There are currently no proven methods to improve this situation outside of expensive, non-selective patient navigation services which can only be maintained by the large, wealthy, centralized facilities which require patients to be able to travel to them in the first place. This project is very novel, but is grounded by the team’s data, expertise, and preparation. “We will validate the first automated informatics strategy ever developed to directly improve access to radiation treatment for vulnerable cancer patients via personalized social support,” Dr. Schwartz said. “This is a cost-efficient virtual platform to democratize treatment access for all Tennesseans as we transition out of COVID-19. Since supportive care strategies such as this are not commonly funded by traditional academic sponsors, the Department’s PT&E funding opportunity is a special chance for us to partner with the state to validate a fresh, community-centered approach, obtain longitudinal follow-on funding, and establish the platform as a durable asset appropriate for scaling to other clinical contexts and Tennessee centers.”

The team will utilize first-of-its-kind data science to screen patient electronic health records against population-level social determinants of health data to automate clinic coordination of patient support to overcome modifiable barriers to radiotherapy access. This functioning platform, named X-CART (“eXplainable Cancer Radiation Therapy”), will provide secure access to individual and population-level social/health information to select patients most in need of support. X-CART will use social determinants of health data from community-level data resources, individual-level data about our patients, and clinical data from electronic health records to create a fully interoperable health information platform. X-CART can clearly explain to busy providers why individual patients are at risk for radiotherapy interruptions, and then immediately triage them toward intervention. This represents a fundamental advance by the data science team members towards real-world application of digital innovation to reduce cancer treatment access obstacles. “Nothing this sophisticated is available anywhere in the United States,” Dr. Schwartz said.


This patient support strategy leverages a proven intervention model used by the group in its community engagement work supporting children experiencing mental illness. This intervention will be the first in the U.S. to utilize experienced community health support specialists to directly support cancer radiotherapy patients, particularly socially vulnerable patients.

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