构建日常健康基础设施,让个人健康管理像水电支付一样无缝运行。
Personal Care Utility: Health as Everyday Infrastructure

- 提出分层事件驱动的个人健康架构PCU,整合连续生理信号
- 通过个体基线动态评估健康状态,生成个性化干预建议
- 分离临床决策与沟通逻辑,适合慢性病管理与隐私敏感场景
医疗体系设计为专家主导、偶发性服务,每年仅约1小时就诊时间,而其余8,759小时的饮食、睡眠、运动、用药和压力等日常行为才真正影响长期健康,却缺乏相应支撑基础设施。本文提出个人照护公用事业(Personal Care Utility, PCU),作为日常健康所需的通用基础设施,类比支付、网络和电力系统。PCU通过人本体(Personicle)将持续个人信号转化为语义化生活事件,基于个体基线动态估计健康状态,推断因果与上下文,并由编排器分层处理临床决策逻辑、行为策略选择与自然语言表达。该分离机制使大模型可支持推理与沟通,同时确保关键临床判断基于验证证据。以2型糖尿病为例,整合血糖监测、餐食、活动、用药、睡眠、压力及临床数据,形成血糖事件、个体化状态评估、因果解释与知识驱动干预。案例显示同一系统可实时提醒、周报总结、用药确认、静默或确定性安全警报,依情境与风险而定。论文最后探讨其向其他慢病扩展的可能性及始终在线健康工具的治理挑战。结果表明,个性化应是日常健康指导的架构属性,而非附加功能。
原文摘要 · Abstract (English)
Healthcare is essential, expert, and episodic by design - built around the roughly one hour per year a person spends with a clinician. The 8,759 hours outside clinical settings, where eating, sleeping, movement, medication, and stress actually shape long-term health, have no comparable infrastructure. The bottleneck for personalized health is not raw data or reasoning capability; it is the absence of that infrastructure layer. This paper introduces the Personal Care Utility (PCU): a layered, event-driven architecture proposed as the missing utility for everyday health, in the way that payments, networks, and power are utilities for their domains. PCU organizes continuous personal signals into semantically meaningful life events through a Personicle, estimates dynamic health state against personal baselines, reasons about cause and context, and routes guidance through an orchestrator that separates clinical decision logic, behavioral strategy selection, and natural-language expression. This separation lets large language models support reasoning and communication while keeping safety-critical clinical decisions grounded in validated evidence. We instantiate PCU for Type 2 Diabetes - turning CGM, meal, activity, medication, sleep, stress, and clinical data into glycemic events, individualized state estimates, causal explanations, and knowledge-grounded interventions. A day-in-the-life scenario shows the same infrastructure producing real-time nudges, weekly summaries, medication check-ins, silence, or deterministic safety alerts depending on context and risk. We close with how PCU generalizes to other chronic conditions and the governance questions any always-on personal health utility must address. The result is a blueprint that treats personalization not as a final messaging layer, but as an architectural property of everyday health guidance.
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