"Streaming Knowledge: Transforming Healthcare Infrastructure in the Era of Real-Time Science"

Agenda

In recent years, we have been witnessing a profound reconfiguration of the epistemological foundations of contemporary public health. The classical system, consolidated during the Pasteurian revolution and the hygienist movement, was institutionally organized around the conception of knowledge as a product: localizable, verifiable, and delegable to specialized expert agents. It was precisely this exclusivity of knowledge that underwrote the legitimacy of power and coercion in the domain of population health governance.

A different logic is now becoming increasingly apparent. Big data, streaming analytics, and widely accessible machine learning tools are driving a radical compression of the temporal gap between observation, analysis, and decision-making — to the point of its near-elimination. Health knowledge no longer exists as a completed outcome but as a continuous flow of perpetually revised and decentralized findings. We propose to designate this shift — from epistemic stasis to epistemic dynamics — as Real-Time Science (RTS).

RTS is not merely a technological innovation but a systemic transformation: healthcare itself, both as a concept and as an institutional infrastructure, is thrown into question. The biopolitical power of medicine has historically been conditioned by its monopoly over the production and interpretation of health knowledge. Broad access to streaming data and its automated processing — including through generative AI tools — effectively dismantles this monopoly, problematizing the very possibility of localizing expertise and accountability. In the terms of Bowker and Star, the classificatory infrastructures that sustained healthcare as a biopolitical system are losing their prior legitimacy.

This transformation carries a distinctly material dimension as well: the production and storage of streaming data presupposes enormous computational capacity, energy and water consumption, and dependence on geopolitically vulnerable microelectronics supply chains. The healthcare infrastructure of the future encompasses not only organizational models and legislative frameworks but also physically distributed computational resources, access to which is fundamentally uneven. The implementation of real-time systems encounters barriers related to data quality, ethical governance, and inequality in technological provisioning.

Research Questions

The shift described above gives rise to a set of fundamental questions submitted for collective discussion:

- Epistemological: If health knowledge ceases to be localizable and complete, is it possible to sustain the conception of healthcare as a system grounded in the delegation of expertise?

- Biopolitical and bioethical: To whom is responsibility attributed when expertise is transferred to a machine? How are mechanisms of oversight and accountability to be organized when the "responsible party" for an error cannot be localized?

- Political-economic: What scenarios of response to this transformation are available — accelerationist, reactionary (conservation of existing knowledge institutions), or statist (state monopolization of streaming knowledge)?

Topics for Discussion

The conference invites researchers, practitioners, and theorists from public health, medicine, sociology of health, philosophy, Science and Technology Studies (STS), medical anthropology and related fields. Proposed lines of inquiry include:

- In what ways does the shift toward a streaming model of knowledge transform the concept of "healthcare" — institutionally, normatively, and biopolitically?

- Can public health systems function under conditions of distributed and decentralized expertise, and where in that case is accountability located?

- What are the epistemological and ethical consequences of the "democratization" of medical knowledge — its transition from a zone of exclusive competence to one of broad, including AI-mediated, access?

- How do accelerationist and reactionary strategies on the part of states, transnational corporations, scientific institutions, and civil society relate to one another?

- What are the material constraints of "streaming healthcare" — particularly in the context of unequal access to computational resources across different national and regional settings?

Abstract Submission

The conference will be held in person in Moscow, September 23–25, 2026, with an online participation option available.

Abstracts of up to 250 words (in English or Russian), or a text-to-text prompt for abstract generation, along with a brief biographical note, should be submitted to the organizers by September 9, 2026:

i.martynov[at]iea.ras.ru (Innokentiy A. Martynov, Centre for Medical Anthropology, Russian Academy of Sciences, Moscow)

ste.kozlov[at]gmail.com (Stepan V. Kozlov, Moscow School of Social and Economic Sciences, Moscow)

Bibliography

Foucault M. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage Books; 1994.

Bowker GC, Star SL. Sorting Things Out: Classification and Its Consequences. Cambridge, MA: MIT Press; 1999.

Star SL. The ethnography of infrastructure. Am Behav Sci. 1999;43(3):377–391.

Crawford K. Atlas of AI: Power, Politics, and the Planetary Costs of Artificial Intelligence. New Haven: Yale University Press; 2021.