Precision Care Companion: The US Oncology Network’s Strategy for Personalizing Cancer Care

Precision Care Companion, from The US Oncology Network, is a new value-based care initiative that seeks to revolutionize high-value cancer care delivery in the community setting by using data analytics to boost efficiency through testing and treatment standardization. Key factors to the success of the program are technology integration, robust clinical decision support tools, and acknowledging and addressing the complexity of precision medicine, and could also include guidance on biomarker testing and clinical trial identification.

Clear communication and realistic expectations are also paramount to Precision Care Companion’s success, with panelists emphasizing the necessity of patient education in this regard in light of the rapid pace of therapeutic discoveries. Moderator Rhonda Henschel, MBA, senior vice president of payer and care transformation, The US Oncology Network, was joined by Suzzette Arnal, PhD, now vice president of precision medicine, oncology, and multispecialty; Les Busby, MD, chief medical officer; and Paul Forsberg, PharmD, BCOP, MHA, vice president, pharmacy programs. Their panel discussion at Patient-Centered Oncology Care^® was titled, “Integrated Personalized Cancer Care.”

“We are really focused on providing the operational excellence, best practices, and foundation to support community oncology and what they do,” said Henschel, “along with providing them more stable financial stability, and allowing them to practice and focus on the clinical care delivery that they do.”

Addressing Fragmentation and Treatment Complexity

Before the development of the Precision Care Companion, fragmentation and lack of standardization were prevalent issues. Busby referred to findings they saw after implementation of the MYLUNG Consortium, or Molecularly Informed Lung Cancer Treatment in a Community Cancer Network: A Pragmatic Consortium, a partnership across The US Oncology Network, US Oncology Research, and Ontada, of McKesson.¹ Results were disappointing: compared with what they thought, patients actually being tested for lung cancer comprised less than half of that total. Then, feedback from several pharma companies on top of that, led to these fundamental questions:

1. Who should be tested?
2. When should you test them: up front, later, or both?
3. How you should test them?
4. Are local hospital labs better than major labs?
5. Did the hospital release the pathology report?
6. Are there any insurance barriers?

To combat the systemic fragmentation, the Precision Care Companion was structured around 3 foundational pillars: technology integration, decision support tools, and clinical decision support. Arnal emphasized the goal of bringing technology into physician workflows “at scale” to improve patient testing and treatment. The core strategy involves integrating technology throughout the patient journey, from diagnosis to treatment, which means implementing technology-enabled decision support tools to guide providers on appropriate tests to order, which biomarkers to test for, what are the best tests to order, integrating those results into the electronic medical record (EMR), and then interpreting them, for example. Analytics are crucial, allowing the network to measure the impact of workflow improvements and provide timely education to providers, aligning everyone.

“I think of it as, instead of driving on 6 lanes of the highway, which is what we are doing when it comes to precision medicine, really coming into one lane,” Arnal explained. “The last piece is providing timely education when providers need it so they can make the best-informed decisions for their patients when they're making care plans.”

Forsberg noted that mapping out the steps revealed that the entire journey was "so complicated" and full of opportunities for error. “This is absolutely where technology needs to come in and help support and make this more standardized,” he said, “so that we make sure that we're getting the right results for the patient and [that this is] scalable.”

It’s about finding ways to turn results into discrete-level data, he added, so that therapy choice is actually based on the patient’s molecular profile. “Having all that information packaged into one location, having it standardized, and having it in a format that we can then take and then move on to the payer is going to really help not only provide the information we need, but expedite that process.”

Focusing on Personalized Treatment and Clinical Trial Access

One of the more crucial aspects of Precision Care Companion that the panel emphasized was the seamless flow of molecular information. Test results often arrive in a manner that is not standardized across different vendors, making clinical interpretation challenging, the discussants agreed. To solve this, the network is developing tools—which Arnal dubbed a "Google Translate for molecular information"—to standardize test results across the board before feeding them into the clinical decision support system for therapy selection.

This standardized technological infrastructure facilitates several key steps in personalized care:

• Guiding testing: clinical decision support tools prompt physicians on which tests to order and when to order them. This includes pharmacogenomic testing that can inform decisions about dose reduction or high-risk warnings, such as neutropenia. Two prominent examples highlighted were testing for dihydropyrimidine dehydrogenase, or the DPYD gene, which is involved in breaking down certain chemotherapy drugs that treat colorectal cancer,² and for UGT1A, which can help predict severe adverse effects from the same.³
• Monitoring and progression: precision medicine tools are beginning to be used to monitor molecular progression, and they are utilizing technology circulating tumor DNA, as an alternative to relying on radiologic images alone.
• Expediting therapy: The integration of test results into the EMR as discrete data is critical, with Forsberg adding that this data structure allows the network to identify patients who might qualify for a new FDA-approved drug 6 months after their original diagnosis, thereby enabling proactive patient outreach. Having this standardized information packaged together also can help the medically integrated dispensing team expedite prior authorizations, he said.

Another key driver of high-value integrated care is connecting patients with clinical trials. Precision Care Companion leverages the Genospace platform and the Sarah Cannon Research Institute—now part of The US Oncology Network—personalized medicine team to flag patients who qualify for trials and to help physicians be more efficient, Busby noted. He shared an experience where, almost simultaneously with reviewing a new diagnosis of chronic myeloid leukemia, a colleague called to inform him of an open study.

The goal is to move beyond manual notification to an automated system that balances necessary alerts with the need to avoid "too many alerts,” he noted.

To support complex case review, the network has a cross-functional molecular tumor board, which brings together the pharmacy, genetics, and precision medicine teams. There is also a molecular help desk, of sorts, to whom physicians can send questions about difficult mutations and receive a response, often within 24 hours, from PhD-level scientists.

Empowering Patients Through Shared Decision-Making and Education

Although technological integration improves efficiency, precision medicine often necessitates difficult conversations with patients, the experts emphasized. They address this challenge by focusing on proactive communication and educational support, including developing patient education materials designed to set expectations around testing outcomes, especially since many patients hope for an actionable result.

“You might not get anything that's actionable. I think people are really hopeful, and they hear about how well these drugs are working, and the amazing response rates, and how long these people are living,” Arnal explained. Then, if “they don't get a positive result, it's really disappointing.”

Furthermore, it is essential that the entire care team—the provider, the nurse, and the pharmacist—is aligned and speaks the same language to maintain patient confidence and prevent conflicting information from derailing decision-making.

Forsberg concurred. “Patient confidence in the decision-making is such a critical point, and it can get very clouded by a lot of the nonactionable items that are out there,” he said. “If the provider has a great conversation with the patient, they're aligned on what they're going to do, and then they move downstream.

In a compelling example of utilizing emerging tools, Busby described using artificial intelligence to simplify complex medical explanations, such as describing a Bruton tyrosine kinase inhibitor to a patient at a middle-school comprehension level. Especially since patients may have only basic scientific understanding. “We’re at the forefront, where we can sue these tools to help our patients understand,” he said.

References

1. MYLUNG study launches, aiming to advance use of precision medicine for metastatic non-small cell lung cancer patients. The US Oncology Network. 2025. Accessed October 27, 2025. https://usoncology.com/news/mylung-study-launches-aiming-to-advance-use-of-precision-medicine-for-metastatic-non-small-cell-lung-cancer-patients/
2. DPYD. Know Your Biomarker. Accessed October 27, 2025. https://www.knowyourbiomarker.org/biomarkers/dpyd
3. UDP-glucuronosyltransferase 1A1 (UGT1A1), full gene sequencing, varies. Mayo Clinic Laboratories. Accessed October 27, 2025. https://www.mayocliniclabs.com/test-catalog/overview/610064