Patt: RTM in Oncology Should Be “Standard of Care,” Sees Guidelines Coming—and Billing Should Be Next

As evidence mounts to support use of remote therapeutic monitoring (RTM) in cancer care, Debra Patt, MD, PhD, MBA, FASCO, of Texas Oncology, says the time has come to adopt clinical guidelines—along with payer coverage.

“Monitoring patients with electronic patient-reported outcomes should be the new standard of care,” Patt said in an interview with The American Journal of Managed Care^® (AJMC^®), which took place during the recent annual meeting of the American Society of Clinical Oncology (ASCO).

Patt, the current president of the Community Oncology Alliance (COA) and an ASCO board member, presented a talk on artificial intelligence (AI) in oncology and was a coauthor on several abstracts involving RTM and the electronic patient-reported outcomes (ePROs).^1-3 Use of AI and remote monitoring technology was prominently featured during COA’s Community Oncology Conference, which took place in late April.⁴

“Guidelines are likely to emerge,” said Patt, executive vice president of policy and strategic initiatives for Texas Oncology, one of the nation’s largest community oncology practices with more than 300 service sites across Texas and southeastern Oklahoma. She noted that the European Society for Medical Oncology (ESMO) already has a clinical guideline in this area,⁵ and ASCO is working on a guideline.

Having clinical guidelines would pave the way for more consistent coverage from payers, who have benefited from the cost savings that RTM generates when patients avoid the emergency department (ED) or overnight hospital stays.

“For Texas Oncology, we've done this as a practice and really not billed for any of it, but it's important that you are able to bill for remote therapeutic monitoring of patients,” Patt said. “We can't continue to provide incremental services for free; that's hard to sustain. But I think that guideline adoption, guideline formulation, and payer coverage determinations are things that [would] help transform organizations' adoption of these tools to serve patients.”

Evidence at ASCO Makes Case for Use of RTM

One study that Patt coauthored was featured in an ASCO oral abstract session; it showed how an RTM platform developed by Canopy, using its ePROs, significantly reduced hospitalizations in patients with metastatic solid tumors, especially among high-risk patients. Savings were estimated at $3 million per 1000 treated patients annually.¹

“We've known for a long time that having better management of patient symptoms is better for them. We've studied [this] before in our own practice, looking at how it influences hospitalizations, [ED] visits, and the total cost of care—and that's been favorable,” Patt said. “This continues to reaffirm that this is a way to monitor patients that's modern and important. Patients do better, so they're able to stay on therapies longer, they're able to avoid ED visits and hospitalizations, and their total costs are reduced. It's very exciting.”

A separate abstract showed the Canopy platform helped patients receiving checkpoint inhibitors to stay on therapy for 99 more days, compared with a group not supported by the system.² For Patt, these data make the case that remote monitoring is essential for high-quality care, given the nature of today’s complex therapies.

“Patients on advanced therapy need to have real-time ways to monitor their toxicities for a lot of important reasons,” she said. “Toxicities linger if they are not addressed clinically urgently, and with some of the novel therapies that we are using, like checkpoint inhibitors or bispecific therapies or cellular therapies, if we don't intervene right away, patients can have serious adverse outcomes. It becomes important for us to have real-time patient monitoring.

“These modern tools to monitor patient symptoms and to intervene to control patient symptoms more rapidly are really going to be useful, and will help us deliver the highest quality cancer care close to patients' homes,” Patt said.

Although Medicare has created billing codes to allow for some payment for RTM,⁶ reimbursement for patients on Medicaid and commercial plans is highly inconsistent; it varies state by state or plan by plan.^7-9 A paper published this spring by Rocque et al cited the example of Highlands Oncology of Arkansas—the same practice in the Canopy ePRO study—which was able to bill $45,000 per month for RTM through Medicare.⁶ But practices with a more diverse case mix might have problems supporting RTM for all patients, and most oncology practices extend quality initiatives to every patient, regardless of insurance status.

AI Exceeds Expectations at the Practice Level

In January 2025, AJMC spoke with Patt as she took the helm at COA and asked about her hopes for technology and AI in community oncology; at the time, she said it would “touch every aspect of care delivery.”¹⁰ Nearly 18 months later, has AI lived up to its promise?

“It is so much better than anticipated,” Patt said. At Texas Oncology, an AI scribe is saving physicians an average of 2 hours per week on documentation, and “that's just one AI tool we have implemented.”

ePROs are being used across the practice, she said; this allows AI solutions “to help nurses navigate nursing guidelines better, and that allows them to not have the secretarial work of documentation in the same way that they did before; it's helping them act more efficiently.

“We're using it to answer the phones in some places,” Patt said. “So, yes, there's so many ways that it is already helping us so much more than I would have anticipated.”

Patt also coauthored an ASCO abstract describing the OncoPRO initiative, a national collaboration of oncology practices working to implement remote monitoring and ePROs.³ With funding from the Patient-Centered Outcomes Research Institute, the collective shares ideas and evidence, and Patt said members learn from the shared experiences of other practices on everything from how to use vendors to what staffing levels are appropriate for different projects. The abstract reported that participating practices have a 100% attendance record.³

“Cancer care is a team sport,” Patt said. “The beauty of the OncoPRO initiative is that we have the opportunity to share learnings with each other that help us navigate this landscape a lot more easily, and then we have fewer speed bumps and roadblocks and detours because we're learning from each other.”

References

1. Essell JH, Derman BA, Kolodziej MA, et al. Impact of remote therapeutic monitoring with patient-reported outcomes on hospitalization in real-world patients receiving therapy for metastatic solid tumors. J Clin Oncol. 2026;44(suppl 16):abstr 11005. doi:10.1200/JCO.2026.44.16_suppl.11005
2. Derman BA, Kolodziej MA, Essell JH, et al. Impact of remote therapeutic monitoring on time to discontinuation and acute care events among patients treated with immune checkpoint inhibitors. J Clin Oncol. 2026;44(suppl 16):abstr 11108. doi:10.1200/JCO.2026.44.16_suppl.11108
3. Basch E, Jansen J, Carr PM, et al. National implementation of electronic patient-reported outcomes (ePROs) for remote symptom monitoring in oncology: The OncoPRO initiative. 2026;44(suppl 16):abstr 1571. doi:10.1200/JCO.2026.44.16_suppl.1571
4. Caffrey M. AI in oncology practice: innovation in the delivery of care itself. AJMC. May 1, 2026. Accessed June 6, 2026. https://www.ajmc.com/view/ai-in-oncology-practice-innovation-in-the-delivery-of-care-itself
5. Di Maio M, Basch E, Denis F, et al., on behalf of the ESMO Guidelines Committee. The role of patient-reported outcome measures in the continuum of cancer clinical care: ESMO Clinical Practice Guideline. Ann Oncol. 2022;33(9):878-892. doi:10.1016/j.annonc.2022.04.007
6. Rocque G, Patt D, Hunnicutt J, et al. Supporting reimbursement for electronic patient-reported outcomes in clinical cancer care using current procedural terminology codes for remote therapeutic monitoring. JCO Oncol Pract. Published online April 3, 2026. doi:10.1200/OP-26-00041
7. Joo JH, Lieu N, Tang Y, Browne DS, Agusala B, Liao JM. Trends in utilization of remote monitoring in the United States. Health Aff Sch. 2025;3(6):qxaf115. doi:10.1093/haschl/qxaf115
8. Lamboley L. Economics of comprehensive remote care management. Prevounce. July 30, 2025. Accessed June 6, 2026. https://blog.prevounce.com/economics-of-comprehensive-remote-care-management
9. Remote therapeutic monitoring billing: CPT codes guide. LimberHealth.com. Updated January 2026. Accessed June 6, 2026. https://www.limberhealth.com/blog/remote-therapeutic-monitoring-billing-tips-and-best-practices
10. Caffrey M. As COA president, Patt promotes advocacy: “Each of us holds an important part of the story.” Am J Manag Care. 2025;31(Spec No. 2):SP109-SP111.