Closing the outpatient monitoring gap in cancer

The newest wave of cancer therapies, including CAR-T cell therapy, bispecific antibodies and antibody-drug conjugates, is reaching patients in outpatient clinics and even at home faster than the healthcare system has built the staffing and monitoring to support it, according to Dan Nardi, CEO of Reimagine Care.

Treatments like CAR-T cell therapy were traditionally given in the hospital, with patients monitored for 30 to 60 days afterward. Nardi said many patients now get their initial infusion and go home soon after, without enough nurses and advanced practice providers available to keep close track of them outside the clinic.

That gap has typically been filled by asking nurses to call or text patients directly or by telling patients to call if something feels wrong, an approach Nardi said doesn't scale as more complex treatments move into outpatient settings.

“This is one of those examples where the science has really outpaced our ability as a care delivery system to keep up with it,” Nardi said.

Reimagine Care, now combined with precision oncology company Cureety, is positioning its technology to close that gap. The platform pairs Remi, an AI-based virtual assistant that checks in with patients proactively as well as responding to them, with connected devices that track vitals such as temperature, pulse oxygen and blood pressure, giving care teams digital visibility into patients between visits.

When a patient reports a symptom, Remi asks a set of questions to triage it, sorting cases into one of 16 pathways built around common cancer treatment side effects. Under the combined company, that triage will also draw on Cureety's therapy-specific symptom management engine, which weighs a patient's diagnosis, treatment and disease stage rather than applying the same rules to everyone.

Nardi pointed to the difference between a 65-year-old man with prostate cancer and a 38-year-old woman with early-stage breast cancer to illustrate why that specificity matters: their symptoms, and what those symptoms signal, can look very different.

In this interview with Managed Healthcare Executive, Nardi discusses how the combined platform aims to help cancer centers and community oncology practices scale their ability to safely monitor patients as more complex cancer treatment moves outside the hospital.