# MedCache: Efficient and Temporally Valid Memory for Longitudinal Clinical Agents

arXiv: https://arxiv.org/abs/2608.29528 · HTML: https://mlsanity.com/paper/2608.29528/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 12 of its 27 references that are in the map.
- First posted on arXiv 30 Aug 2026.

## Builds on (most cited first, 12 of 12)

- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [MemGPT: Towards LLMs as Operating Systems](https://mlsanity.com/paper/2310.08560/) (2023)
- [SGLang: Efficient Execution of Structured Language Model Programs](https://mlsanity.com/paper/2312.07104/) (2023)
- [A Survey on the Memory Mechanism of Large Language Model based Agents](https://mlsanity.com/paper/2404.13501/) (2024)
- [Zep: A Temporal Knowledge Graph Architecture for Agent Memory](https://mlsanity.com/paper/2501.13956/) (2025)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [MemAgent: Reshaping Long-Context LLM with Multi-Conv RL-based Memory Agent](https://mlsanity.com/paper/2507.02259/) (2025)
- [MedAgentBench: A Realistic Virtual EHR Environment to Benchmark Medical LLM Agents](https://mlsanity.com/paper/2501.14654/) (2025)
- [MedXIAOHE: A Comprehensive Recipe for Building Medical MLLMs](https://mlsanity.com/paper/2602.12705/) (2026)
- [ClinicalAgents: Multi-Agent Orchestration for Clinical Decision Making with Dual-Memory](https://mlsanity.com/paper/2603.26182/) (2026)

## Built on by (most cited first, 1 of 1)

- [Personalized State-Transition-Aware Memory for Clinical Agents](https://mlsanity.com/paper/2609.38490/) (2026)

## Abstract (arXiv)

Longitudinal clinical agents must maintain an evolving patient state from evidence distributed across visits, time points, and specialties. However, how agent memory should be designed for this setting remains unclear. We introduce a benchmark of multi-visit, multi-specialty patient records that evaluates long-context evidence retrieval, cross-time evidence aggregation, and cross-specialty clinical reasoning. Using this benchmark, we systematically study four memory design choices: curation, organization, retrieval, and memory-augmented reasoning. We find that temporal validity is more important than simply retaining more history; specialty-factorized memory reduces context but can hide shared evidence; and multiple agents help when specialists must reason together, not merely when evidence comes from multiple memories. Guided by these findings, we propose textitMedCache, a hybrid framework that constructs temporally valid patient memory, organizes evidence into overlapping specialty views, routes each query to relevant memories, and adaptively invokes one or multiple specialists. Experiments show that MedCache improves reasoning accuracy and memory efficiency over strong single-agent and multi-agent baselines, while generalizing across model backbones and external datasets.