From Prediction to Action: Population Health World Model for Digital Medicine

Abstract

Digital medicine now captures data that traces individual health trajectories and reveals population health dynamics through electronic health records, claims, remote monitoring, wearable devices, mobile devices, social sensing data, medical images, etc. But much of its modeling still centers on task-specific, outcome-specific, and prediction-specific estimation. The next frontier is not simply better prediction, but action in an evolving health world shaped by multiple decision-makers, heterogeneous populations, resource constraints, and feedback in care delivery. This is why digital medicine now needs world models: not only to estimate what will happen, but to represent how actions change what can happen next -- whom to prioritize, how to allocate scarce resources, how to adapt care across subgroups, and how interventions reshape future health trajectories and population dynamics. We call such a model population health world model (PHWM): a more foundational representation of an evolving health world in which health states, individual trajectories, population health dynamics, interventions, constraints, and feedback are intrinsically coupled. Building a PHWM endows three unmet structural gaps in current digital medicine: dynamic health-state modeling, population-level intervention intelligence, and validation, equity, and governance for action-oriented use. We argue that addressing these gaps requires three minimal capabilities: representation learning under action-dependent observation, multi-scale intervention intelligence, and validation with explicit decision boundaries, while highlighting the importance of social, contextual, and public-health sensing data for action-oriented digital medicine.