Software development in biomedicine continues to face challenges due to many factors including the complexity of the field, communication difficulties between healthcare professionals and software developers, and lack of standards that would facilitate communication among multiple institutions. In this work, approaches to dealing with biomedical decision making are discussed with implications in modeling the status of each patient on an individual basis. The software is based on an intelligent agent structure that incorporates a number of reasoning paradigms and a variety of input parameters ranging from text description to numerical data. The methods are illustrated in an application for cardiac diagnosis.