Oncology Practices Weigh Automation Against Live Patient Access

Community oncology practices say they cannot staff to optimal levels at present because of the constantly changing demand for cancer care. However, the automated processes meant to close these care gaps have a limit: Seriously ill and often older patients prefer to speak to a live human being. This tension ran through the panel discussion, “Scaling the Oncology Practice for Tomorrow’s Patients,” at the Patient-Centered Oncology Care^® conference, hosted by The American Journal of Managed Care^® on September 24, 2026.

The panel, moderated by Sibel Blau, MD, president of Northwest Medical Specialties and cochair of the ONCare Alliance, included leaders from practices ranging from 6 sites in Myrtle Beach, South Carolina, to a national network of 400 providers in 21 states.

Workforce Limits Define Practice Growth

Panelists argued that the hardest part of growth is not deciding to expand but finding people who fit. Emily Touloukian, DO, FASCO, president and CEO of Coastal Cancer Center, warned against filling openings with “any warm body” and said leaders should ask whether they should add a physician or service line—not only whether they can.

Barry Russo, MBA, CEO of The Center for Cancer and Blood Disorders, said prior authorization and coding roles are especially hard to fill. His practice is testing artificial intelligence (AI) for both, as well as AI documentation tools for physicians.

Josh Eaves, MBA, chief development and strategy officer of Florida Cancer Specialists & Research Institute, said scale does not simply mean size. He said that networks must plan for a shrinking oncologist workforce as more patients reach the age range at which cancer risk peaks, citing reports that more than 40% of oncologists are older than 55 years and that metropolitan areas are projected to have adequate coverage whereas rural markets are not. A 2014 projection similarly anticipated that demand for oncologic services would grow by 40% by 2025 while supply would grow by 25%.¹

Todd Schonherz, CEO of American Oncology Network, said earlier detection is turning some cancers into chronic conditions and that practices should not respond by turning patients away or choosing who to treat, with patients staying on care longer. His network uses scheduling data to fill capacity outside of the midday appointment crush, ambient listening tools to reduce physicians’ after-hours charting, and advanced practice providers to increase throughput. Staff, he said, do not leave over small pay differences. “They leave because they are not being treated properly,” he said. He also pointed to front-desk staff, medical assistants, and technicians as likely bottlenecks of clinical delays, as they keep patients checked in, roomed, and ready to see the physician.

Where Does Automation Help, and Where Does It Fall Short?

Russo said his practice checks on patients every 2 hours after infusion with chimeric antigen receptor T-cell therapy and ensures phones are answered around the clock. He said these capabilities cannot be staffed by people alone, so proactive bots and remote monitoring reach out first. Further, this approach extends beyond cell therapy. “This is the future of what community oncology should look like,” he said.

The Center for Cancer and Blood Disorders works with Reimagine Care on postinfusion monitoring, and the platform’s CEO said that without connected devices and AI check-ins, nurses would need to call patients several times a day—a workload that will not scale as more practices adopt cell therapy.² Touloukian said the technology has improved markedly over the past 6 months to 1 year and suits data collection. Still, she expressed concern that nuance is lost, such as whether a patient speaks slowly because of difficulty breathing.

Her practice replaced a menu-driven phone system with a single button that connects callers to a live person, a change she said appeared to increase patient satisfaction and help patients requiring urgent care reach that care faster; approximately 75% of her patients are on Medicare. Larger practices may route calls by issue type, she said, but a practice of her size cannot run 2 pathways.

“I’m not convinced we’re quite there yet,” she said.

Schonherz described a hybrid approach: automating routine tasks such as intake and phone trees while keeping care coordination and care management staffed by people. Eaves said that narrowly defined tasks, such as monitoring patients after cell therapy, are well suited to AI that can carry out multistep tasks independently (agentic AI), but that broad, variable tasks are harder to reliably automate at scale. He added that poorly informed human call centers can fail patients as badly as a bot.

What the Debate Means for Payers and Practices

Russo said cell therapy is changing his organization’s identity. With rheumatologists now in the group and a lupus cell therapy trial being considered, the practice is rebranding so that patients with lupus or multiple sclerosis see it as a cell therapy center rather than only a cancer center.

Blau said bispecific antibodies and radioligand therapies are also arriving in the community. Because of this, research needs to scale, too. Her practice’s research director told her it could not grow further without doubling or tripling the share of patients in clinical trials. Schonherz said his network is not accruing enough patients for trials and sees its infusion and radiation assets as a basis for adding rheumatology and urology services.

Touloukian said the most valuable platforms are “the ones that give your team members time back,” citing ambient scribes that free pharmacists for face-to-face patient time. Schonherz was blunt about the economics: “We’re not going to be paid more tomorrow for what we’re doing today.”

Payment policies may shape how fast monitoring spreads, with previous expert conversations explaining that remote monitoring investments have not always paid for themselves, and that patients without supplemental insurance may have to pay out of pocket for monitoring, which many cannot afford.³

In closing, Eaves borrowed a line from economics—“There are no solutions, only trade-offs”—and said practices should weigh each new tool against the goal of delivering better care tomorrow.

References

1. Yang W, Williams JH, Hogan PF, et al. Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage. J Oncol Pract. 2014;10(1):39-45. doi:10.1200/JOP.2013.001319
2. Caffrey M. Reimagine Care, Center for Cancer and Blood Disorders offer key support layer in crucial weeks after CAR T-cell therapy. American Journal of Managed Care. July 1, 2026. Accessed November 6, 2026. https://www.ajmc.com/view/reimagine-care-center-for-cancer-and-blood-disorders-offer-key-support-layer-in-crucial-weeks-after-car-t-cell-therapy
3. Caffrey M. AI in oncology practice: innovation in the delivery of care itself. American Journal of Managed Care. May 1, 2026. Accessed November 6, 2026. https://www.ajmc.com/view/ai-in-oncology-practice-innovation-in-the-delivery-of-care-itself