in confusion, desperation,
and frustration. Living in a constant
state of medical uncertainty is
terrifying.
More than 26% of all cases – 1 in 5 are
Misdiagnosed.
Millions of people suffer everyday without a
diagnosis
Rare diseases it takes about 8 years to get a
proper diagnosis
Misdiagnosis is third-leading cause of death
after heart disease and cancer.
A wonderful serenity has taken possession of my
entire soul, like these sweet mornings

52. Unnecessary tests or procedures
More tests
79%
More referrals
74%
Physicians say the frequency of unnecessary
tests and procedures is a very or somewhat
serious problem
73%
More invasive procedures
51%
w w w . K n o w u r t u r e . c o m
Defensive Medicine

53. Solution shop business models
Secondary and tertiary care hospitals
Hospitals assemble impressive—and very
expensive—medical infrastructure to fix
people when they are sick or injured.
However, they fail to provide continuum of
care and expertise required to deal with
complex, complicated, chronic ailments
and rare diseases.
Healthcare today

54. 36000 questions in knowledge base
Branching using rule based & Bayesian Logic
Covers 98% symptoms
Produces a report in Pdf in patient & Physician Language
300 + Scales
Holistic covers Physiological & Psychological symptoms
Codify - History Collection
Chief&Complaint
Jane%Doe%is%a%31%year%old%female.%Her%reason%for%visit%is%"I%am%pregnant%and%I%
need%a%check%up".
Past,&Family,&and&Social&History
Past&Medical&History
History%of:%Abnormal%Pap%smear.%Diabetes%mellitus.%Hypertension.
Pregnancy&History
History%of:%Prenatal%visit.%Secundigravida.%Paragravida%2.%Two%fullFterm%
pregnancies.%Had%a%child%with%a%birth%weight%over%9%pounds%(4%Kg).%
Pregnancy,%labor,%or%delivery%complications.%Edema%with%past%pregnancy.%
Eclampsia.%Gestational%diabetes.%Two%vaginal%deliveries.
She%denied:%Infertility.%Ectopic%pregnancy.%Pregnancy%involving%multiple%
fetuses.%Anemia.%Hyperemesis.%Polyhydramnios%or%oligohydramnios.%
Premature%rupture%of%membranes.%Premature%labor.%Hemorrhage.%Cervical%
incompetence.%Intrauterine%growth%retardation.%Preterm%delivery.%
Prolonged%labor.%Postpartum%depression.%Miscarriage.%Having%a%fetal%
death.%Abortion.
Family&History
History%of:%Diabetes%in%family.%High%blood%pressure%in%family.%Cystic%
fibrosis%in%family.
She%denied:%Parental%history%of%birth%defect,%history%of%stillborn,%history%of%
miscarriages,%and%history%of%infant%death.%Parent%with%birth%defect.%Multiple%
births%(twins,%triplets)%in%family.%Personal%or%family%history%of%asthma.%
Tuberculosis%(TB)%in%family.%Alcohol%or%drug%problems.%Depression%or%
mental%illness%in%family.%Baby's%father%older%than%42%years.%Baby's%parents%
blood%relatives.%Jewish%ancestry.%African%ancestry.%Asian%ancestry.%
Mediterranean%ancestry.%FrenchFCanadian%ancestry.%Cleft%palate%in%family.%
Club%foot.%Deafness%in%family.%Blindness%in%family.%Down's%Syndrome%or%
other%chromosome%problem%in%family.%Spinal%defects%in%family.%Mental%
retardation%or%very%slow%learner%in%family.%Huntington's%chorea%in%family.%
Heart%defect%in%family.%Muscle%or%nerve%disease%in%family.%Sickle%cell%
disease%in%family.%Bleeding%problems%in%family.%Metabolic%disorder.%Genetic%
disorders.
Social&History
History%of:%Within%the%last%six%months%fired%from%work,%change%to%entirely%
different%line%of%work,%changing%residence,%change%in%number%of%
arguments%with%spouse,%change%in%responsibilities%at%work,%trouble%with%
boss,%change%in%work%hours%or%conditions,%change%in%recreation,%change%in%
social%activities,%and%change%in%number%of%family%getFtogethers.%Within%the%
last%two%years%divorce,%marital%separation,%marital%reconciliation,%change%in%
financial%state,%and%death%of%a%close%friend.%Tattoos.%Cat%at%home.%Problem%
with%healthcare%appointments.%Moving%residence%2%or%3%times%in%the%past%
year.%Money%problems.%Unhappy%with%work.%Hit,%slapped,%kicked,%or%in%
some%way%physically%hurt%in%the%past%year.%Emotionally%or%mentally%abused
01/12/2016

55. Codify – Disease Signatures
SICKLE'CELL'ANEMIA'
!
Grid:&Has&physician&specialty&
Has'Physician'Specialty' Rank'
Hematology,!Oncology!and!Palliative!medicine! 10!
Internal!medicine! 9!
Pediatrics! 10!
'
CLINICAL'CLARIFICATION'!
A!hemoglobinopathy!caused!by!an!autosomal!recessive!mutation!of!beta!(β)Bglobin!gene!that!
produces!abnormal!sickle!hemoglobin!(HbS);!characterized!by!hemolytic!anemia,!vasoBocclusive!
events,!and!vasculopathy!leading!to!organ!damage!and!early!mortality!
!
! CLASSIFICATION'
o! Patients!develop!sickle!cell!anemia!if!they!inherit!sickle!hemoglobin!from!both!
parents!!
o! Patients!may!inherit!sickle!hemoglobin!from!one!parent!and!abnormal!
hemoglobin,!such!as!hemoglobin!C,!from!another!parent;!manifests!as!other!
forms!of!sickle!cell!disease!(compound!heterozygote)!
o! Sickle!cell!trait!refers!to!the!simple!heterozygous!carriers!of!mutation!
o! Homozygous1
!
B! Hemoglobin!SS!disease!(HbSS)!
o! Heterozygous!conditions1
!
B! Hemoglobin!Sβ0
!thalassemia!
B! Hemoglobin!Sβ+
!thalassemia!
B! Hemoglobin!SC!disease!(HbSC)!
!
'
DIAGNOSIS'
! CLINICAL'PRESENTATION'
o! History!
!! Family!history!of!sickle!cell!anemia!
!! Acute!painful!crises!
►! !Pain!and!swelling!in!the!hands!and!feet,!but!may!occur!anywhere!
!! Acute!chest!syndrome!
►! Fever!
►! Chest!pain!
►! Cough!
►! Dyspnea!on!exertion!!
!! Anemia!
►! Dyspnea!
►! Fatigue!
!! Delayed!growth!and!puberty!is!a!major!concern!during!adolescence;!however,!
sexual!maturity!is!attained!eventually!
!! Splenic!sequestration!
►! abdominal!pain!!
18000 + disease Fingerprints
Ranking of parameters
Researched and Authored by Medical Professionals
Validated by practicing Experts and Academicians
01/12/2016

56. Interactive
Map of tests,
referrals &
Differential
Diagnosis by
Mapping
History to
Disease
Signatures
Physician View
01/12/2016

57. Qualified
Authority
No Vested Interest
Peer
Referred
Global Expert Network
We ask a physician “If
you or your family
member is facing a
medical situation ...
Who would you go
to?
01/12/2016

58. Treatment Options
Multi criteria
decision with
Pairwise
comparison

59. Serendipitously…
• Corrected or altered a
diagnosis 53% of the
time
• Prevented a surgery
47% of the time
• Patient adherence at
86% compared to 37%
otherwise

60. Questions ?
Thankyou for the conversation