Reducing ReADmissions through Innovative ApplicatioNs of Telemedicine (RADIANT)

The Reducing ReADmissions through Innovative ApplicatioNs of Telemedicine (RADIANT) trial aims to build the evidence base necessary to establish a scalable remote patient monitoring (RPM) and integrative medicine (IM) intervention delivered via telemedicine platform to medical oncology patients discharged to home after hospitalization. The 12-week readmission rate for patients with cancer ranges from 33%-55% and reducing these readmissions would alleviate the high psychosocial, physical, and financial costs for patients and caregivers. We developed and implemented an RPM program that identifies medical oncology patients at hospital discharge and monitors their symptoms using electronic patient-reported outcomes (ePROs). Extended from approaches in other high-risk areas of oncology, the system intervenes as necessary to help manage symptoms. However, oncology patients discharged from the hospital have additional complicated needs related to their lingering symptom burden. Clinical guidelines now include interventions such as exercise and mind-body therapies (eg, yoga, tai chi, meditation) for symptom management during cancer treatment. Yet few patients have access to these treatments due to barriers for patients (eg, time, costs, transportation) and at the system level (eg, resource allocation, staffing, space constraints). Recently, the investigators completed a pilot randomized controlled trial (RCT) using telemedicine for IM and found that the intervention not only improved symptom burden, but also reduced rates of hospitalizations relative to enhanced usual care. Each of these approaches—RPMs and telemedicine for IM—has shown effectiveness in reducing hospital admissions, but no single platform connects ePROs and symptom management with mind-body therapies. We will combine IM therapies with the existing RPM capacity, such that the RPM can recommend a live, synchronous IM class to a patient based on RPM symptom inputs. Our hypothesis is that patients engaged in this telemedicine intervention, Connected Care, will have reduced rates of 12-week readmissions, and these reductions will correlate with reduced symptom burden as compared with control group patients receiving enhanced usual care. To test this hypothesis, we bring together a multidisciplinary team, including Medical Oncology, IM, Informatics, Implementation Science, and Biostatistics. We will randomly assign 530 medical oncology patients recently discharged to home to either 12 weeks of Connected Care or enhanced usual care. Our specific aims are to: (1) determine the effect of Connected Care on rates of 12-week readmissions among medical oncology patients; (2) evaluate the effects of Connected Care on symptom burden; and 3) develop implementation strategies to address real-world barriers to implementation of Connected Care. By addressing critically important gaps in care delivery of symptom monitoring and IM therapies via telemedicine, RADIANT will have a practice-changing effect, providing an evidence-based, replicable model of supportive care for patients with cancer discharged from the hospital. Project Number: 1R37CA300137-01A1 | Fiscal Year: 2026 | NIH Institute/Center: National Cancer Institute (NCI) | Principal Investigator: Robert Daly | Institution: SLOAN-KETTERING INST CAN RESEARCH, NEW YORK, NY | Award Amount: $747,660 | Activity Code: R37 | Study Section: Clinical Management in General Care Settings Study Section[CMGC] View on NIH RePORTER: https://reporter.nih.gov/project-details/11298101