Proteus* is a software
technology that allows creating clinical executable decision support
guidelines with little effort.
Indeed, it should be fun creating your own
Once a guideline for a condition has been created, it can be
executed to provide stepwise advice for any patient having that
This site is dedicated to the Proteus executable guidelines
model, tools based on the Proteus approach and the automated guidelines
created using those tools.
A software tool that allows creating and executing clinical
decision support guidelines using the Proteus approach is available.
The tool called Protean may be downloaded from here.
allows creating new guidelines or editing existing ones very
easily. Much of the editing is done by dragging and dropping.
Why Proteus is Special - A Quick Overview
The Proteus guidelines are created with modular entities
called Knowledge Components (KCs).
Each KC represents a clinical activity and is available to the
clinician as a module of executable knowledge with its own intelligence.
- The KCs may be easily modified. Simple drag and drop
operations constitute significant part of editing.
- The KCs may be reused. For example, a KC created for
diagnosis of diabetes can be used in guidelines as disparate as
“investigation of coma”, “routine preoperative checkup for major
elective surgery”, “investigation of unexplained weight loss” and
“evaluation for risk of infection”. One can simply drop a KC in a
guideline and begin using it. The KCs are also shareable, therefore
anyone who authors guidelines can have a library of pre-built KCs at
their disposal to drag and drop in their guideline.
- Experts at remote locations may manage individual KCs,
keeping them in sync with the current medical concepts, while the
clinicians automatically get the state-of-the-art executable knowledge.
This is akin to opening a web page using a hyperlink; the user gets the
fresh content by clicking on the same URL when the author of the web
page updates it. Unlike a web page however, the Proteus KCs are
executable knowledge and not passive information. Each guideline may
have many KCs, each being updated by a different expert or a group of
- The intelligent decision-making in the KC comes from the
Inference Tools in the Proteus approach. Any thing that can make the
inferences that a KC needs can be declared its inference tool. Simple
software algorithms, sophisticated artificial intelligence tools or
even remote human experts can be specified as inference tools for KCs.
The inference tool can be as easily swapped as they can be declared.
Therefore, if a tool with better inferencing capabilities becomes
available, it can be used to replace the previous one in a few simple
- The KCs offer a template for capturing data pertaining to
the clinical activity that they represent and serve as components of an
Electronic Medical Record.
- Since the KCs represent discretely identifiable clinical
activities they also allow attaching related elements from the
non-clinical processes of healthcare. Each such non-clinical process
can be assigned a separate layer, with components within it
communicating with a logically related KC in the clinical process. For
example, execution of a KC representing Colonoscopy in the clinical
process may be linked with an event that increments the list of
billable items for the patient. The latter event exists in a parallel
process layer called “billing” which gets its hints from the core
clinical process as it progresses. This allows conceiving of an
integrated healthcare information system with logically related parts
and unlimited extensibility.
Proteus is an ambitious approach with a potential to touch
many aspects of healthcare. Several prototype software tools developed
have validated the core features of the Proteus approach. The
experience of development carried out to date suggests that a more
exhaustive implementation be created and tested with healthcare
Run the animated
tutorial to get a quick feel for the Proteus
Read more about Proteus. A brief
introduction of Proteus in simple English.
Download and Learn
prototype tool for authoring and executing Proteus Guidelines).
You can download and explore Protean. The simple tutorial can help you
get you familiar with the software tools and the essential concepts of
to Proteus - Executable Guidelines with Knowledge Components
of Protean and GreEd in use (Quality Expo 2009), Teresa Hantz and
Shah H., Proteus: A Model for Clinical
Protocols created from Knowledge Components, Proc.
14th IEEE Symposium on Computer-Based Medical Systems. Los Alamitos,
CA: IEEE Computer Society. July 2001, 59-64.(Abstract) (HTML) (PDF)
* in Greek mythology, Proteus is the sea god who
possessed the knowledge about everything and had the ability to change
shape at will.
Proteus is also an Acronym - PROcesses and Transactions
Editable by USers