AI Gains, Barriers in Community Oncology: Debra Patt, MD, PhD

In part 1 of an interview with The American Journal of Managed Care^® (AJMC^®) at the Community Oncology Alliance (COA) Payer Exchange & Innovation Summit, Debra Patt, MD, PhD, MBA, MPH, discussed the applications and challenges of artificial intelligence (AI) adoption in community oncology practices.

Patt is the executive vice president at Texas Oncology, president of the Community Oncology Alliance, and a member of the American Society of Clinical Oncology Board of Directors. On September 14, day 1 of the meeting, she served as a panelist in the “Executing Innovative AI Solutions: Lessons from Community Oncology” session.

Patt told AJMC about her excitement surrounding AI tools that let skilled staff work "top of license" by reducing administrative burden. A key example was an ambient AI scribe service, part of the "Home for Dinner" campaign, used by roughly 600 physicians in her practice that eliminates the need to dictate notes after a demanding clinical day. This tool lets physicians spend clinic time engaging with patients rather than documenting on a computer, restoring the more meaningful, joyful aspects of medicine, she noted.

Similar gains have come from AI tools supporting triage nurses, who can now pre-populate notes using clinical decision support. This has shifted their workload from roughly 50% nursing and 50% administrative tasks to 80% nursing and 20% administrative, Patt highlighted, reducing decision fatigue without dictating clinical judgment.

She added that AI will touch every part of cancer care, with the underlying goal of easing the burden for clinicians and administrators.

“I like to say, as we think about AI in cancer care, it's like the movie Everything Everywhere All at Once," because everywhere from screening, drug discovery, management of the revenue cycle, and everywhere in between, we are going to see that these systems are easing the burden of practice, easing the burden for our administrators, and that's really critical to us completing our jobs in a timely way, allowing us to have better work-life balance and have [sustainable] practices,” Patt said.

Regarding barriers to AI integration, Patt identified advocacy as the first hurdle, as practices must build a case and demonstrate return on investment to executive leadership before adopting new tools. Because point solutions are unsustainable given how many would be needed, she emphasized that practices should instead seek innovative vendors as a broader "channel" or "sphere" solution. Patt, in particular, pointed to vendor flexibility as a related strength, describing a 6-year partnership with vendor Canopy, which began with electronic patient-reported outcomes and expanded to remote patient monitoring, including temperature tracking, as the practice's needs grew.

Additional challenges include security and compliance concerns, along with inherent AI risks like bias, hallucination, and error, which must be understood and managed. To help practices navigate these issues, Patt highlighted that COA formed an AI task force and published a playbook offering guidance for informed adoption decisions.