Intelligent Systems in the Knowledge Systems Laboratory at

Past Project: Patient Advocate

The Patient Advocate project was completed in 1996. This page contains references to some of the original Patient Advocate materials and group members. A final list of all Patient Advocate publications can be found on the AIS Publications page. The content of this page was last updated in 1996.

Project Description

Knowledge-based monitoring and therapy planning systems were mainly built for the convenience of health care providers. They neglect the consumers of health care, namely, the patients. Our approach is concentrated on the individual patient's demands and needs. We are designing, building, and demonstrating cooperative agents to support patients' management of their own health-related behavior on a day-to-day basis at home, called Patient Advocate. Patient Advocate helps patients to comply with physicians' instructions and advice, to exercise health-related common sense, and to monitor themselves for condition-specific danger signs. In general, Patient Advocate assists in clinical practice by helping patients to get a closer insight into their health conditions (e.g., helping them to identify and report relevant symptoms, getting additional explanations on users' request) and to decide when they need unscheduled consultation with heath-care professionals. Clinical treatment protocols are represented in an intention-based temporal representation language to overcome the drawbacks of vague or ill-structured problem definitions (e.g., missing functional dependencies). These representations are used to guide the patient, to provide necessary explanations, and to observe and critique whether the patient obeys the instructions of the health-care provider.

Patient Advocate's Functionality

In general, the Patient Advocate project supports the following functionality :

  • Monitoring and consulting of the patient's health condition:
    Nowadays, there are several kinds of data about the patient's health condition available from different clinical analyses and devices. All this information is time-stamped and has to be interpreted by the health care provider and in particular has to be understood by the patients following health care providers' advice. Medical consulting time is expensive. Furthermore, some patients cannot effort the expense or the time for adequate and regular medical consulting meeting. Nevertheless, a computer-supported advice-giving system can provide the patient with the necessary information and explanations to cope with her/his health condition as well as to react to life-threatening situations correctly and in time.

    Therefore, the central aim of the Patient Advocate project is to present task-adequate methods to give a global, comprehensive picture of all information available (e.g., observed parameters available at home, physicians'/nurses' instructions and advice) and explanations with respect to patients' demands and experiences as well as to the degree of severity of a situation. Such a comprehensive picture can be achieved by context-sensitive interweaving of different knowledge-based approaches to classify input data and by adequate visualization techniques. The attention will be spent on this interweaving, even though it is a very complex and partially domain-specific task.

    The monitoring and consulting tasks consist of data selection, data validation, data abstraction, data visualization, recommendations, and explanations of data and vision.

  • Facilitating access to web resources:

    Today hundreds of medical information resources around the world are available on the world wide web (WWW), including information from federal agencies (e.g., NIH, FDA), clinical protocols and guideline information, literature and library services, medical encyclopedias, continuing medical education resources and, of course, many other non-medical services. Exploring the WWW is a time-consuming and unreliable task: (1) too much data, (2) too much noise, (3) no good organization. The variety of candidate sites and paths results in failing to retrieve necessary and accurate information in time.

    The Patient Advocate project facilitates a context-sensitive access to these various resources, providing the patient with additional explanation or teaching utilities on request. The guiding principle is that only those sites and resources are activated which are meaningful for the current patient's health condition. These sites and resources are annotated with an importance ranking to simplify the search process.

  • Coordinating patient-relevant information:

    The patient is usually confronted with a lot of coordination issues. She/He has to schedule a new appointment with the health care provider, has to remember scheduled or unscheduled therapy, and more. The Patient Advocate provides the patients with necessary tools to assist these coordination tasks (e.g., an appointment scheduler, email connection to the medical staff, reminder of therapies and medications).

    In the current phase of the Patient Advocate project we are working on a prototype to implement an intelligent assistant performing the monitoring and consulting of the patient's health condition. Figure 1 shows a mock-up of a prototype which monitors and consults women with gestational diabetes mellitus.

    Implementation: We are using knowledge-based techniques to interpret the raw data, to derive explanations and recommendations and to visualize the information (BB1 architecture). It is important that the Patient Advocate run on widely available hosts.

    Figure 1: Mock-up of Patient Advocate's user interface (scenario GDM Type-II)

    Project Members

    • Medical Collaborators:
      California diabetes & pregnancy program "Sweet Success",
      Stanford University Medical Center
      • Anne Regenstein, MD, Medical Director
      • Gretchen D. Flanagan, RD, Clinical Nutritionist, Program Coordinator
      • Lylia Needham, RN, MPA, Nurse Specialist

    Research Funding

    Patient Advocate is part of the HIIP project (Health Information Infrastructure Program) supported by DARPA Grant N66001-94-D-6055. Silvia Miksch is supported by "Erwin Schrödinger Auslandstipendium, Fonds zur Förderung der wissenschtlichen Forschung", J01042-MAT.


    The full list of Patient Advocate publications can be found on the AIS Publications page.

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