Knowledge is generated and accessed from heterogeneous spaces. The recent advances in in-formation technologies provide enhanced tools for improving the efficiency of knowledge-based decision support systems. The purpose of this paper is to present the frameworks for developing the optimal blend of technologies required in order to better the knowledge acquisition and reuse in large scale decision making environments. The authors present a case study in the field of clinical decision support systems based on emerging technologies. They consider the changes generated by the upraising social technologies and the challenges brought by the interactive knowledge building within vast online communities.