The Dilemma project has addressed clinical, technical and methodological questions in the design and implementation of aids for medical decision making and patient management. Technically, the project has focused on the use of logic programming and knowledge-based methods for constructing a generic technology to support clinical decision making, and for assisting in the scheduling and execution of clinical tasks in protocol-based care. Dilemma has succeeded in integrating its generic decision support technology and electronic health care record with existing clinical information systems in a number of clinical domains, thereby adding value in such areas as patient data entry and retrieval and knowledge based and hypermedia access to clinical knowledge and data. Applications of the technology have been developed in oncology, cardiology and primary care, and in telematic communication and coordination for multi-site shared care. Project activities have been underpinned by a methodology for establishing clinical and functional requirements for decision support systems, and a generic business model which formalises protocol-based care.