Real-time quality-of-life reporting via on-line tool is great, but what happens when you propose an app to an older patient and they request mozzarella sticks? This ingenious prospective trial randomized 416 patients age 75 and older (median age 82) to +/- regular “low-tech” telephone (we’re picturing rotary) calls with lay health workers who would verbally ask them standardized QOL questions. These lay folk would then (often) same-day communicate symptom scores to one of two advanced practice practitioners who could perform interventions and who, importantly, were independent of the patients’ oncology practices (read: this was not layered onto other clinical duties meaning two APPs could handle 416 patients). This remarkably yielded significantly less emergency department visits (48% → 31%) and halved hospitalizations (40% → 19%). This ultimately translated to an average reduction in healthcare costs of $12 000 per participant even after paying for the lay healthcare workers’ and two APP’s time. As the accompanying editorial puts it: “Patients often prefer speaking to people—not interacting with software—particularly when they are struggling.” | Patel, JAMA 2025 & Wright, JAMA 2025
