Supporting multiple agents in the execution of clinical guidelines

Clinical guidelines (GLs) exploit evidence-based medicine to enhance the quality of patient care, and to optimize it. To achieve such goals, in many GLs different agents have to interact and cooperate in an effective way. In many cases (e.g. in chronic disorders) the GLs recommend that the treatment is not performed/completed in the hospital, but is continued in different contexts (e.g. at home, or in the general practitioner’s ambulatory), under the responsibility of different agents. Delegation of responsibility between agents is also important, as well as the possibility, for a responsible, to select the executor of an action (e.g., a physician main retain the responsibility of an action, but delegate to a nurse its execution). To manage such phenomena, proper support to agent interaction and communication must be provided, providing them with facilities for (1) treatment continuity (2) contextualization, (3) responsibility assignment and delegation (4) check of agent “appropriateness”. In this paper we extend GLARE, a computerized GL management system, to support such needs. We illustrate our approach by means of a practical case study.