Electronic Health Record (EHR) prediction models in the intensive care unit must learn from sparse and irregular measurements while preserving the clinical meaning of time and supporting transparent decision-making. We present INTERVenE, a family of Transformer architectures whose input is an interval-based, knowledge-based temporal abstraction (KBTA), a token stream of named clinical concepts (states, trends, events, contexts) drawn from a curated medical ontology, rather than an unnamed bin index or a raw measurement triplet. This naming layer is what we ask KBTA to do: it makes the model's per-token attributions resolve to clinical concepts by construction. INTERVenE offers two complementary variants: an auto-regressive decoder that generates future abstraction trajectories with a per-step risk readout (localizing \emph{when} and \emph{after which events} risk rises), and a bidirectional encoder for single-pass joint risk and time-to-event prediction. Evaluated on 57,078 MIMIC-IV admissions against GRU-D, STraTS, and KarmaLego, INTERVenE-Enc reaches a support-weighted AUPRC$_w$ of 0.672, improving by 0.041 over the strongest neural baseline with non-overlapping 95\% bootstrap CIs, while also taking the best AUROC$_w$ (0.901) and length-of-stay MAE (44.4\,h). INTERVenE-Ar (AUROC$_w$ $0.854$, AUPRC$_w$ $0.587$ under the same evaluation contract - a strictly harder generative readout) provides a complementary token-level risk trajectory. An input-representation ablation confirms the lift transfers across structured discretizations, positioning KBTA-based intervals as the interpretable substrate that makes per-token attributions resolve to meaningful clinical concepts within the deployed model.
Hierarchical state-space models (HSSMs) offer a promising approach to long-horizon prediction by segmenting sequences into temporal chunks. However, their performance hinges on how chunk boundaries are determined. While prior HSSMs typically rely on fixed-length chunking or similarity-based boundary detection, these methods often misalign with the intrinsic temporal structure of the data. We argue that chunking should instead be driven by prediction errors, which more directly indicate when longer-range context becomes necessary. Nevertheless, integrating surprise-based chunking into HSSMs introduces critical challenges, including hierarchical collapse during end-to-end training and the absence of surprise signals during open-loop prediction. To address these issues, we propose Surprise-based Nested Temporal Abstraction (SUNTA), a method that employs a decoupled training strategy to preserve surprise signals and uses internal inconsistency as a top-down surprise metric to determine chunk boundaries within imagined rollouts. Experiments on video prediction tasks in 2D and 3D environments demonstrate that SUNTA outperforms baselines, uniquely maintaining accurate predictions over 250 timesteps, whereas all baselines degrade within the first 10 timesteps.