Multi-agent Patient Representation in Primary Care

Though multi-agent systems have been explored in a wide variety of medical settings, their role at the primary care level has been relatively little investigated. In this paper, we present a system that is currently being piloted for future rollout in Scotland that employs an industrial strength multi-agent platform to tackle both technical and sociological challenges within primary care. In particular, the work is motivated by several specific issues: (i) the need to widen mechanisms for access to primary care; (ii) the need to harness technical solutions to reduce load not only for general practitioners, but also for practice nurses and administrators; (iii) the need to design and deploy technical solutions in such a way that they fit in to existing professional activity, rather than demanding changes in current practice. With direct representation of individuals in health care relationships implemented in a multi-agent system (with one multi-functional agents representing each patient, doctor, nurse, pharmacist, etc.) it becomes straightforward first to model and then to integrate with existing practice. It is for this reason that the system described here successfully widens access for patients (by opening up novel communication channels of email and SMS texting) and reduces load on the practice (by streamlining communications and semi-automating appointment arrangement). It does this by ensuring that the solution is not imposed on, but rather, integrated with what currently goes on in primary care. Furthermore, with agents responsible for maintaining audit trails for the patients they represent, it becomes possible to see elements of the electronic patient record (EPR) emerging under agent control. This EPR can be extended through structured interaction with the practice system (here, we examine the GPASS system, the market leader in Scotland), to allow rich agent-agent and agent-human interactions. By using multi-agent design and implementation techniques, we have been able to build a solution that integrates both with individuals and extant software to successfully tackle real problems in primary care.