APPs Have Become Essential Members of Oncology Care Teams

Roles for advanced practice providers include care coordination, patient education, and patient navigation, according to this CMO.

Advanced practice providers (APPs) such as nurse practitioners and physician assistants are playing a growing role on cancer care teams, according to the CMO of the American Oncology Network.

Oncology care is complex, with multiple care providers working with patients in clinic and hospital settings. APPs have the potential to coordinate care, close multiple gaps in care, and relieve pressures on physicians.

"It takes a village to shepherd a patient along their journey," says Stephen "Fred" Divers, MD, CMO of American Oncology Network (AON). "Most healthcare providers have recognized the significant value that APPs bring with respect to the patient care experience."

Divers points to survey data collected by the Oncology Care Index launched by Johnson & Johnson earlier this year.

"If you look back at surveys conducted in 2024 that launched the Oncology Care Index, nine out of 10 healthcare providers saw a significant improvement in patient satisfaction related to the involvement of APPs in the patient experience," Divers says.

Divers added that the Make It HAPPen program, which Johnson & Johnson launched in collaboration with the Advanced Practitioner Society for Hematology and Oncology, is one of the ways AON is elevating role that APPs play in oncology care.

APPs can free up physicians to have meaningful personal interactions with patients, which boosts patient satisfaction, according to Divers, who adds APPs help generate a positive patient experience.

"The APPs enable the clinical delivery team to have that feel and approach," Divers says. "Having APPs on cancer care teams not only allows for more patient touches in the clinic but also allows for care in an efficient manner to move patients through a clinic seamlessly."

Reliance on APPs at AON reflects their growing roles on oncology care teams across the country.

"There was a time less than 10 years ago when AON had few APPs working within our oncology clinics," Divers says. "Now, within our network of more than 340 providers in nearly two dozen states, about half of our providers are APPs."

Stephen "Fred" Divers, MD, is CMO of American Oncology Network. Photo courtesy of American Oncology Network.

How APPs are working on cancer care teams

APPs are playing several important roles on oncology care teams and in the entire range of cancer care, Divers explains.

"They are helping with initial patient intakes whether that is in a clinic for a new patient visit or in a hospital with a new diagnosis," Divers says. "APPs are involved from Day 1 in gathering and collating information as well as integration of data within the electronic health record."

APPs provide continuous cancer education for the patients and their families throughout the care delivery process as well.

"Typically, they see patients before, during, and after a visit with a healthcare provider," Divers says.

Once a patient is diagnosed, there are numerous appointments and clinic visits that must be coordinated. At many hospitals and oncology clinics, APPs conduct patient navigation duties.

"There is monitoring for side effects and toxicity, which falls to APP navigators in many cases," Divers says. "So, there is following up with patients after treatment and making sure that patients understand the side effects of their medications."

APPs are also working with cancer patients in the survivorship phase of their care journey.

"We have APPs who are functioning in a survivorship role by providing ongoing follow-up for patients because they have established relationships with those patients," Divers says.

APPs as leaders and their relationship with physicians

At AON, the network of community oncology practices has elevated APPs to leaderships roles, since many of them have spent years perfecting the craft of oncology care delivery.

"We recognize the ability of APPs to play leadership roles and have created a track for APPs to continue their education," Divers says. "Clearly, we recognize the value that APPs provide and want to elevate them to leadership roles whenever possible."

For example, AON has an APP who serves on the Community Oncology Alliance board of directors.

Lastly, the relationship between physicians and APPs on cancer care teams varies by what physicians need, according to Divers.

"For example, the nurse practitioner who works with me in the clinic works side-by-side with me all day making sure I do not forget anything and making sure all the data has been reviewed appropriately as well as making sure that care plans have been documented," Divers says. "At the end of the day, we meet and make sure that the patient inbox has been reviewed and everything has been taken care of."