Scaling Whole-Person Care: Virtual Collaborative Models in Oncology

In part three of an interview, Nina Balanchivadze, MD, of the Sarah Cannon Research Institute at Virginia Oncology Associates, and Kyle Lavin, MD, MPH, of the UNC School of Medicine at the University of North Carolina at Chapel Hill, discuss a study evaluating integration of virtual collaborative behavioral health care for patients with breast cancer.

From the perspective of practicing oncologists, the study’s key finding is the need to treat patients holistically rather than focusing solely on cancer or physical symptoms. A cancer diagnosis is inherently stressful, and many patients experience mental health challenges such as adjustment disorders during their treatment. The researchers argue that mental health solutions must be integrated at a system level, designed to remove barriers and remain highly accessible without adding clinical burden for oncology teams.

A major advantage of the virtual collaborative care model is its frictionless integration into existing oncology workflows. The model is built to fit the schedules of busy oncologists, delivering high-quality psychological care within the oncology framework in ways that improve efficiency and preserve clinician time rather than creating extra tasks.

Financial sustainability is addressed through implementation of fee-for-service billing codes that make the virtual collaborative care model reimbursable. This reimbursement framework aims to ensure patient access while making the program financially viable for practices. The researchers describe the model as a potential “digital front door,” providing immediate, integrated support at the time of diagnosis and aiming for expansion to all cancer patients.

Looking ahead, the team plans to scale the model across community oncology practices and academic centers with varying resources, using a stepwise approach to reduce wait times and ensure patients receive appropriate care at the right time. They also emphasize integrating mental health interventions into clinical trials, noting that psychological support can influence treatment adherence and retention and should be studied for its impact on broader oncology outcomes.