Reinforcement learning (RL) is typically viewed as the problem of estimating single-step policies (for model-free RL) or single-step models (for model-based RL), leveraging the Markov property to factorize the problem in time. However, we can also view RL as a sequence modeling problem: predict a sequence of actions that leads to a sequence of high rewards. Viewed in this way, it is tempting to consider whether powerful, high-capacity sequence prediction models that work well in other supervised learning domains, such as natural-language processing, can also provide simple and effective solutions to the RL problem. To this end, we explore how RL can be reframed as one big sequence modeling problem, using state-of-the-art Transformer architectures to model distributions over sequences of states, actions, and rewards. Addressing RL as a sequence modeling problem significantly simplifies a range of design decisions: we no longer require separate behavior policy constraints, as is common in prior work on offline model-free RL, and we no longer require ensembles or other epistemic uncertainty estimators, as is common in prior work on model-based RL. All of these roles are filled by the same Transformer sequence model. In our experiments, we demonstrate the flexibility of this approach across imitation learning, goal-conditioned RL, and offline RL.

Reinforcement learning (RL) is typically viewed as the problem of estimating single-step policies (for model-free RL) or single-step models (for model-based RL), leveraging the Markov property to factorize the problem in time. However, we can also view RL as a sequence modeling problem: predict a sequence of actions that leads to a sequence of high rewards. Viewed in this way, it is tempting to consider whether powerful, high-capacity sequence prediction models that work well in other supervised learning domains, such as natural-language processing, can also provide simple and effective solutions to the RL problem. To this end, we explore how RL can be reframed as "one big sequence modeling" problem, using state-of-the-art Transformer architectures to model distributions over sequences of states, actions, and rewards. Addressing RL as a sequence modeling problem significantly simplifies a range of design decisions: we no longer require separate behavior policy constraints, as is common in prior work on offline model-free RL, and we no longer require ensembles or other epistemic uncertainty estimators, as is common in prior work on model-based RL.

Reinforcement Learning in Healthcare is typically concerned with narrow self-contained tasks such as sepsis prediction or anesthesia control. However, previous research has demonstrated the potential of generalist models (the prime example being Large Language Models) to outperform task-specific approaches due to their capability for implicit transfer learning. To enable training of foundation models for Healthcare as well as leverage the capabilities of state of the art Transformer architectures, we propose the paradigm of Healthcare as Sequence Modeling, in which interaction between the patient and the healthcare provider is represented as an event stream and tasks like diagnosis and treatment selection are modeled as prediction of future events in the stream. To explore this paradigm experimentally we develop MIMIC-SEQ, a sequence modeling benchmark derived by translating heterogenous clinical records from MIMIC-IV dataset into a uniform event stream format, train a baseline model and explore its capabilities.