A recently published review contends that operational excellence, including digital transformation, workforce support, and practice infrastructure, is as essential as scientific innovation to delivering high-quality cancer care in community oncology practices. The review, written by Debra Patt, MD, PhD, MBA, the Executive Vice President of Texas Oncology, and Lucio Gordan, MD, the president and a managing physician at Florida Cancer Specialists & Research Institute, and published in JCO Oncology Practice, also emphasizes the importance of clinician-administrator leadership partnerships to align clinical priorities with operational execution and accelerate practice transformation.

More than 2 million new cancer cases were projected in the United States in 2025, and the number of cancer survivors is expected to exceed 22 million by 2035, increasing demands on community oncology practices related to care coordination, survivorship, workforce capacity, and financial pressures.

The survivorship burden is especially evident in survivors of adolescent and young adult (AYA) cancer. As of January 2020, more than 2.1 million people in the United States were living with a history of an AYA cancer, adding to the demand for long-term survivorship infrastructure and post–cancer care coordination.

The review asserts that digital transformation, including AI and change management, may help ease administrative and workforce challenges while preserving patient-centered care, without replacing clinical decision-making. Along with scientific innovation and improved outcomes, however, operational excellence is critical to maintaining quality care as community oncology practices face growing demands from precision medicine, survivorship, workforce shortages, payer requirements, financial pressures, and increasing electronic health record (EHR) burdens.

These operational issues are more than administrative concerns, the review argues, and addressing these concerns appropriately directly influences patient access and quality of care.

Digital Transformation and AI

Rising EHR documentation requirements, increasing inbox volume, and administrative tasks performed outside scheduled clinic hours have contributed substantially to physician burnout and reduced clinical capacity. Digital transformation with AI is just one component of the challenges facing independent community oncology practices, but successful implementation depends as much on operational change management as on the technology itself.

“The modern cancer practice must repeatedly redesign workflows involving phones, triage, scheduling, referrals, precertification, infusion operations, prescribing, symptom monitoring, and patient communication—all while continuing to deliver care safely. In this context, [digital] transformation is best understood as a competency, not a one-time project,” the review notes. Technology can reduce administrative burden, but only when paired with workflow redesign, training, and team-based redistribution of work.

Rather than viewing AI as a replacement for clinicians, the review advocates for an “augmented oncologist” model in which ambient AI scribes, clinical decision support, documentation assistance, and workflow automation help reduce clinicians’ administrative burdens while preserving physician oversight. They caution, however, that these tools require careful change management that includes governance, workflow redesign, and quality monitoring to ensure they improve rather than complicate care delivery. Approaching AI implementation should be managed “with the same rigor (and caution) once reserved for EHR rollouts,” the review explains, adding that “Ambient AI, clinical decision support, and automation tools can create meaningful gains, but only if organizations define target workflows, quality checkpoints, governance, and physician review responsibilities before scaling.”

Staffing Shortages and the Oncology Workforce

Protecting the oncology workforce is presented as another critical priority. The review notes that staffing shortages extend beyond physicians and include nurses, pharmacists, infusion personnel, and administrative staff, creating challenges that directly affect patient access. Oncology practices should focus not only on recruitment efforts but also on redesigning workflows through task redistribution, improved documentation support, and selective adoption of technologies that reduce unnecessary administrative work. Reducing preventable friction within daily operations may improve job satisfaction, strengthen retention, and ultimately enhance continuity of patient care. Protecting the oncology workforce is not simply a wellness initiative but also a patient-access strategy.

Beyond workforce considerations, the review outlines several operational strategies designed to improve efficiency while maintaining high-quality patient care.

Operational Strategies

There are operational strategies that may improve care delivery while maintaining quality, according to the review. Examples include virtual nurse triage, remote pharmacist services, electronic patient-reported outcomes, optimized infusion scheduling, and EHR-integrated clinical decision support to streamline treatment planning and symptom management. Collectively, these approaches are intended to improve efficiency without compromising quality of care.

Beyond routine clinical care, community practices must invest in sustainable research infrastructure by embedding clinical trials into everyday workflows and expanding access for patients who might otherwise face geographic barriers to participation, the review contends. Digital innovations such as AI-assisted trial matching, automated eligibility screening using EHR data, and electronic trial alerts are potential tools to improve trial enrollment efficiency.

Finally, long-term sustainability requires coordinated investment across multiple operational domains, including integrated pharmacy services, revenue cycle management, patient education, multidisciplinary service-line planning, public policy engagement, and strategic partnerships. Rather than viewing these areas as separate administrative functions, they should be viewed as interconnected components of a modern community oncology practice that support timely, high-quality, patient-centered cancer care.

Summary

Drs. Patt and Gordan suggest that investments in digital transformation, workforce resilience, and coordinated care infrastructure will increasingly determine how effectively scientific advances reach patients in community oncology practices.

Digital transformation is not only the adoption of new technologies, but instead it is part of the broader redesign of the modern business of community oncology practice. AI and other digital tools should support—not replace—clinical judgment, reduce administrative burden, and improve care coordination, with appropriate governance and physician oversight. Aligning leadership, workforce support, research, pharmacy services, revenue-cycle management, patient education, and policy engagement will determine how effectively scientific advances reach patients in community oncology settings. Accordingly, scientific advances alone are insufficient unless practices have the infrastructure that sustains it.

“Community oncology [practices] will continue to deliver high-quality, accessible, and value-oriented cancer care—but only if leaders treat operations, data, workforce, digital transformation, and public policy as integral parts of the cancer care mission. In the era of digital transformation, we have the tools necessary to improve our ability to deliver the highest quality of cancer care possible to our patients—close to home,” Drs. Patt and Gordon conclude.

DISCLOSURES: For full disclosures of Dr. Patt and Dr. Gordon, visit ascopubs.org.

ASCO AI in Oncology is published by Conexiant under a license arrangement with the American Society of Clinical Oncology, Inc. (ASCO^®). The ideas and opinions expressed in ASCO AI in Oncology do not necessarily reflect those of Conexiant or ASCO. For more information, see Policies.