Abstract
Care pathways are excellent tools for the standardization of care delivery and the improvement of clinical efficiency. The high dynamism and unpredictability of the clinical environment require pathways to be adaptable to the deviations that may arise during their execution. In this work we present a methodology for the identification, monitoring, detection and managing of these deviations. Such deviations include evolving patient conditions, arbitrary medical modifications and unpredicted clinical settings. The care pathways are dynamically generated based on a knowledge-driven planning process that personalizes treatments according to up-to-date patient conditions and guarantees adherence to clinical guidelines recommendations. The implementation of the proposed methodology in a domain-independent continuous planning architecture is presented.
This work has been partially supported by the Spanish MICIIN projects TIN2008-06701-C03 and TIN2011-27652-C03-03 and the Andalusian Regional Ministry of Innovation under project P08-TIC-3572.
Access provided by Autonomous University of Puebla. Download to read the full chapter text
Chapter PDF
Similar content being viewed by others
Keywords
References
Alcázar, V., Guzmán, C., Prior, D., Borrajo, D., Castillo, L., Onaindía, E.: Pelea: Planning, learning and execution architecture. In: UK Planning and Scheduling Special Interest Group, PlanSIG (2010)
Alexandrou, D.A., Skitsas, I.E., Mentzas, G.N.: A holistic environment for the design and execution of self-adaptive clinical pathways. In: Information Technology and Applications in Biomedicine, ITAB (2009)
Booch, G., Rumbaugh, J., Jacobson, I.: The unified modeling language user guide. Inc. (1999)
Campbell, H., Hotchkiss, R., Bradshaw, N., Porteous, M.: Integrated care pathways. BMJ 316(7125), 133–137 (1998)
Castillo, L., Fdez-Olivares, J., García-Pérez, O., Palao, F.: Efficiently handling temporal knowledge in an htn planner. In: International Conference on Automated Planning and Scheduling, ICAPS (2006)
Fdez-Olivares, J., Castillo, L., Cózar, J.A., García Pérez, Ó.: Supporting clinical processes and decisions by hierarchical planning and scheduling. Computational Intelligence 27, 103–122 (2011)
Gonzalez-Ferrer, A., ten Teije, A., Fdez-Olivares, J., Milian, K.: Automated generation of patient-tailored electronic care pathways by translating computer-interpretable guidelines into hierarchical task networks. In: Artificial Intelligence In Medicine (2012)
Greiner, U., Mueller, R., Rahm, E., Ramsch, J., Heller, B., Loeffler, M.: Adaptflow: protocol-based medical treatment using adaptive workflows. Methods of Information in Medicine 44, 80–88 (2005)
Grimshaw, J.M., Russell, I.T.: Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. The Lancet 342, 1317–1322 (1993)
SEOP Working Group. National protocol for diagnosis and treatment of hodgkin’s desease - eh-seop.003. Technical report, SEOP (May 2000) (in Spanish)
Huang, Z., Lu, X., Duan, H.: Using recommendation to support adaptive clinical pathways. Journal of Medical Systems 36, 1849–1860 (2012)
Isern, D., Moreno, A.: Computer-based execution of clinical guidelines: A review. International Journal of Medical Informatics 77(12), 787–808 (2008)
Kelsey, S.: Managing patient care: are pathways working? Practice Development in Health Care 4(1), 50–55 (2005)
Marinagi, C.C., Spyropoulos, C.D., Papatheodorou, C., Kokkotos, S.: Continual planning and scheduling for managing patient tests in hospital laboratories. Artificial Intelligence in Medicine 20(2),139–154 (2000); Planning and Scheduling in the Hospital
Miksch, S., Horn, W., Popow, C., Paky, F.: Vie-vent: knowledge-based monitoring and therapy planning of the artificial ventilation of newborn infants. Artificial Intelligence in Medicine 10, 218–229 (1993)
Miksch, S., Seyfang, A.: Continual planning with time-oriented, skeletal plans. In: European Conference on Artificial Intelligence (ECAI 2000), pp. 511–515 (2000)
Müller, R., Greiner, U., Rahm, E.: Agentwork: a workflow system supporting rule-based workflow adaptation. Data & Knowledge Engineering 51(2), 223–256 (2004)
Palao, F., Fdez-Olivares, J., Castillo, L., García, O.: An extended htn knowledge representation based on a graphical notation. In: Workshop Knowledge Engineering for Planning and Scheduling, ICAPS (2011)
Panella, M., Marchisio, S., Di Stanislao, F.: Reducing clinical variations with clinical pathways: do pathways work? International Journal for Quality in Health Care 15, 509–521 (2003)
Peleg, M., Somekh, J., Dori, D.: A methodology for eliciting and modeling exceptions. Journal of Biomedical Informatics 42(4), 736–747 (2009)
Sánchez-Garzón, I., Fernández-Olivares, J., Castillo, L.: An Approach for Representing and Managing Medical Exceptions in Care Pathways Based on Temporal Hierarchical Planning Techniques. In: Lenz, R., Miksch, S., Peleg, M., Reichert, M., Riaño, D., ten Teije, A. (eds.) ProHealth 2012/KR4HC 2012. LNCS (LNAI), vol. 7738, pp. 168–182. Springer, Heidelberg (2012)
White, S.: Introduction to bpmn. Technical report, IBM Cooperation (2004)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Milla-Millán, G., Fdez-Olivares, J., Sánchez-Garzón, I., Prior, D., Castillo, L. (2013). Knowledge-Driven Adaptive Execution of Care Pathways Based on Continuous Planning Techniques. In: Lenz, R., Miksch, S., Peleg, M., Reichert, M., Riaño, D., ten Teije, A. (eds) Process Support and Knowledge Representation in Health Care. ProHealth KR4HC 2012 2012. Lecture Notes in Computer Science(), vol 7738. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36438-9_3
Download citation
DOI: https://doi.org/10.1007/978-3-642-36438-9_3
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-36437-2
Online ISBN: 978-3-642-36438-9
eBook Packages: Computer ScienceComputer Science (R0)