UK activity on Mobilising Computable Biomedical Knowledge (MCBK)


This is a joint working group between the FCI (co-chair Jeremy Wyatt) and the British Computer Society (co-chair Philip Scott).


Background to the UK MCBK activity

Many different calculators (eg. CHADSVASC2), GP templates, checklists and ePrescribing systems are used to support professionals and improve patient safety. Each of these embeds clinical knowledge, sometimes as a dedicated single purpose computer program and sometimes as an explicit, computer readable “knowledge base” and a generic “inference engine”. A further opportunity for these clinical knowledge and computable decision support systems is the widening of the range of NHS providers. This means that a central library supporting computable knowledge systems  will enable working to a common knowledge base and support similar standards of care whoever is providing it, in any setting.

Most of these knowledge systems are of high quality, but unfortunately, some have not been maintained or implemented correctly, so algorithm-related patient safety incidents occur quite frequently. This problem may originate at any stage from the  design, programming, testing, clinical use, or maintenance of these computable decision support systems.

Increasing interest in these knowledge systems  has led to the development of the US Mobilising Computable Biomedical Knowledge (MCBK) group:

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

They are keen to develop standard methods for representing the clinical knowledge as “knowledge objects”, include these in open 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 computable 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 computable knowledge for accurate recall; locking the knowledge so that its integrity is protected; preserving the meaning of computable knowledge when clinical coding systems change; adjusting computable knowledge to fit specific contexts (eg. primary vs. secondary care investigation guidelines); archiving of obsolete computable 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:

https://www.youtube.com/playlist?list=PLn7CfTWFFBSzTZtK4bTpo7Q2kBLjr0RUM

Aims and outputs of the UK MCBK activity

We aim to support UK organisations to adopt computable 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 computable 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 – Clinical Cell at NHSX, Principal Investigator on the Newcastle University Learning Healthcare Project and Senior Lecturer, Newcastle University

Jonathan Kay – FCI Chair; Professor of Health Informatics at University College London and City University London

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

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

Philip Scott – Reader, Centre for Healthcare Modelling and Informatics, University of Portsmouth & Chair, BCS Health & Care (co-chair)

John Williams – former Chair, Faculty of Clinical Informatics; 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 (co-chair)

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

Secretariat:

Jan Hoogewerf - Business Manager, Faculty of Clinical Informatics

Joe Jubb - Communications and Membership Officer, Faculty of Clinical Informatics