Evaluating a Virtual Care Navigation Program for Enhanced Oral Oncolytics Management

Cancer care is radically shifting as precision medicine drives the rise of oral oncolytics, now the fastest-growing segment in the oncology precision medicine market.^1-2 Approximately 85% of precision oncology drugs in preclinical development are small molecules optimized for oral dosing.^2-3 This pivot from intravenous to oral regimens for numerous hematologic and solid tumors enhances patient autonomy while shifting more day-to-day treatment management into the home setting.^4-6 Compared with infusion therapies, patients taking oral oncolytics often have fewer in-person touchpoints with their care team, creating opportunities for additional support and monitoring between visits.

To enhance continuity of care for patients receiving oral oncolytics, Texas Oncology, a practice in The US Oncology Network, piloted a remote virtual care platform to manage certain administrative, clinical and navigation tasks. Over the course of the pilot, the digital framework evolved from basic symptom check-ins into a robust, hybrid care model that provided comprehensive clinical oversight alongside emotional and social support. This approach can support optimized practice operations and enhanced continuous care delivery without disrupting primary care workflows. Insights from this pilot may offer a model for organizations seeking to improve care delivery to patients on self-administered oral therapies.

Oral Oncolytic Patients Have Unique Support Needs

As needs for oncology services continue to grow, practices are exploring effective ways to support patients receiving oral therapies between scheduled visits. Patient needs often evolve when treatment shifts from a highly supervised clinical environment to the home setting, where patients assume a greater role in managing their care. This transition can introduce barriers and adverse events that may affect treatment outcomes.⁷

The complexities associated with oral oncolytic regimens can contribute to adherence challenges that may affect treatment effectiveness.^{7, 8} Reported nonadherence rates average 48.1%,⁹ and 18% of patients discontinue treatment within the first 90 days.⁹ These findings underscore the importance of supportive interventions that help patients successfully navigate self-administered therapies.

Texas Oncology’s Virtual Care Navigation Pilot: Implementation and Outcomes¹⁰

To strengthen support for patients on oral oncolytics, Texas Oncology launched a centralized virtual care pilot program. The following operational framework developed for the initiative shifted care delivery from a reactive, clinic-dependent model into a proactive, data-driven remote system that optimized both clinical performance and financial metrics:

✓ Pilot Parameters and Resource Allocation

• Timeline: The program’s Early Phase took place from May 2025 through January 2026.
• Enrollment: 740 oral cancer patients participated during this timeframe.
• Scale: The initiative was deployed across 11 community sites, supporting a network of roughly 40 physicians.
• Staffing: A small, centralized dedicated unit scaled the program, utilizing two Registered Nurse navigators working alongside one non-clinical lay navigator.

✓ Protocol and Workflow Automation

• Transition away from Manual Tracking: The program replaced cumbersome spreadsheets with an automated, digital outreach system.
• The 90-Day Framework: Patient tracking occurred within a 90-day episode of care.
• Automated Clinical Check-ins: The system scheduled ~20 automated, targeted touchpoints linked to crucial intervals in the treatment path.
• Key Administrative Assistance: Staff intervened during specific points along the care path to provide critical education, expedite insurance prior authorizations, secure the initial prescription refill, and monitor long-term compliance.

✓ Social Determinants of Health and Digital Observation

• Screening for Socioeconomic Barriers: Navigators administered Medicare’s 26-question Health-Related Social Needs assessment. This structured tool uncovered non-clinical vulnerabilities such as food, housing, or transit instability that routinely go unnoticed during brief clinic appointments.
• Enhanced Monitoring: Patients were onboarded onto electronic Patient-Reported Outcomes (ePROs), establishing an immediate digital reporting link for remote symptom tracking and timely clinical intervention between visits.

✓ Operational and Financial Performance Outcomes

• Platform Adoption: Concerted outreach through the pilot contributed to a 491% surge in active patient enrollment on the ePRO platform.
• Acute Care Overutilization: Earlier identification and management of emerging symptoms may have helped reduce emergency department visits and urgent care utilization, which are primary expenditures in value-based care environments.
• Total Cost of Care Reduction: Despite introducing billing fees for navigation services, total medical expenditures for enrolled individuals often remained lower than non-enrolled patients due to decreased urgent care.
• Revenue Sustainability: The pilot’s operational structure proved economically viable by aligning its supportive care with the Centers for Medicare & Medicaid Services 2024 Principal Illness Navigation billing codes.

Operational Takeaways

Texas Oncology’s pilot program proved virtual care efficiently complemented and enhanced traditional in-person oncology services for oral oncolytic patients. Separating the virtual navigators from on-site clinical duties enabled proactive patient outreach, ensured care continuity, and improved practice efficiency. By adopting milestone-driven digital processes and interventions, the practice successfully enhanced existing care delivery with more proactive and preventative interventions. This consistent monitoring allowed navigators to catch minor health deviations and psychosocial needs early, intervene promptly, and deliver targeted education precisely when needed.

Outcomes from the initiative and stakeholder feedback confirmed the program helped strengthen continuity of care and enhanced the patient experience through an accessible, high-touch layer of support. This additional layer of support provided reassurance for anxious patients self-administering therapies at home. Beyond its immediate success, the program achieved national recognition as second runner-up for the 2026 American Nurse Journal’s All-Pro Nursing Team Award.¹¹For practices exploring virtual and hybrid approaches to meet the growing demand for services, this innovative model offers a scalable blueprint for expanding quality care beyond traditional clinical settings.

REFERENCES

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4. Lv X, Ren W, Ran S, Zhao Y, Zhang J, Chen J, Zhang N. Trends and prescribing patterns of oral anti-neoplastic drugs: a retrospective longitudinal study. Front Public Health. November 2023. Nov 23;11:1294126. doi: 10.3389/fpubh.2023.1294126.

5. American Cancer Society medical and editorial content team. Getting Oral Chemotherapy. American Cancer Society.May 15, 2025. Accessed July 14, 2026. https://tinyurl.com/5n8yhjud

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7. Wyatt L. Barriers to Initiating Oral Oncolytics by Specialty Pharmacy or Payers Can Affect Patient Outcomes. Journal of Hematology Oncology Pharmacy. August 15, 2024. Accessed July 17, 2026. https://tinyurl.com/2dzj4ept

8. Naser, A. Ofori-Asenso R, et al. Real World Adherence to and Persistence With Oral Oncolytics in Multiple Myeloma: A Systematic Review and Meta-analysis. Clinical Lymphoma Myeloma and Leukemia. 2022; 22, 760-773. Accessed July 17, 2026. https://tinyurl.com/y9rwpt2z

9. Advisory Board. Oral oncolytics: Strategies for improving adherence and persistence. Pfizer. 2025. Accessed July 15, 2026. https://tinyurl.com/pb54a3y4

10. Texas Oncology proprietary company data: Virtual Care Navigation Pilot Program for Oral Oncolytics. 2026.

11. Cullen J. Celebrating nurses: 2026 All Pro Nursing Teams. American Nurse Journal. May 4, 2026. Accessed June 25, 2026. https://tinyurl.com/hycj7a63