CIIC, 3 September 2016, Auckland

Pete Rive kicked-off the day with a very timely keynote on the implications of zero marginal cost on the future of human societies.


Following a lively discussion of the keynote topic, participants picked up on the healthcare theme that emerged out of the last two unconferences, and focused on the problem statement submitted by Seyedjamal Zolhavarieh:

In the domains of health informatics and clinical decision support systems there is a lack of quality assessment of extracted knowledge for clinical decision making. There are two questions:
  • Can clinical decision support systems (CDSS) can cope with rare or unusually presenting diagnoses?
  • How to make sure that the knowledge provided by CDSS is reliable?
The knowledge used in clinical decision support systems must be both up to date and relevant for the cases that are being presented to it. However, finding the latest accurate clinical knowledge to support clinical decision making is difficult, because knowledge is changing rapidly, and it might be located in many different repositories in different formats. Additionally, the range of knowledge required in a particular case may be very wide, especially when dealing with multiple co-morbidities.
Seyedjamal outlined the knowledge validation challenges that he is uncovering and addressing in his research.
The discussion quickly led to the implicit assumptions and established structures in the healthcare sector that may stand in the way of making significant further progress in terms of reliable knowledge.
Participants mapped out the economic ecosystem and the interests that inform and complicate the healthcare practitioner – patient relationship.
Patients are surrounded by the following sources of information and interests:
  1. Family
  2. Health insurers
  3. Advocacy organisations
  4. Non government organisations
  5. Patient knowledge bases
  6. Blood services
  7. Pharmaceutical advertisements

Healthcare practitioners operate in a context that is influenced by:

  1. Funding providers, Ministry of Health, Pharmac
  2. Hospitals and universities
  3. Triage providers
  4. Medical equipment providers
  5. Pharmaceutical companies
  6. Peers working in other domains / silos of healthcare service delivery

For clinical decision support systems to be useful, they must consider the sources of different pieces of knowledge and information, and keep in mind the multitude of potentially conflicting interests that may exist around a particular patient.