Many different computer-assisted management systems for Computer Interpretable Guidelines (CIGs) have been developed. While CIGs propose evidence-based treatments of “typical” patients, exceptions may arise, as well the need to cope with comorbidities. Though the treatment of both phenomena involves a deviation from the “standard” execution of CIGs, until now they have been managed as different problems, and no homogeneous approach to cope with both of them has been devised. In this paper we present the extensions to META-GLARE to overcome such a limitation. To achieve such a goal, we propose a modular architecture supporting the concurrent execution of multiple guidelines, integrated with an ontological knowledge base and with several reasoning mechanisms, including temporal reasoning and goal-based planning.