# PatientWM: Towards Generalizable Clinical World Models via Unified Patient States

arXiv: https://arxiv.org/abs/2610.17059 · HTML: https://mlsanity.com/paper/2610.17059/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and surgical world models, one of 11 directions in World models.
- Builds on 25 of its 43 references that are in the map.
- First posted on arXiv 12 Oct 2026.

## Placed in

- World models / [Medical and surgical world models](https://mlsanity.com/wm/medical-and-surgical-world-models/)

## Builds on (most cited first, 25 of 25)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Dream to Control: Learning Behaviors by Latent Imagination](https://mlsanity.com/paper/1912.01603/) (2019)
- [World Models](https://mlsanity.com/paper/1803.10122/) (2018)
- [Genie: Generative Interactive Environments](https://mlsanity.com/paper/2402.15391/) (2024)
- [DayDreamer: World Models for Physical Robot Learning](https://mlsanity.com/paper/2206.14176/) (2022)
- [RETAIN: An Interpretable Predictive Model for Healthcare using Reverse Time Attention Mechanism](https://mlsanity.com/paper/1608.05745/) (2016)
- [Driving into the Future: Multiview Visual Forecasting and Planning with World Model for Autonomous Driving](https://mlsanity.com/paper/2311.17918/) (2023)
- [Reinforcement Learning in Healthcare: A Survey](https://mlsanity.com/paper/1908.08796/) (2019)
- [Multitask learning and benchmarking with clinical time series data](https://mlsanity.com/paper/1703.07771/) (2017)
- [Scalable and accurate deep learning for electronic health records](https://mlsanity.com/paper/1801.07860/) (2018)
- [Understanding World or Predicting Future? A Comprehensive Survey of World Models](https://mlsanity.com/paper/2411.14499/) (2024)
- [Deep EHR: A Survey of Recent Advances in Deep Learning Techniques for Electronic Health Record (EHR) Analysis](https://mlsanity.com/paper/1706.03446/) (2017)
- [MOTOR: A Time-To-Event Foundation Model For Structured Medical Records](https://mlsanity.com/paper/2301.03150/) (2023)
- [Deep Representation Learning of Patient Data from Electronic Health Records (EHR): A Systematic Review](https://mlsanity.com/paper/2010.02809/) (2020)
- [Medical World Model: Generative Simulation of Tumor Evolution for Treatment Planning](https://mlsanity.com/paper/2506.02327/) (2025)
- [EHRWorld: A Patient-Centric Medical World Model for Long-Horizon Clinical Trajectories](https://mlsanity.com/paper/2602.03569/) (2026)
- [medDreamer: Model-Based Reinforcement Learning with Latent Imagination on Complex EHRs for Clinical Decision Support](https://mlsanity.com/paper/2505.19785/) (2025)
- [ChronoMedicalWorld: A Medical World Model for Learning Patient Trajectories from Longitudinal Care Data](https://mlsanity.com/paper/2605.21963/) (2026)
- [CLARITY: Medical World Model for Guiding Treatment Decisions by Simulating Context-Aware Disease Trajectories](https://mlsanity.com/paper/2512.08029/) (2025)
- [Medical world models: representing medical states, modelling clinical dynamics and guiding intervention policies](https://mlsanity.com/paper/2606.16721/) (2026)
- [Medical world models in healthcare: foundations, applications, and challenges for trustworthy clinical translation](https://mlsanity.com/paper/2607.25242/) (2026)
- [Toward World Modeling of Physiological Signals with Chaos-Theoretic Balancing and Latent Dynamics](https://mlsanity.com/paper/2605.15465/) (2026)
- [Beyond Patient Invariance: Learning Cardiac Dynamics via Action-Conditioned JEPAs](https://mlsanity.com/paper/2604.22618/) (2026)
- [Agentifying Patient Dynamics within LLMs through Interacting with Clinical World Model](https://mlsanity.com/paper/2605.14723/) (2026)
- [Intervention-Aware Clinical World Model for Post-Op Outcome Forecasting in Cardiology](https://mlsanity.com/paper/2608.13518/) (2026)

## Abstract (arXiv)

Clinical decisions depend on anticipating how a patient's condition will evolve as treatment is adjusted and new evidence becomes available. Existing medical world models capture patient-state evolution, but often define the evolving state around a particular modality or task, limiting reuse as inputs or prediction targets change. These models also retain history through observation sequences or recurrent or latent summaries rather than exposing preceding patient states and clinical actions as an ordered transition context. This distinction matters because similar current measurements may follow different recent changes, treatment exposures, and observed responses. To tackle these limitations, we propose PatientWM, a clinical world-model framework built around a unified patient state and sequential latent history. Availability-aware encoders integrate observations available at each decision time into the patient state, while typed decoders produce task-specific clinical readouts without defining the state around any single target. PatientWM further conditions each next-state prediction on the current state and supplied action together with a bounded, ordered history of preceding latent patient states and clinical actions, preserving recent treatment and response context. Experiments across MIMIC-III, MIMIC-IV, and three external clinical datasets show superior performance in clinical prediction, multi-step forecasting, and action-planning evaluation. Transfer experiments further demonstrate the generalizability of PatientWM's patient state. Together, these results establish its ability to forecast clinical evolution and support planning.