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Dr Lalan Wilfong Discusses Growth in Remote Monitoring, Future of Value-Based Cancer Care


Lalan Wilfong, MD, executive vice president, Value Based Care & Quality Programs, Texas Oncology, and cochair, Payment Reform, Community Oncology Alliance, speaks on the evolution of remote monitoring in cancer care and how value-based oncology may look in the near future.

Lalan Wilfong, MD, is the executive vice president of Value Based Care & Quality Programs at Texas Oncology and Payment Reform Cochair at the Community Oncology Alliance.


In an effort to improve remote monitoring, Texas Oncology rolled out the Navigating Cancer management system back in 2019. Fast forward to now with the pandemic, how has the system fared and what goals do you have to continue growth in this field?

We rolled out the Navigating Cancer management system initially in order to help us manage our patient experience more effectively. What we found was patients were calling in for issues and we didn't have a good system in place to manage that, to monitor what was happening, and then to execute on those issues. There was a lot of variability in our practice around that.

So, we instituted that to help us identify and find ways to improve patient experience, especially as they were calling in with symptom-related calls, because we felt that was a significant issue causing hospitalizations and ED [emergency department] visits when patients would call in with a problem and we weren't addressing it in a timely fashion.

Fast forward to the pandemic, what that allowed us to do was be able to be flexible in management of that, meaning staff were able to work from home, we were able to have staff cover for each other much more fluidly by having an electronic system in place.

Then fast forward to doing remote patient monitoring with electronic patient-reported outcomes, which we've started initiating just this past year, to be able to have patients self-report symptoms, rather than having to call in, it’s an evolution in process. It takes time and effort, a practice change, to continue to improve that. So, I'm looking forward to seeing what we do the rest of this year and then moving forward.

As we grow closer to transitioning toward the Oncology Care First model, what are your thoughts on how value-based cancer care will look in the near future?

That’s a great question. I'm not sure exactly what value-based care will look like in the future. There's a lot of models out there, a lot of discussions about what it should look like. If anybody had the answer, we would know it by now, and so I think there's going to be a lot of continued evolution in this space, trying to figure out exactly what the best payment models are. How do we best collaborate with payers, practices, and patients to continually improve the value that we provide?

I think the current fee-for-service model is unsustainable, and we all know that with the cost increases, the price of drugs, and all the other challenges that we face, that we have to do this differently. It's going to be interesting to see how that evolves, because there are many different paths we can take. And I think it will be a series of continued evolutions to get to where we need to be.

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