arXiv:2609.12277v1 Announce Type: cross Abstract: Electronic health record (EHR) foundation models trained on longitudinal patient trajectories have demonstrated strong performance across diverse clinical prediction tasks. However, their clinical reasoning capabilities remain constrained by next-token prediction on limited and incomplete EHR data. To address this, we propose a reinforcement learning (RL) fine-tuning framework that treats EHR foundation models as generative policies over patient trajectories. We formulate common clinical prediction problems (e.g., hospital readmission) as event-conditioned, time-windowed reasoning tasks. We then design time-aware, rollout-sensitive rewards to account for finite rollout lengths and temporally inconclusive outcomes. We find that RL fine-tuning consistently improves over pre-trained backbones and strong baselines. Notably, it enables smaller models to surpass larger pre-trained models in data-limited regimes and induces positive transfer across tasks. Further analysis shows that RL fine-tuned models generate trajectories with stronger structural and semantic alignment to ground truth and greater downstream utility.

arXiv:2603.03296v1 Announce Type: cross Abstract: Long-term memory is essential for large language model (LLM) agents operating in complex environments, yet existing memory designs are either task-specific and non-transferable, or task-agnostic but less effective due to low task-relevance and context explosion from raw memory retrieval. We propose PlugMem, a task-agnostic plugin memory module that can be attached to arbitrary LLM agents without task-specific redesign. Motivated by the fact that decision-relevant information is concentrated as abstract knowledge rather than raw experience, we draw on cognitive science to structure episodic memories into a compact, extensible knowledge-centric memory graph that explicitly represents propositional and prescriptive knowledge. This representation enables efficient memory retrieval and reasoning over task-relevant knowledge, rather than verbose raw trajectories, and departs from other graph-based methods like GraphRAG by treating knowledge as the unit of memory access and organization instead of entities or text chunks. We evaluate PlugMem unchanged across three heterogeneous benchmarks (long-horizon conversational question answering, multi-hop knowledge retrieval, and web agent tasks). The results show that PlugMem consistently outperforms task-agnostic baselines and exceeds task-specific memory designs, while also achieving the highest information density under a unified information-theoretic analysis. Code and data are available at https://github.com/TIMAN-group/PlugMem.