The Case Manager: An Agent Controlling the Activation of Knowledge Sources in a FHIR-Based Distributed Reasoning Environment.


Journal

Applied clinical informatics
ISSN: 1869-0327
Titre abrégé: Appl Clin Inform
Pays: Germany
ID NLM: 101537732

Informations de publication

Date de publication:
08 2023
Historique:
medline: 15 9 2023
pubmed: 21 6 2023
entrez: 20 6 2023
Statut: ppublish

Résumé

Within the CAPABLE project the authors developed a multi-agent system that relies on a distributed architecture. The system provides cancer patients with coaching advice and supports their clinicians with suitable decisions based on clinical guidelines. As in many multi-agent systems we needed to coordinate the activities of all agents involved. Moreover, since the agents share a common blackboard where all patients' data are stored, we also needed to implement a mechanism for the prompt notification of each agent upon addition of new information potentially triggering its activation. The communication needs have been investigated and modeled using the HL7-FHIR (Health Level 7-Fast Healthcare Interoperability Resources) standard to ensure proper semantic interoperability among agents. Then a syntax rooted in the FHIR search framework has been defined for representing the conditions to be monitored on the system blackboard for activating each agent. The Case Manager (CM) has been implemented as a dedicated component playing the role of an orchestrator directing the behavior of all agents involved. Agents dynamically inform the CM about the conditions to be monitored on the blackboard, using the syntax we developed. The CM then notifies each agent whenever any condition of interest occurs. The functionalities of the CM and other actors have been validated using simulated scenarios mimicking the ones that will be faced during pilot studies and in production. The CM proved to be a key facilitator for properly achieving the required behavior of our multi-agent system. The proposed architecture may also be leveraged in many clinical contexts for integrating separate legacy services, turning them into a consistent telemedicine framework and enabling application reusability.

Sections du résumé

BACKGROUND
Within the CAPABLE project the authors developed a multi-agent system that relies on a distributed architecture. The system provides cancer patients with coaching advice and supports their clinicians with suitable decisions based on clinical guidelines.
OBJECTIVES
As in many multi-agent systems we needed to coordinate the activities of all agents involved. Moreover, since the agents share a common blackboard where all patients' data are stored, we also needed to implement a mechanism for the prompt notification of each agent upon addition of new information potentially triggering its activation.
METHODS
The communication needs have been investigated and modeled using the HL7-FHIR (Health Level 7-Fast Healthcare Interoperability Resources) standard to ensure proper semantic interoperability among agents. Then a syntax rooted in the FHIR search framework has been defined for representing the conditions to be monitored on the system blackboard for activating each agent.
RESULTS
The Case Manager (CM) has been implemented as a dedicated component playing the role of an orchestrator directing the behavior of all agents involved. Agents dynamically inform the CM about the conditions to be monitored on the blackboard, using the syntax we developed. The CM then notifies each agent whenever any condition of interest occurs. The functionalities of the CM and other actors have been validated using simulated scenarios mimicking the ones that will be faced during pilot studies and in production.
CONCLUSION
The CM proved to be a key facilitator for properly achieving the required behavior of our multi-agent system. The proposed architecture may also be leveraged in many clinical contexts for integrating separate legacy services, turning them into a consistent telemedicine framework and enabling application reusability.

Identifiants

pubmed: 37339683
doi: 10.1055/a-2113-4443
pmc: PMC10499504
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

725-734

Informations de copyright

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Déclaration de conflit d'intérêts

D.G. is an employee of and shareholder in Deontics Ltd., which is the company producing the PROforma CIG authoring tool and the execution engine. The remaining authors have no conflict of interest of any kind to declare.

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Auteurs

Giordano Lanzola (G)

Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.

Francesca Polce (F)

Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.

Enea Parimbelli (E)

Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.

Matteo Gabetta (M)

Research and Development Division, Biomeris S.r.l, Pavia, Italy.

Ronald Cornet (R)

Medical Informatics, Amsterdam Public Health Institute, Methodology & Digital Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Rowdy de Groot (R)

Medical Informatics, Amsterdam Public Health Institute, Methodology & Digital Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Alexandra Kogan (A)

Department of Information Systems, University of Haifa, Haifa, Israel.

David Glasspool (D)

Deontics Ltd., London, United Kingdom.

Szymon Wilk (S)

Research and Development Division, Institute of Computing Science, Poznan University of Technology, Poznan, Poland.

Silvana Quaglini (S)

Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.

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