How Electronic Patient-Reported Outcomes Are Transforming Symptom Management and Value-Based Cancer Care
In this interview, Deborah Patt, MD, PhD, MBA, discusses data presented at the 2026 American Society of Clinical Oncology Annual Meeting showing how electronic patient-reported outcomes and remote therapeutic monitoring can improve symptom management, reduce hospitalizations and total cost of care, and support the future of value-based oncology care.
Please share your name, title, and a brief overview of your professional history.
Debra Patt, MD, PhD, MBA: My name is Debra Patt. I serve as Executive Vice President of Policy and Strategy at Texas Oncology, and I am President of the Community Oncology Alliance.
My clinical expertise is in breast cancer, but I spend a great deal of time working in public policy, clinical informatics, and business strategy to support cancer care.
Could you share a brief overview of the study you presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting and your key findings?
Dr Patt: Let me begin by saying that controlling patient symptoms is critically important. There is a central axiom that, when patients are receiving therapy for cancer, the faster we can intervene and control their symptoms, the more likely they are to be successful with that therapy. That concept has been understood for a long time.
In 2017, Ethan Basch, MD, presented data on the use of electronic patient-reported outcomes (ePROs) in patients with advanced cancer and demonstrated that patients were able to remain on therapy longer and actually live longer when ePROs were used to manage symptoms. The rationale was to reduce the time it takes for patients to report symptoms, particularly because patients may sometimes be reluctant to report them.
Texas Oncology has participated in numerous research initiatives focused on improving symptom management. We implemented ePROs in 2020 and presented those implementation data at ASCO before subsequently publishing them in JCO Clinical Cancer Informatics. We later evaluated outcomes, including emergency department visits, hospitalizations, and total cost of care, all of which were reduced among patients with advanced cancer who used ePROs while receiving therapy.
What we presented at ASCO this year was different. It was a collaboration with our ePRO vendor, Canopy, which has been an outstanding partner in this initiative. Canopy aggregated data from practices using ePROs among patients receiving active cancer treatment and demonstrated reductions in hospitalizations as well as decreases in total cost of care.
Although these findings are not entirely new—given that Dr Basch first demonstrated the benefits of ePROs in 2017, and we presented similar findings from our own practice in 2023—the important observation is the consistency of the results. Across multiple practices and large patient populations, the findings consistently show that ePROs can improve symptom management, reduce hospitalizations, and decrease the total cost of care for patients receiving active cancer treatment.
The study found significant reductions in hospitalizations among patients using the Canopy platform. What factors do you think drove those results?
Dr Patt: There is a great deal happening behind the scenes. It is not simply that patients report their symptoms. You also need a vendor that effectively facilitates symptom reporting.
Canopy has been an excellent partner in proactively engaging patients and encouraging participation with the ePRO tool. We have worked with multiple vendors, and this level of patient engagement has been a real differentiator.
Another important aspect, which was not discussed extensively during the presentation, is that Canopy has introduced artificial intelligence (AI) tools that make care-management pathways more accessible to nurses. These tools help reduce decision fatigue, improve efficiency, and allow nurses to practice at the top of their license.
All of these operational improvements help integrate ePROs more effectively into clinical practice. Ultimately, the key finding is that successful implementation of these tools is associated with fewer hospitalizations and lower total costs of care.
From a business strategy perspective, practices must think carefully about how to adopt technologies that truly advance value-based care and improve patient outcomes. Operational considerations are extremely important. As practices pursue digital transformation, they need vendor partners who will help them implement solutions successfully, integrate them into workflows, and support staff in working at the top of their license.
How did the care team use patient-reported symptom data in real time, and can you share an example of an intervention that may have helped a patient avoid hospitalization?
Dr Patt: Absolutely.
Patients receiving active cancer therapy are prompted to report symptoms at least once weekly, and they can also report symptoms on demand. In certain disease states or with particularly high-risk therapies—for example, bispecific antibodies—patients may be queried much more frequently.
The information is routed to a team of remote triage nurses who use care-management pathways and are empowered to intervene based on the symptoms being reported.
For example, I had a patient with advanced breast cancer who was receiving a therapy associated with gastrointestinal toxicities, including nausea, vomiting, and diarrhea. Shortly after beginning treatment, she reported significant diarrhea.
My nurse was able to intervene immediately by instructing her to hold the medication, begin loperamide therapy, and ensure adequate hydration. The nurse also communicated the intervention plan to me through the established care pathway.
Once the patient’s symptoms resolved, I was able to restart therapy at a reduced dose that was more appropriate and less likely to cause gastrointestinal adverse effects.
As a result, the patient avoided an emergency department visit for dehydration and severe diarrhea. Left untreated, diarrhea, nausea, and vomiting can lead to dehydration, hypotension, and potentially life-threatening complications.
By intervening early—holding the medication, initiating antidiarrheal treatment, and encouraging hydration—we were able to prevent escalation and avoid hospitalization.
When we intervene early, we have an opportunity to calm the storm before it arrives.
Given the potential cost savings and improved outcomes observed in this study, what role do you see remote therapeutic monitoring playing in the future of community oncology care?
Dr Patt: I believe electronic patient-reported outcomes and remote therapeutic monitoring will become the standard of care for patients receiving active cancer treatment.
The goal of modern cancer therapy is for patients to live with their cancer controlled while minimizing the impact of treatment on their daily lives. By maintaining close symptom control and intervening early, we can help patients have the best possible treatment experience while continuing to work, spend time with their families, and maintain their quality of life.
Patients want on-demand symptom management and on-demand care. Our health care system is often too inefficient to provide that consistently.
Any steps practices can take to improve the patient experience are highly valuable, and I believe these approaches will become standard practice moving forward.
Is there anything else you would like the audience to take away from this presentation?
Dr Patt: As someone who co-leads our digital transformation efforts, I spend a great deal of time thinking about digital transformation in oncology.
I often talk about the “road to nirvana,” with nirvana representing the ideal practice we aspire to become. We may never fully arrive there, but we can continue moving closer over time.
Many people think digital transformation involves adopting a single vendor solution. In reality, the journey involves many steps. Practices need a clear roadmap and vendor partners that are willing to evolve alongside them.
Our partnership with Canopy has been particularly successful because they have adapted to our changing needs. We have worked together to co-develop solutions that support patients, and I am very grateful for that collaboration.
Implementation is challenging. Whenever a practice introduces new digital tools, obstacles will arise.
That is why having a strong partner is so important. You want a partner that will help guide you through the process and contribute to long-term success.
