PIA: A Personal Intelligence Agent Turning Health Conversations into Records and Records into Understanding

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.

Patient-managed Personal Health Records (PHRs) promises to empower patients to better understand their health; but information in the record is complex, potentially hindering insights. In this study, we assess the potential of large language models (LLMs, Gemini 3.0 Flash) to provide helpful answers to user health queries, when provided clinical data from PHRs as context. A total of 2,257 user queries were drawn from 3 different distributions to represent patient questions: shorter web search queries, longer questions derived from templates of chatbot conversations, and questions patients asked to their healthcare team (patient calls). Queries were matched with de-identified PHRs (from a pool of 1,945). Gemini responses were generated (1) without PHR context; (2) with a basic summary of demographics, conditions, and medications; (3) with full, extensive clinical notes. For evaluation, we leveraged an existing rating framework (SHARP), and developed a new framework for specific error modes when interpreting PHRs. Evaluation was performed using autoraters for the full set, and with clinician ratings for a subset (n=95), with both sets of raters knowing the full PHR context. We see significant improvements in the helpfulness of answers to all question types with PHR data (p < 0.001, paired t-test). We also observe potential gains in safety, accuracy, relevance and personalization of answers. Our PHR evaluation framework further identifies gaps in LLM understanding of particular aspects of complex PHRs, such as temporal disorientation, and rare but meaningful confabulations. These results suggest potential for PHR data to help people with a wide range of user needs; and provide a framework for monitoring for gaps in LLM answers based on PHR context. This study motivates further work to assess and realize potential benefits to users from understanding their health records.

Personalized interpretation of health checkup results requires reasoning across longitudinal records, medical knowledge, lifestyle guidance, and healthcare navigation. We present a multi-agent large language model (LLM) system that identifies multiple intents, maps each to a task-specific agent, executes them in parallel, and synthesizes their outputs. We compared answers generated in Single Agent and Multi Agent settings on 120 Korean compound queries combining two to four requirements, using synthetic health checkup records. The Multi Agent improved the weighted LLM-judge score from 1.695 to 1.797 (p = 0.027), and three additional LLM judges showed consistent improvements ($Δ$ = +0.111 to +0.186, all p < 0.05). The gains came from usefulness, consistency, and the handling of every requirement in compound queries, whereas numerical accuracy and grounding improved significantly under only one of the four judges and medical safety did not differ, and critical failures occurred at similar rates (Single Agent 15.0% vs. Multi Agent 13.3%). Two human evaluators preferred Multi Agent in 66.7% and 68.3% of pairwise comparisons. Multi Agent execution increased latency and cost by 1.31$\times$ and 2.02$\times$, respectively. In exploratory subgroup analyses, the improvement was concentrated in queries involving personal-record lookup.