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ReLMem addresses the computational bottleneck of processing expanding patient histories in longitudinal EHR modeling by introducing a framework that maintains a fixed-capacity memory through recurrent compression. This approach allows large language models to integrate new clinical visits without rereading full historical records, significantly reducing storage costs while preserving predictive accuracy for downstream tasks like medication prediction. The method demonstrates that learning adaptive memory updates can effectively balance efficiency with the retention of critical historical evidence needed for complex medical AI applications.
ReLMem: Learning Recurrent Memory for Longitudinal EHR Modeling
arXiv:2609.37587v1 Announce Type: new Abstract: Longitudinal electronic health record (EHR) modeling requires integrating new visits with an expanding patient history. Yet the continual accumulation of clinical information imposes increasing computational and memory costs on large language models (LLMs) when they process and retain complete patient histories. A practical alternative is visit-wise recurrent compression, which incorporates each incoming visit into a compact, continually updated patient memory. However, under a fixed memory budget, successive updates must integrate new information without progressively losing critical historical evidence needed to subsequent tasks. To address this challenge, we introduce Recurrent Longitudinal Memory (ReLMem), a framework that learns to maintain fixed-capacity patient memory for efficient downstream prediction with a frozen LLM. ReLMem equips this LLM with lightweight compression adapters to recurrently update the memory from its previous state and each incoming visit, without rereading earlier records. Specifically, we develop a multi-granularity optimization strategy to preserve task-relevant information throughout recurrent updates and support downstream prediction from the final memory. The intermediate supervision aligns attention outputs from compressed memory and the full history under identical queries, while prediction supervision minimizes cross-entropy with ground truth answers conditioned on the final memory. On EHR-based medication prediction, ReLMem approaches the F1 scores of full-history baseline while reducing average retained historical storage by 97.1%. Under the same memory budget, it improves macro- and micro-F1 over the strongest compressed-memory baseline by 4.66 and 4.75 percentage points, respectively. These results highlight the value of learning recurrent patient memory for efficient longitudinal EHR modeling.
Abstract:Longitudinal electronic health record (EHR) modeling requires integrating new visits with an expanding patient history. Yet the continual accumulation of clinical information imposes increasing computational and memory costs on large language models (LLMs) when they process and retain complete patient histories. A practical alternative is visit-wise recurrent compression, which incorporates each incoming visit into a compact, continually updated patient memory. However, under a fixed memory budget, successive updates must integrate new information without progressively losing critical historical evidence needed to subsequent tasks. To address this challenge, we introduce Recurrent Longitudinal Memory (ReLMem), a framework that learns to maintain fixed-capacity patient memory for efficient downstream prediction with a frozen LLM. ReLMem equips this LLM with lightweight compression adapters to recurrently update the memory from its previous state and each incoming visit, without rereading earlier records. Specifically, we develop a multi-granularity optimization strategy to preserve task-relevant information throughout recurrent updates and support downstream prediction from the final memory. The intermediate supervision aligns attention outputs from compressed memory and the full history under identical queries, while prediction supervision minimizes cross-entropy with ground truth answers conditioned on the final memory. On EHR-based medication prediction, ReLMem approaches the F1 scores of full-history baseline while reducing average retained historical storage by 97.1%. Under the same memory budget, it improves macro- and micro-F1 over the strongest compressed-memory baseline by 4.66 and 4.75 percentage points, respectively. These results highlight the value of learning recurrent patient memory for efficient longitudinal EHR modeling.
Machine Learning (cs.LG); Artificial Intelligence (cs.AI)
arXiv:2609.37587 [cs.LG]
(or arXiv:2609.37587v1 [cs.LG] for this version)
https://doi.org/10.48550/arXiv.2609.37587 Focus to learn more arXiv-issued DOI via DataCite (pending registration)
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