An Approach to Guidelines Implementation in an E-health System Supporting Chronic Care

Abstract

Guidelines developed in line with Evidence-Based Medicine paradigm usually take form of narrative recommendations formulated on the basis of available evidence resulting from clinical trials and other types of studies. For past ten years there were developed several Formal Guidelines Representation languages that attempted to express them in form of algorithms or processes. Analysis of specific requirements related to e-health and in particular telemonitoring systems indicated, that a process oriented formalization of guidelines is in this case inappropriate, as such systems should be reactive, event driven and enable adaptation to cope with the quality of entered data.  In this paper we describe an approach to guidelines implementation in the e-health system. Contrary to various FGR languages developed earlier the decision support will be based on the set of fuzzy rules that on the technical level will be implemented as XQuery transformations of XML data. We discuss this approach on an example related to the management of bronchial asthma, as customization of the system to this disease was selected as one of the proof-of-concept exemplifications of the system.