The Patient Is Not a Moving Document: Why Clinical AI Needs World Models
A patient chart looks like a document because hospitals make it look that way. There are notes, medication lists, lab panels, procedure codes, imaging references, adverse events, survival outcomes, and enough timestamps to make a database administrator feel briefly useful. So it is tempting to treat the electronic health record as a very long piece of text: serialize the events, train a model to predict the next token, extract an embedding, and hope that clinical meaning emerges somewhere inside the transformer fog. ...