UK activity on Mobilising Computerised Biomedical Knowledge (MCBK)


Background to the UK MCBK activity

The NHS already uses computerised knowledge to support professionals and patient safety, such as embedded calculators (eg. CHADSVASC2, QRisk2), GP prompts and checklists or ePrescribing systems. Many of these are of high quality but unfortunately, some have not been maintained or implemented correctly. As a result, at least 8 serious algorithm-related incidents have occurred in the last few years. This raises questions about the development, validation, use, maintenance and retirement of such computerised decision support systems. A further reason why the NHS now needs to focus on the governance of clinical knowledge and computerised decision support is the push towards widening the range of NHS providers, so that working to a common knowledge base and standards of care become even more important.

The idea of computerised knowledge and clinical decision support systems has existed for at least 50 years. With increasing pressures on health systems and staff and progress in technology, it has become both more feasible and more important to mainstream this idea, as the US Mobilising Computerised Biomedical Knowledge (MCBK) group has recognised:

https://medicine.umich.edu/dept/lhs/service-outreach/mobilizing-computable-biomedical-knowledge

However, broad issues arise that raise both professional and technical challenges, including:

Professional challenges: protection of intellectual property, freedom from bias, measuring and improving knowledge quality and currency, legal liability for suppliers and users of decision support resources; prioritising computerised knowledge for procurement or quality assurance; tracking the source of the knowledge and how it has changed since the original version.

Technical challenges: encoding knowledge so it can be reused in a variety of systems, indexing computerised knowledge for accurate recall; locking the knowledge so that its integrity is protected; preserving the meaning of computerised knowledge when clinical coding systems change; adjusting computerised knowledge to fit specific contexts (eg. primary vs. secondary care investigation guidelines); archiving of obsolete computerised knowledge to support later research or legal investigation.

UK MCBK launch workshop 29-10-2019

A group including NICE, BCS Health & Care, HL7 UK and the Faculty of Clinical Informatics organised the first UK-wide workshop on 29/10/19 at Friends House at which 65 participants discussed these challenges and how the NHS, Arm’s Length Bodies, regulators and others can address them. Watch the videos from this workshop.

Aims and outputs of the UK MCBK activity

We aim to support UK organisations to adopt computerised biomedical knowledge and help realise its benefits for patients, professionals and the NHS, by:

  1. Promoting networking around organisations interested in this area
  2. Developing a prioritised list of issues, actions to take and leaders for these
  3. Identifying suitable host organisations and resources to support this activity
  4. Planning further meetings and activities and identifying suitable organisations and individuals to lead them
  5. Publicising the activity at conferences and as a short publication in BMJ Health & Care Informatics

Expressions of interest invited

We are keen to extend the range of participation in our activity, especially of front line health delivery organisations, so are asking interested organisations and individuals to complete our Expression of Interest form:

https://forms.gle/zJWugA8AHvmskeU97

By telling us about your organisation and its interest in MCBK, you will:

  1. Contribute your knowledge and expertise to help shape the direction of UK and NHS strategy on computerised biomedical knowledge
  2. Help consolidate UK’s strengths (eg. in evidence based healthcare) and contribute to or collaborate with the US MCBK activity
  3. Network with other senior decision makers in this area

We are looking for clinical and other input for defining MCBK use cases, understanding potential barriers and incentives for MCBK and other input to our work. This may take the form of an online survey, email exchange or potentially a brief Skype interview.

Thank you for your interest in our work.

UK MCBK steering group

Tom Foley – Senior Clinical Lead for Data – Insights and Statistics, NHS Digital

Jan Hoogewerf – Business Manager – Faculty of Clinical Informatics

Ben McAlister – Chair – HL7 UK Management Board; Senior Solution Strategist at Cerner

Pritesh Mistry – Head of Innovation – RCGP

Andrew Mitchell – Associate Director – Information Architecture, Search and Business Analysis, NICE

Philip Scott – Reader in Health Informatics, University of Portsmouth & Chair, BCS Health & Care

John Williams – Chair of Faculty of Clinical Informatics Council – Senior Clinical Research Fellow, Primary Care Health Sciences, Oxford University

Jeremy Wyatt – Emeritus professor of digital healthcare – University of Southampton & convenor, Faculty of Clinical Informatics AI Special Interest Group (chair)

Nick Booth – Honorary Treasurer of the Faculty of Clinical Informatics & Visiting Professor of Practice, Newcastle University