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Cancer care does not pause when a patient leaves the clinic. For many patients with cancer, especially those actively receiving treatment, the hardest hours can arrive quietly at home, when new pain develops, fatigue becomes overwhelming, or social-related needs begin to affect care.
When issues arise, patients often hesitate to reach out to their care teams. Some worry about overreacting; others don’t want to “bother” their care team. Many feel uncertain about what’s normal during treatment or feel uncomfortable calling. In fact, study data show that as few as 10% of patients with cancer call before going to the emergency department.1 As a result, symptoms that begin as subtle changes can escalate into urgent situations before clinicians even know they exist.
Silence, in oncology, can be the most dangerous symptom. Patients do not always know when something is serious, and many simply do not want to burden the team. At Highlands Oncology, one of the largest independent oncology practices in Arkansas, we needed a way to hear from patients sooner—before a quiet concern turned into a crisis. Our journey began years before remote patient monitoring became mainstream in community oncology, driven by the belief that technology, when implemented thoughtfully, can break down barriers to between-visit care.
The Promise of Remote Symptom Monitoring
Remote monitoring through electronic patient-reported outcomes (ePROs) offers a structured way for patients to share symptoms they experience in real time through digital tools. When integrated into triage workflows, ePROs can help triage nurses intervene early and catch problems before they become bigger issues.
Evidence supporting the clinical impact of ePROs is strong. In landmark randomized studies, Ethan Basch, MD, MSc, FASCO, demonstrated that routine symptom reporting during cancer treatment led to:
• Improved quality of life
• Fewer emergency department visits and hospitalizations
• Longer time on treatment
• Improved overall survival by 20%.2-4
These findings established a compelling clinical truth: When oncology teams hear from patients between visits and can proactively respond, patient outcomes improve.
For Highlands, this finding aligned with an existing philosophy. “When patients are struggling at home, we need to know—not after the fact,” Hughes shared. “Remote monitoring offered a real path to delivering on that need at scale.”
Launching Remote Monitoring During the Oncology Care Model
Highlands first implemented remote symptom monitoring during the Oncology Care Model (OCM) to reduce avoidable hospital utilization and improve patient-centered care.
In June 2020, Highlands partnered with Canopy, a leader in enterprise artificial intelligence (AI) for oncology, to implement an ePRO program across 3 sites. The care teams at Highlands partnered closely with Canopy to embed reporting and triage decision support directly into clinical workflows. Staff training occurred on site, and Canopy team members joined daily huddles to iterate in real time on workflows, dashboards, and nurse triage pathways.
Enrollment began at infusion check-in and later expanded to “chemo class,” where new patients learned how to download the app, complete a practice submission, and understand when to report symptoms. A blended model supported patient preferences, offering mobile app, web, and interactive voice response options.
This collaborative approach ensured the program worked for patients and for the nurses delivering care. As Highlands rolled out the model, digital symptom reports were routed to a centralized triage team, auto prioritized based on clinical severity and guided by standardized triage pathways, which enabled timely intervention without adding another manual inbox.
“It took a lot of teamwork, but [members of] the Canopy team were on site with us,” said Tracy Thurow, RN, OCN. “They incorporated our needs and the needs of our patients into their technology, while taking into consideration our workflows.”
From day one, the program was designed not as a standalone initiative, but as a new foundation for patient support. When OCM ended, Highlands didn’t scale back, it expanded.
“We had transformed,” said Jeff Hunnicutt, CEO of Highlands Oncology. “You can’t un-transform. This is the way we care for patients now.”
Real-World Results at Scale
Since the launch in 2020, Highlands Oncology has expanded remote monitoring to thousands of patients across infusion and oral therapies, including bispecific antibodies and other emerging regimens.
Patient engagement
Clinical outcomes
Operational efficiency
Highlands Oncology also participated in a study evaluating remote therapeutic monitoring to reduce hospitalizations due to infection in patients being treated for hematologic malignancies, whose findings were selected for oral presentation at the 2025 ASH Annual Meeting and Exposition in December.12
Sustaining Continuous Care With Remote Therapeutic Monitoring
Because Highlands saw remote support as essential to patient well-being, leadership prioritized long-term sustainability through alternative reimbursement programs.
When OCM ended, the practice adopted Chronic Care Management (CCM) and later integrated remote therapeutic monitoring (RTM) to support structured outreach, symptom review, and follow-up.
“Integrating ePROs with programs like CCM and RTM builds a sustainable model that improves outcomes, eases staff workload, and generates revenue to reinvest in between-visit care,” said Hunnicutt.
Today, the program generates around $1 million in annual recurring revenue to reinvest directly into nursing resources and supportive care infrastructure.5
AI and the Future of Remote Monitoring
As Highlands Oncology’s remote care program continues to grow, the focus has shifted to scaling responsibility. Automation and AI features through Canopy help streamline predictable, manual tasks and lighten the load for nurses and nonclinical staff alike.
To support growth without increasing administrative burden, Highlands incorporated:
• Digital enrollment workflows for ePROs
• Smart reporting reminders • Decision support and autocharting
• AI-assisted patient messaging across patient services (eg, scheduling).
Technology will never replace clinical expertise. But it can help direct that expertise to the right moments.
Next, Highlands will pilot an agentic after-hours phone center, offering patients real-time support outside clinic hours while ensuring overnight needs are routed appropriately and nurses receive actionable tickets when they return.
Through thoughtful use of automation and cross-team coordination, Highlands Oncology is creating a sustainable, patient-centered model for remote monitoring.
Lauren Hughes, RN is the director of Infusion Services at Highlands Oncology in Springdale, Arkansas.
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