At the lowest level, knowledge is represented by means of practice guidelines. Guidelines are grouped into categories, according to the guideline's purpose. When a single category contains a number of guidelines, a panel of physicians analyses them and extracts a number of features, defining a task specification. This specification is then implemented into the reminder system and into the KBE, after which physicians are able to revise the terms and relations of the defined task structure. Although the KBE and the reminder system are in practical use only for a few months now, the first results are promising.
Physicians are able to enter guidelines without assistance of a knowledge engineer.
When they have entered enough instances of a task, they are able to extract and describe a task's general features. We believe that this bottom-up strategy, combined with automated knowledge acquisition tools, enables medical specialists themselves to improve the quality of the knowledge base, the EPR, and hopefully, of the care in critical care environments such as ICUs.