Mercy Receives PCORI Funding to Expand AI-Driven Smart Texting Program

The ACCC Innovator Awards are an annual opportunity to recognize ACCC Cancer Program Members who are revolutionizing the way we deliver cancer care today, so that other programs can see firsthand the incredible work being done in all aspects of oncology and implement these strategies at their own programs. The awards also serve to elevate winning programs so they can receive the necessary support to continue refining and expanding their innovations.  

Mercy Health is a prime example of one such program, as the institution received a 2020 ACCC Innovator Award for its predictive algorithm that identifies and manages chemotherapy patients at high risk of hospital admissions or emergency department (ED) visits, a 2024 ACCC Innovator Award for expanding this model to include AI-driven smart texting, and—more recently—a 4-year funding award from the Patient-Centered Outcomes Research Institute (PCORI). 

“The coordination required from our team to submit an ACCC Innovator Award application allowed us to solidify our goals and mission with the Chen Model and our smart texting initiative,” said Jay Carlson, DO, medical director of the oncology service line and clinical research chair for Mercy Research. “There is no doubt in my mind that the addition of smart texting left Mercy well-positioned for the PCORI award.” 

Expanding the Reach of Smart Texting 

Mercy’s Chen Model currently sends texts to high-risk patients receiving chemotherapy; with its PCORI funding, Mercy will create an electronic patient-reported outcome (ePRO) pathway for all patients over the age of 18, regardless of their type of cancer. This larger group will include patients with leukemia, who were originally excluded from the Chen Model because it was aligned with the Centers for Medicare & Medicaid Services OP-35 initiative.  

“We will also be incorporating questions over more domains within the smart texting function,” Dr. Carlson explained. “Currently, our questions are related to the symptom domain, but with this funding, we will create a functional domain, a behavioral health domain, and a social determinants of health domain.” 

In line with Mercy’s mission to provide innovative, personalized care for its patient population, the program also plans to use its funding to improve the user interface component of its smart texting initiative.  

“When a patient receives a text via their smartphone, they need to respond in MyMercy [in Epic], so it pushes them from one platform to another,” Dr. Carlson said. “We believe most patients would prefer to communicate solely via their smartphone, so we are exploring solutions to shift the EHR component to a phone interface.” It is small changes like these that reduce burden for patients that make the biggest difference in adherence and utilization of services. 

Embracing Telehealth to Reduce Hospitalizations 

Across Mercy’s health system, different health care professionals—such as medical assistants, nurse practitioners, and advanced practice providers (APPs)—are responding to ePROs as they come in, depending on location. In the future, Mercy’s team is looking to establish a centralized team that can provide virtual visits for patients who have an acute issue.  

“To achieve our goal of preventing unnecessary visits to the ED and hospital admissions, we need a standardized response and a standardized workflow so we can manage patients through ambulatory services instead,” said Dr. Carlson.  

Michelle Eichelmann, executive director of oncology, integrative medicine, and precision medicine at Mercy, added that there is tremendous opportunity to leverage telehealth in the smaller communities Mercy serves. “Allowing these patients to have access to the same high-quality care as larger communities is critically important to patient education and patient management,” she said. 

Leaning on APPs in a Workforce Shortage 

With the national oncology workforce shortage still at the forefront of challenges in cancer care, Mercy is using more than just technological innovation to reduce burnout among providers. The program is also leveraging APPs to triage at-risk patients and provide symptom management when possible, thereby freeing up oncologists to see new patients and patients with more complex cases. 

“Our utilization of APPs varies considerably across our health system. Some locations have more APPs than physicians, while others have 9 physicians and only 1 APP,” Dr. Carlson noted. Because of this variation, Mercy developed a standardized process to ensure balanced workloads for its oncologists. Once a provider reaches a certain number of relative value units (a metric that defines the value of a medical service or procedure), they are required to incorporate an APP in their patient encounters—typically for follow-up visits or for hematology. 

Mercy also leverages its APPs for patient education, from chemotherapy teaching encounters to shared decision-making, as well as same-day appointments that can take the place of an ED visit. 

“We have a vision of how we would like to see APPs utilized in our program, but we need more of them,” stated Dr. Carlson. “This will be a cultural change for our providers, and it will take a bit of time to see it fully realized.” 

A Continued Commitment to Improving the Patient Experience 

Dr. Carlson reaffirmed the role that the ACCC Innovator Award program played in Mercy’s overall success with the Chen Model and its smart texting initiative. “When it came time for our presentation at the ACCC National Oncology Conference and drafting an article for Oncology Issues, it forced us to re-examine our data with a fine-tooth comb, which is how we identified issues different communities were having with the smart texting,” he explained. “This award and the entire process pushed us to keep our finger on the pulse and make the necessary corrections quickly.” 

Mercy is transforming cancer care through technology that is both innovative and patient-centric, and its 4-year funding award from PCORI positions this program to reach a broader patient population than ever before. As the program evolves, Mercy’s commitment to enhancing the user experience of its smart texting innovation is setting a new standard for proactive, accessible, and equitable cancer care—offering a powerful model for other institutions to follow. 

Read more about Mercy’s 2020 and 2024 Innovator Awards and the 6-part blog series covering the 2025 ACCC Innovators.