Four members of Reimagine Care’s ATM team on why remote patient monitoring is a necessary input — but not a solution — and what it takes to get outpatient advanced therapy right.
John Elliott | Chief Growth Officer, Belinda Conte | Chief Operating Officer, Jenn Smith, RN | Director of Product, Sarah Krumme, MSN, NP-C, AOCNP, BSN, BS, RN | Director, Clinical Services
Advanced therapies are rewriting what’s possible in oncology. CAR-T cell therapies and bispecific antibodies are delivering meaningful clinical benefit to patients who previously had no good options. The market reflects it — CAR-T alone generates approximately $1.2 billion in quarterly revenue and is projected to roughly double by 2028. FDA approvals are accelerating. Eligible patient populations are expanding as therapies move into earlier lines of treatment.
And yet only about 20% of eligible CAR-T patients are currently being treated. The bottleneck isn’t the drug. It’s the infrastructure to deliver it safely.
That infrastructure gap is where this piece begins. Four members of our team share the same view from different vantage points: remote patient monitoring is a necessary input to advanced therapy management — but it is not, on its own, a solution. Here’s why that distinction matters, and what it takes to get this right.
The Market Moment Demands More Than Monitoring
John Elliott, MBA | Chief Growth Officer
When I look at where advanced therapy is heading, I see an enormous opportunity and a real risk arriving at the same time.
The opportunity: more patients eligible for potentially curative treatments, more community health systems positioned to deliver them, and a growing recognition that care doesn’t have to happen inside a hospital to be safe. The risk: a wave of vendors entering this space claiming that remote patient monitoring — or generic care management platforms adapted for oncology — is sufficient infrastructure to support it.
It isn’t. And health system leaders who build their advanced therapy strategy around RPM alone will find themselves with a data stream, no scalable response model, and patients exposed in the space between alerts.
The question facing oncology program leaders right now isn’t whether to move advanced therapy outpatient. That direction is set. The question is whether the infrastructure will be ready when volume arrives — and whether it was built for this specific clinical problem or assembled from tools that were built for something else.
Capacity Expansion Requires an Operating Model, Not a Device
Belinda Conte, MS, MBA | Chief Operations Officer
From an operational standpoint, RPM is a monitoring tool. It captures physiologic data between visits and that data is important and valuable. But monitoring and data collection is not the same thing as care delivery.
What RPM alone cannot provide: structured escalation pathways, supply chain and device logistics management, coordinated documentation that connects back to the primary oncology team, or the operational backbone that allows a program to take on more advanced therapy patients without proportionally expanding clinical headcount.
This is also where capacity is either created or constrained. Health systems do not expand advanced therapy access simply by adding devices. They expand access when the work around patients becomes repeatable, reliable, and scalable. The goal is to support more outpatient advanced therapy patients without creating a linear increase in inpatient utilization, provider burden, or clinical burnout. The market opportunity is real, the clinical risk is real, and the only way to reconcile both is disciplined operations
Safe outpatient advanced therapy requires an operating model that is built before the first patient is enrolled. That means device logistics are managed end to end, so nurses are not troubleshooting equipment issues at night. It means monitoring expectations are clear to the patient and caregiver. It means dashboards are not just visible, but owned with defined responsibility for who reviews information, when they review it, and what happens next. It means escalation pathways are agreed upon in advance and documented, so the team is not improvising in a time-sensitive clinical moment
RPM is one input into that model. Organizations that mistake the input for the model will find that their capacity doesn’t expand — it just moves the risk from the hospital floor to the patient’s living room.
What Our Care Model Taught Us Before We Built ATM
Jenn Smith, MSN, RN | Director of Product & Advanced Therapy Management
Before we launched the Advanced Therapy Management (ATM) program, we had already supported thousands of cancer patients through active treatment — across symptom management, between-visit care, and continuous monitoring. That experience is the foundation ATM is built on.
What we learned is that engagement is the clinical variable that drives everything else. It determines whether a patient reports a symptom early enough to intervene, whether a caregiver knows what to watch for, and whether the care team has enough signal to act before a manageable problem becomes an acute one. Ninety-three percent of patients in our program engage at 30 days. Eighty percent are still active at 60 to 90 days. That consistency of engagement is not accidental — it’s designed.
We also learned that resolution capability is what protects provider capacity. Ninety-seven percent of encounters in our Virtual Care Center are resolved without escalation. That number is the product of oncology-trained clinicians with the right protocols, the right context, and the right escalation pathways — not a device generating alerts into a queue. When we built ATM, we didn’t start from scratch. We built it on top of a care model we had already pressure-tested at scale.
The Clinical Reality of CRS and ICANS
Sarah Krumme, MSN, NP-C, AOCNP, BSN, BS, RN | Director Clinical Services
The toxicity profile of CAR-T and BiTE therapies is specific, serious, and time-dependent. This is not a clinical context where general-purpose monitoring is adequate.
For CAR-T patients, cytokine release syndrome risk is front-loaded — concentrated in the days immediately following infusion, with a narrow window between early symptoms and serious progression. For BiTE patients, that risk doesn’t resolve after cycle one. It requires ongoing reassessment across the full treatment course. ICANS can present subtly: a patient who is slightly more confused, slower to respond, or reporting a headache on day three may be showing the earliest signs of neurotoxicity. A temperature reading from an RPM device does not tell you that.
What distinguishes a safe outpatient advanced therapy program from a risky one is clinical triage discipline: the ability to assess a symptom report in context, understand where a patient is in their treatment timeline, apply oncology-specific escalation criteria, and respond within minutes — not hours. Our Virtual Care Center averages a response time of under 10 minutes from alert to clinician action. That speed is a safety variable, not an operational metric. For a CAR-T patient on day four post-infusion with a fever, the difference between a 10-minute response and a two-hour response can determine whether they’re managed at home or admitted through the ED.
RPM contributes objective physiologic data to that picture. It does not replace the clinical judgment required to interpret it.
Reimagine Care’s Advanced Therapy Management program is designed to support health systems scale outpatient advanced therapy delivery safely — with the infrastructure, clinical coverage, and operating model to support it. To learn more, visit reimaginecare.com.