From the Home to the Tertiary Center: A Personal Health Care Model in Oncology

Background:Tertiary cancer centers were built for depth and nuance rather than speed, yet patients increasingly judge access by how quickly and with how little friction they can reach a clinician. This mismatch is widening as cancer demand rises and the workforce fails to scale, and added physical capacity alone cannot close it. Durable gains in access, quality, and cost instead require safe, evidence-based capabilities beginning in the patient’s home. Summary:This review outlines a personal health care (PHC) model in oncology that relocates the early work of evaluation from the clinic into the home and examines where the model holds and where it does not. Key Messages:The model is organized as five capability layers: sensing, deciding and acting, monitoring with governance and safety, escalation, and external integration. Patient-owned sensing at home, such as validated at-home urine testing and wearable smart devices, feeds clinician-supervised decision support, while the first in-person visit is preserved for treatment initiation. The clinician remains in the loop across all five layers, as a clinically trained reviewer can draw more decision-relevant information from a brief virtual encounter than an untrained intermediary following a fixed algorithm. For at-home diagnostics and artificial intelligence (AI) tools, the appropriate comparator is not the leading specialists but the large share of patients who currently reach no specialist at all. As the cost of cancer care is driven by the workforce rather than by buildings or equipment, relocating an encounter to the home does not by itself reduce cost, and only a lower-cost workforce meaningfully changes that trajectory.