By Eric Whitman

Technology, treatments, and patient expectations in the field of oncology are evolving at an unprecedented pace. With millions of dollars and lives impacted, how do health systems know they’re exercising sound financial stewardship? As a system medical director of the oncology service line, I’ve successfully employed a framework to guide these decisions. In this article, I’ll outline how a thoughtful application of the cost-benefit principle can improve patient experience and quality of care, enhance the work environment, and strengthen clinical excellence.

There’s a famous quote often attributed to Wayne Gretzky: “Skate to where the puck is going to be, not where it has been.” While it’s unclear if Gretzky coined it, the sentiment is highly relevant to cancer care. Health systems must envision what cancer centers will look like in 10 years, not just incremental improvements from today. Oncology is particularly compelling in this context, given the tremendous pace of innovation in recent years. These advances present both opportunity and challenge: how do you know when to adopt new technology? Adopt too early, and you risk investing in unproven results; wait too long, and your patients and institution may miss out on meaningful benefits.
You can ground your decision in three key pillars, much like the legs of a stool. You don’t want to place your full weight on something until you’re confident it will hold.

First, the starting line isn’t the bottom line. The most critical question is whether the investment benefits the patient. Will it provide a better experience? Will it enhance the quality of their care? It may sound like a familiar checklist, but it remains the most important measure.

Second, and equally important, is whether it benefits clinicians. When evaluating a new technology, the next question is how it will elevate the workplace. If it adds even five extra minutes to a clinician’s already overpacked day, it is unlikely to be sustainable.

Third is cost, understood in its full context. And that goes beyond the price of the service or technology itself. It includes staff training, workflow integration, ongoing maintenance, compliance, operational efficiency, and patient access. Cost is not just the machine or therapy; it is the ecosystem it creates.

What does this look like in the real world?
A concrete example of this decision framework in action is the MEVION S250-FIT Proton Therapy System, the first and only full proton therapy system that can fit in an existing LINAC vault, significantly reducing the size, cost and complexity of proton therapy.

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