A Framework for Longitudinal Health AI Agents

Personal health management unfolds over repeated encounters, yet most health AI systems treat each request in isolation. We developed HealthClaw, an open-source agent architecture that updates support as a person's routines, preferences, measurements and risks change. It separates shared safety rules and medical knowledge from private longitudinal memory containing profile facts, reusable procedures and episodic traces. After each episode, induction determines what should update the profile, revise a procedure, remain episodic or be excluded. We evaluated HealthClaw with a synthetic year-long benchmark and nine 200-case biomedical tasks. Across 900 longitudinal support probes, answer accuracy increased from 0.2% with current-query prompting to 45.7% with HealthClaw, while prompt-side context exposure was 71.7% lower than with full-history prompting. In 100 privacy probes, HealthClaw produced higher privacy-aware answer quality and fewer unsafe disclosures than both baselines. Across the biomedical tasks, the mean absolute gain in the task-specific primary metric was 27.0 percentage points, and seven gains remained significant after false-discovery-rate correction. These offline benchmarks support governed, self-evolving memory for longitudinal personal health agents, although clinical effectiveness requires prospective evaluation. HealthClaw is publicly available at https://github.com/HC-Guo/HealthClaw.

Large language model based health agents are increasingly used by health consumers and clinicians to interpret health information and guide health decisions. However, most AI systems in healthcare operate in siloed configurations, supporting individual users rather than the multi-stakeholder relationships central to healthcare. Such use can fragment understanding and exacerbate misalignment among patients, caregivers, and clinicians. We reframe AI not as a standalone assistant, but as a collaborator embedded within multi-party care interactions. Through a clinically validated fictional pediatric chronic kidney disease case study, we show that breakdowns in adherence stem from fragmented situational awareness and misaligned goals, and that siloed use of general-purpose AI tools does little to address these collaboration gaps. We propose a conceptual framework for designing AI collaborators that surface contextual information, reconcile mental models, and scaffold shared understanding while preserving human decision authority.

Wearable health questions often combine data retrieval, longitudinal analysis, and health advice over structured records. Prompting a single large language model with a complete record and a composite query obscures whether every request is executed and which evidence supports the answer. We propose a task-oriented multi-agent framework that represents a composite query as distinct intents and typed tasks with explicit intra-intent dependencies. Specialized agents execute retrieval, analysis, and advice tasks; isolated intent states preserve request boundaries and evidence relationships before aggregation. We evaluate the framework on a synthetic dataset of $10{,}000$ virtual users with one month of longitudinal wearable records, covering structured data retrieval, multi-intent recognition, and overall response quality. Across $1{,}500$ retrieval questions, the Query Agent achieves $98.3\%$ accuracy, compared with $97.9\%$ for the Direct LLM baseline, while reducing average query-stage token consumption from $6{,}869$ to $3{,}136$. On $180$ multi-intent questions, the Manager Agent achieves $100.0\%$ Multi-Intent Coverage and $94.4\%$ Multiset Jaccard Similarity. Under the current synthetic evaluation setting, our method receives higher mean Trustworthiness and Transparency scores on both question categories, whereas Actionability does not improve consistently. These results provide preliminary evidence that explicit task organization can support task-relevant data access and data-grounded longitudinal analysis, while leaving health advice generation and validation on real wearable data as open challenges.