Clinical guidelines as plans: an ontological theory

Clinical guidelines are special types of plans realized by collective agents in health care organizations. We use this idea as the basis for a new understanding of the way in which guideline-based systems can be employed in the management of workflow in health care organizations. The framework we propose allows us to represent in formal terms how guidelines are realized through the actions of individuals organized into teams. Implementations built in conformity with our framework will accordingly be marked by two dimensions of flexibility that are designed to make them more likely to be accepted by health care professionals than are standard guideline-based management systems.