Iqbal et, al.

(2016) defines agent based systems are newly adopted technological design, development
and deployment
paradigm for complex sysytem. Within this paradigm, software components are connected with one
another and can actively function in an autonomous way within its assigned technological environments
(Iqbal 2016). Nwana (1996) is of the opinion that intelligent agent can also be referred to as software
agent and defines it as a piece of software that works autonomously in given environment in order to
achieve its designed goals. The use of multiple agents or multi agents system is primarily within an open
environment and they have the features of heterogeneous pattern and their level.of interactivity is
effectively operating a dynamically changing environment rapidly growing data quantity, different data
representation forms, ambient intelligence and
self-service (Luck et al. 2005).
The adoption of the application of intelligent agent in the health sector has made series of marks in the
health sector. There has been adoption near f different technological innovations that has helped to
curb or alienate the series of medical challenges that have been posted towards the health sector. Thus,
intelligent agent has achieved successes since its involvement in the health sector.

Aims and Contributions of Application of Intelligent Agent on the health sector

Iqbal et al (2016) does a comparative analysis of intelligent agent based systems proposed in literature,
implemented practically in healthcare units. The research understands the application of intelligent
agents from five groups based on functional characteristics of the healthcare sector namely planning
and resource management, decision support systems/knowledge base systems, data management
systems, remote care/self care systems and multifunction systems (Iqbal et al. 2016). The aspects of
intelligent agents application in the healthcare is based on the functionality of the sector.

In the study of

One of the major success recorded is the

Intelligent agents are a new paradigm for developing software applications ( Jennings & Wooldridge,
1998). This implies the involvement of software and computer applications as intelligent agents are
known to be agent-based computing exercise that hailed as 'the next significant breakthrough in
software development' (Sargent, 1992). Intelligent agent is also regarded as the new revolution in
software' (Ovum, 1994). It is highly essential to understand that agents are the focus of intense interest
on the
part of many sub-fields of computer science and artificial intelligence (Jennings & Wooldridge, 1998).
To understand the nature of intelligent agent, the characteristics of intelligent agents helps to
understand its primary aim of application in the health sector such as solving new types of problems
within the health industry as well as improving the efficiency of software development in the health
sector (Jennings & Wooldridge 1998). This aims helps to outline the successes recorded in the health
sector. Application of intelligent agents in the health sector has proven highly productive and impactful
in the health sector over its years of implementation ()

Jennings and Wooldridge citing Huang et al. (1996) confirms the activeness of the application of
intelligent agents in the health sector and describes it as a technological system that is designed to
integrate the patient management process, which typically involves many individuals (Jennings &
Wooldridge 1998).

In a recent study by Shakshuki and Reid (2015), there is an identification of the contributions of
intelligent agents in the health sector as the study found out that Multi-agent System (MAS) approach
provides a powerful platform for modeling and solving real world problems such as healthcare
(Shakshuki & Reid, 2015). The involvement of intelligent agent makes it possible for patients to remain
at home and consequently reducing costs. This invariably is denotes a significant contribution of the
agent-based system adopted by the health sector.

The application of intelligent agents have achieved successes in the creation of software that accounts
for various health related challenges such as fall detection, gait analysis, heart rate monitoring using
electrocardiogram (ECG), pulse oximetry, and detecting Parkinson’s episodes and their severity (Calhoun
et al., 2011)

One of the major landmark successes of the application of intelligent agents in the healthcare industry
is the provision of Telecare application for health users and providers. In Camarinha-Matos and
Afsarmanesh (2004) confirms that Telecare is an intelligent agent project that is aimed and designed for
the development of a configurable framework focused on virtual communities for elderly support. By
this, the virtual software community will allow the elderly to stay at home, and keep, to a certain extent,
their typical lifestyle. Telecare has effectively aidedopenness and efficient communication features
between health service users (old people) and the providers (doctors and nurses). This system would
allow elderly citizens to maintain

socially active and independent lifestyles, while maintaining a safety net of healthcare services when
needed
Intelligent agent has helped to curb the "queuing" issues in the hospital by providing Common-pool
Resources and Multi-agent System (CORMAS) (Page et al.
2000). It is a system that helps to propose the runtime waiting of health service users based on their
individual health challenges considering the patients’ medical condition severity/deteriorating
conditions to manage the resource (doctor
or nurse) allocation optimally to the urgent job first (based on patient condition). This system works
hand in hand with Agent based modelling and simulation of emergency department re-triage (AMSEDR)
(Rahmat et al. 2013). An application that is developed for the re-triage of patients who have come to
hospital’s
emergency department and are queued for medical service provisioning.

On the aspect of data management and record keeping of the patients, application of intelligent agents
has made provision for the Simulation Environment for the Optimization of the Data Retrieval
capabilities of an agent

based system in a Healthcare setting (SEODRH) ( Iqbal et al., 2016). In the research by Patriarca-Almeida
et al. (2011),
a simulation based study for optimization of MAS oriented data retrieval and integration
system that helps with the record keeping and retrieval of patient's medical data.

Despite the accredited successes of the application of intelligent agents in the health and wellness
industry, there are gaps which needs to be filled in the aspect of intelligent agents of the healthcare
sector.

intelligent agents have been unable to conform to the local, national and international regulations in
their area. The
use of deontic logic would be appropriate to formalise and

reason about the permissions and obligations of each agent in a

system.

Communication and Ontology barrier

Nealon and Moreno (2003) believes that there is a communication and ontological challenge in the
intelligent agent situation of the health sector. Bioinformatics and healthcare informatics are fields that
already have active
communities developing ontologies, yet the application of such
ontologies as OpenGALEN, Unified Medical Language
System (UMLS), Systematized Nomenclature of Human and Veterinary Medicine (SNOMED), has not
been productive or made any significant impact in the health sector despite the huge drive by health
care
professionals to bring bioinformatics and health care information into clinical workstations and onto the
Internet (Nealon and Moreno, 2003). It is highly important to address the communication issue as it
hinders the progress of intelligent agents in the health sector.

There are several gaps that can be filled in the application of intelligent agents within the health sector.
These gaps mainly revolve around improving healthcare delivery, enhancing patient care, and facilitating
efficient decision-making. Below are some of the key areas where the application of intelligent agents
can be beneficial:

1. Clinical Decision Support: Intelligent agents can be utilized to provide real-time clinical decision
support to healthcare professionals. By analyzing patient data, medical literature, and treatment
guidelines, these agents can suggest appropriate diagnoses, treatment options, and personalized care
plans. This can help improve the accuracy and timeliness of clinical decisions, reducing errors and
improving patient outcomes. [1]

2. Patient Monitoring and Remote Care: Intelligent agents can enable remote monitoring of patients'
health conditions. By collecting data from wearable devices, electronic health records, and other
sources, these agents can continuously track vital signs, detect anomalies, and alert healthcare providers
in case of emergencies or deteriorating conditions. This can help in proactive care management,
reducing hospital readmissions and enabling remote consultations. [2]

3. Health Information Management: Intelligent agents can assist in the efficient management and
analysis of health information. By automating tasks such as data entry, data coding, and data
integration, these agents can reduce administrative burden and improve the accuracy and accessibility
of medical records. Additionally, intelligent agents can facilitate data mining and predictive analytics to
identify patterns, potential outbreaks, and support population health management. [3]

4. Patient Engagement and Education: Intelligent agents can enhance patient engagement by providing
personalized health information, education, and self-management support. These agents can interact
with patients through conversational interfaces, answering their queries, providing medication
reminders, and offering lifestyle recommendations. This can empower patients to take an active role in
their healthcare and improve adherence to treatment plans. [4]

5. Healthcare Workflow Optimization: Intelligent agents can optimize healthcare workflows by

automating routine administrative tasks, scheduling appointments, and coordinating care across
different providers. By streamlining these processes, intelligent agents can reduce administrative errors,
improve resource allocation, and enhance overall operational efficiency in healthcare organizations. [5]

It should be noted that while intelligent agents have the potential to improve healthcare, there are also
challenges to be addressed. These include ensuring data privacy and security, integrating with existing
health information systems, addressing regulatory and ethical considerations, and ensuring trust and
acceptance among healthcare professionals and patients.

References:

[1] Peleg, M., & Tu, S. W. (2020). Supporting Clinical Decision-Making with Intelligent Agents: A Review
of Decision-Support Systems for Clinical Practice Guidelines. Yearbook of Medical Informatics, 29(01),
066–073.

[2] Koch, S. (2019). Opportunities for intelligent agents in health care. Journal of Medical Internet
Research, 21(11), e16176.

[3] Ross, J., & Keshav, S. (2019). Challenges for Emerging Applications of Intelligent Agents in Health
Care: A Commentary. Journal of Medical Internet Research, 21(1), e11945.

[4] Belani, H., & Raghavan, V. K. (2020). The Potential of Conversational Agents in Improving Patient
Engagement: Perspectives on Patient Needs and Expectations. Journal of Medical Internet Research,
22(9), e18951.

[5] Jensen, R. E., & Liyanage, H. A. R. (2019). Opportunities and Challenges of Intelligent Agents in
Healthcare: A Narrative Review. Yearbook of Medical Informatics, 28(01), 185–191.

Opportunity 1: AI-powered diagnosis and treatment recommendations

One significant gap in the health sector is the need for accurate and timely diagnosis of medical
conditions, as well as appropriate treatment recommendations. Intelligent agents can play a crucial role
in this aspect by leveraging artificial intelligence (AI) algorithms to analyze patient data, medical records,
and clinical guidelines to aid in the diagnosis process. These intelligent agents can help healthcare
professionals make more accurate and quicker diagnoses, leading to improved patient outcomes.

Reference:

- Holzinger, A., Langs, G., Denkinger, M., & Zatloukal, K. (2019). Machine learning models in electronic
health records can outperform conventional survival models for predicting patient mortality in coronary
artery disease. PLoS One, 14(1), e0209805.

Opportunity 2: Remote patient monitoring and personalized care

Another gap in the health sector is the need for continuous monitoring of patients, especially those with
chronic diseases or those who live in remote areas. Intelligent agents can address this gap by enabling
remote patient monitoring and providing personalized care. These agents can collect real-time patient
data, such as vital signs, activity levels, and medication adherence, and analyze it to identify patterns,
detect anomalies, and provide personalized recommendations for patients. This can help prevent
complications, reduce hospital readmission rates, and improve overall patient satisfaction.

Reference:

Iqbal, S. et al. (2016) ‘Application of intelligent agents in health-care: Review’, Artificial Intelligence
Review, 46(1), pp. 83–112. doi:10.1007/s10462-016-9457-y.

Jennings, N. and Wooldridge, M. (1998) ‘Applications of intelligent agents’, Agent Technology, pp. 3–28.
doi:10.1007/978-3-662-03678-5_1.

Nealon, J. and Moreno, A. (2003) ‘Agent-based applications in health care’, Applications of Software
Agent Technology in the Health Care Domain, pp. 3–18. doi:10.1007/978-3-0348-7976-7_2.

Shakshuki, E. and Reid, M. (2015) ‘Multi-agent system applications in healthcare: Current Technology
and Future roadmap’, Procedia Computer Science, 52, pp. 252–261. doi:10.1016/j.procs.2015.05.071.

- Tulu, B., Chatterjee, S., & Gupta, A. (2018). A Framework for Designing Telemedicine Systems with
Intelligent Human Computer Interfaces. International Journal of Telemedicine and Applications, 2018, 1-
11.
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Kumar S, Chandarkala D. A survey on customer churn prediction using machine learning techniques. Int.
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