Healthc Inform Res.  2013 Sep;19(3):162-166. 10.4258/hir.2013.19.3.162.

Multi-Agent System as a New Approach to Effective Chronic Heart Failure Management: Key Considerations

• Mohammadzadeh N
• Safdari R
• Rahimi A

• KMID: 2166694
• DOI: http://doi.org/10.4258/hir.2013.19.3.162

Abstract

OBJECTIVES
Given the importance of the follow-up of chronic heart failure (CHF) patients to reduce common causes of re-admission and deterioration of their status that lead to imposing spiritual and physical costs on patients and society, modern technology tools should be used to the best advantage. The aim of this article is to explain key points which should be considered in designing an appropriate multi-agent system to improve CHF management.
METHODS
In this literature review articles were searched with keywords like multi-agent system, heart failure, chronic disease management in Science Direct, Google Scholar and PubMed databases without regard to the year of publications.
RESULTS
Agents are an innovation in the field of artificial intelligence. Because agents are capable of solving complex and dynamic health problems, to take full advantage of e-Health, the healthcare system must take steps to make use of this technology. Key factors in CHF management through a multi-agent system approach must be considered such as organization, confidentiality in general aspects and design and architecture points in specific aspects.
CONCLUSIONS
Note that use of agent systems only with a technical view is associated with many problems. Hence, in delivering healthcare to CHF patients, considering social and human aspects is essential. It is obvious that identifying and resolving technical and non-technical challenges is vital in the successful implementation of this technology.

Keyword

Heart Failure; Multi-Agent Systems; Disease Management

MeSH Terms

Artificial Intelligence
Chronic Disease
Confidentiality
Delivery of Health Care
Disease Management
Follow-Up Studies
Heart
Heart Failure
Humans
Imidazoles
Nitro Compounds
Imidazoles
Nitro Compounds

Reference

1. Stewart S, Jenkins A, Buchan S, McGuire A, Capewell S, McMurray JJ. The current cost of heart failure to the National Health Service in the UK. Eur J Heart Fail. 2002; 4(3):361–371.

2. Center for Disease Control and prevention. Heart failure fact sheet [Internet]. Atlanta (GA): Center for Disease Control and prevention;2012. cited at 2013 July 21. Available from: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/docs/fs_heart_failure.pdf.

3. Lofvenmark C, Karlsson MR, Edner M, Billing E, Mattiasson AC. A group-based multi-professional education programme for family members of patients with chronic heart failure: effects on knowledge and patients' health care utilization. Patient Educ Couns. 2011; 85(2):e162–e168.

4. Konstam V, Gregory D, Chen J, Weintraub A, Patel A, Levine D, et al. Health-related quality of life in a multicenter randomized controlled comparison of telephonic disease management and automated home monitoring in patients recently hospitalized with heart failure: SPAN-CHF II trial. J Card Fail. 2011; 17(2):151–157.

5. Bloom DE, Cafiero ET, Jane-Llopis E, Abrahams-Gessel S, Bloom LR, Fathima S, et al. The global economic burden of non-communicable diseases: a report by the World Economic Forum and the Harvard School of Public Health [Internet]. Geneva: World Economic Forum;2011. cited at 2013 July 23. Available from: http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf.

6. Weintraub A, Gregory D, Patel AR, Levine D, Venesy D, Perry K, et al. A multicenter randomized controlled evaluation of automated home monitoring and telephonic disease management in patients recently hospitalized for congestive heart failure: the SPAN-CHF II trial. J Card Fail. 2010; 16(4):285–292.

7. Dendale P, De Keulenaer G, Troisfontaines P, Weytjens C, Mullens W, Elegeert I, et al. Effect of a telemonitoring-facilitated collaboration between general practitioner and heart failure clinic on mortality and rehospitalization rates in severe heart failure: the TEMA-HF 1 (TElemonitoring in the MAnagement of Heart Failure) study. Eur J Heart Fail. 2012; 14(3):333–340.

8. Patel H, Shafazand M, Schaufelberger M, Ekman I. Reasons for seeking acute care in chronic heart failure. Eur J Heart Fail. 2007; 9(6-7):702–708.

9. Grady KL, Dracup K, Kennedy G, Moser DK, Piano M, Stevenson LW, et al. Team management of patients with heart failure: a statement for healthcare professionals from the Cardiovascular Nursing Council of the American Heart Association. Circulation. 2000; 102(19):2443–2456.

10. Finkelstein J, Khare R, Vora D. Home automated telemanagement (HAT) system to facilitate self-care of patients with chronic diseases. J Syst Cybern Inf. 2003; 1(3):78–82.

11. Cross RK, Finkelstein J. Feasibility and acceptance of a home telemanagement system in patients with inflammatory bowel disease: a 6-month pilot study. Dig Dis Sci. 2007; 52(2):357–364.

12. Finkelstein J, Cha E. Hypertension telemanagement in African Americans. Circ Cardiovasc Qual Outcomes. 2009; 2(3):272–278.

13. Finkelstein J, Wood J. Delivering chronic heart failure telemanagement via multiple interactive platforms. J Syst Cybern Inf. 2013; 11(3):34–39.

14. Dunin-Keplicz B, Verbrugge R. Teamwork in multi-agent systems: a formal approach. Hoboken (NJ): John Wiley & Sons;2010.

15. Annicchiarico R, Cortes U, Urdiales C. Agent technology and e-Health. Basel, Switzerland: Birkhauser;2008.

16. Wooldridge MJ. An introduction to multiagent system. 2nd ed. Chichester, UK: John Wiley & Sons;2009.

17. Isern D, Sanchez D, Moreno A. Agents applied in health care: a review. Int J Med Inform. 2010; 79(3):145–166.

18. Isern Alarcon D. Agent-based management of clinical guidelines [dissertation]. Barcelona, Spain: Universitat Politecnica de Catalunya;2009.

19. Bichindaritz I, Vaidya S, Jain A, Jain LC. Computational intelligence in healthcare 4: advanced methodologies. Heidelberg, Germany: Springer;2010.

20. Randell R, Dowding D. Organisational influences on nurses' use of clinical decision support systems. Int J Med Inform. 2010; 79(6):412–421.

21. Choi W, Rho MJ, Park J, Kim KJ, Kwon YD, Choi IY. Information system success model for customer relationship management system in health promotion centers. Healthc Inform Res. 2013; 19(2):110–120.

22. Khoumbati K, Dwivedi Y, Srivastava A, Lal B. Handbook of research on advances in health informatics and electronic healthcare applications: global adoption and impact of information communication technologies. Hershey (PA): Medical Information Science Reference;2010.

23. Cresswell K, Sheikh A. Organizational issues in the implementation and adoption of health information technology innovations: an interpretative review. Int J Med Inform. 2013; 82(5):e73–e86.

24. Venkatesh V, Thong JY, Xu X. Consumer acceptance and use of information technology: extending the unified theory of acceptance and use of technology. MIS Q. 2012; 36(1):157–178.

25. Hardiker NR, Grant MJ. Factors that influence public engagement with eHealth: a literature review. Int J Med Inform. 2011; 80(1):1–12.

26. Chae YM, Yoo KB, Kim ES, Chae H. The adoption of electronic medical records and decision support systems in Korea. Healthc Inform Res. 2011; 17(3):172–177.

27. Safdari R, Mohammadzadeh N. Patient health monitoring through mobile health systems. In : International Conference on Electronic Health (ICEH 2012); 2012 Nov 29-30; Tehran, Iran.

28. Safdari R, Mohammadzadeh N. Multi-agent systems and health information management. In : 2nd e-Hospital and Telemedicine Symposium; 2011 Nov 8-9; Tehran, Iran.

29. Bellifemine F, Rimassa G, Poggi A. Developing multi-agent systems with a FIPA-compliant agent framework. Softw Pract Exp. 2001; 31(2):103–128.

30. Quaglini S, Stefanelli M, Cavallini A, Micieli G, Fassino C, Mossa C. Guideline-based careflow systems. Artif Intell Med. 2000; 20(1):5–22.

31. EU-Project K4CARE! [Internet]. Tarragona, Spain: K4CARE;2008. cited at 2013 Sep 1. Available from: http://www.k4care.net/.

32. Cripps H, Standing C. The implementation of electronic health records: a case study of bush computing the Ngaanyatjarra lands. Int J Med Inform. 2011; 80(12):841–848.

33. Lucas H. Information and communications technology for future health systems in developing countries. Soc Sci Med. 2008; 66(10):2122–2132.

34. Haux R. Individualization, globalization and health: about sustainable information technologies and the aim of medical informatics. Int J Med Inform. 2006; 75(12):795–808.

35. Viitanen J, Hypponen H, Laaveri T, Vanska J, Reponen J, Winblad I. National questionnaire study on clinical ICT systems proofs: physicians suffer from poor usability. Int J Med Inform. 2011; 80(10):708–725.

36. Hardiker NR, Grant MJ. Factors that influence public engagement with eHealth: a literature review. Int J Med Inform. 2011; 80(1):1–12.

37. Rigby M. The management and policy challenges of the globalisation effect of informatics and telemedicine. Health Policy. 1999; 46(2):97–103.

38. Lin H. Architectural design of multi-agent systems: technologies and techniques. Hershey (PA): Information Science Reference;2007.

39. Alonso E, Kudenko D, Kazakov D. Adaptive agents and multi-agent systems: adaptation and multi-agent learning. Heidelberg, Germany: Springer;2003.

40. Kostiadis K, Hunter M, Hu H. The use of design patterns for the development of multi-agent systems. In : Proceedings of the IEEE International Conference on Systems, Man, and Cybernetics; 2000 Oct 8-11; Nashville, TN. p. 280–285.

41. Bhat S, Wahid A. Multi agent based knowledge management: issues and challenges. Int J Comput Sci Commun. 2010; 1(2):293–297.

42. Han BM, Song SJ, Lee KM, Jang KS, Shin DR. Multi agent system based efficient healthcare service. In : Proceedings of the 8th International Conference on Advanced Communication Technology; 2006 Feb 20-22; Pyeong Chang, Korea.

43. OpenGALEN [Internet]. OpenGALEN Foundation;cited at 2013 July 10. Available from: http://www.opengalen.org.

44. Volot F, Joubert M, Fieschi M, Fieschi D. A UMLS-based method for integrating information databases into an Intranet. Proc AMIA Annu Fall Symp. 1997; 1997:495–499.

45. Safdari R, Partovipour E, Maidani Z. Unified medical language the infrastructure of EHR. Tehran, Iran: Jaffari;2009.

46. Nealon JL, Moreno A. Agent-based health care systems [Internet]. Tarragona, Spain: Universitat Rovira i Virgili;2003. cited at 2013 Sep 1. Available from: http://deim.urv.cat/~itaka/Publicacions/eulat03a.pdf.

47. Lawler EK, Hedge A, Pavlovic-Veselinovi S. Cognitive ergonomics, socio-technical systems, and the impact of healthcare information technologies. Int J Ind Ergon. 2011; 41(4):336–344.