A computer implemented system and method generates a patient-specific model of patient response to stimulation on a neural element basis, receives user-input of target neuromodulation sites, and, based on the patient-specific model, determines which stimulation paradigm and settings, including stimulation sites, would result in the target neuromodulation, where the stimulation sites are not necessarily the same as the resulting neuromodulation sites. The system outputs a visual representation of the stimulation sites that would result in the target neuromodulation. The system monitors a system state and/or patient state and dynamically changes which stimulation program to implement based on the state.