Before Treatment Starts, for health systems
For health systems and cancer centers

Decision-readiness infrastructure for oncology.

Every oncology program is pursuing the same outcomes: informed patients, efficient encounters, scalable navigation, and guideline-concordant care. Those outcomes are often determined before treatment begins, and Before Treatment Starts is infrastructure for that interval: better-prepared patients, more productive conversations, and greater leverage from existing navigation.

6.85/7
Mean rating from early paying patients
2.8
Sessions per patient, on average
38.3
Questions addressed per patient
31.3min
Average session engagement

Early direct-to-patient deployment. While preliminary, the depth of engagement, repeat usage, and question volume suggest patients are using the platform as intended: to prepare for decisions rather than consume information passively.

Why this matters

The critical workflow gap in oncology.

Most cancer centers have invested extensively in diagnosis, treatment delivery, navigation, and survivorship. Relatively few have infrastructure dedicated to preparing patients for the decisions that determine those downstream activities.

The period between diagnosis and treatment initiation is one of the most operationally important, and least structured, intervals in cancer care. Patients are expected to participate in complex decisions while processing a life-changing diagnosis, navigating testing, coordinating logistics, and learning an unfamiliar clinical language.

Patients frequently arrive at treatment discussions:

  • Uncertain which questions require clarification
  • Unaware of potential biomarker, molecular, or staging considerations
  • Unable to clearly communicate treatment priorities and preferences
  • Overwhelmed by logistical, financial, and administrative complexity
  • Dependent on clinicians to reconstruct context during limited visit time

The consequence is predictable: physician time shifts toward information gathering, navigators spend capacity on preparation rather than guidance, and patients struggle to participate fully in decisions that affect treatment trajectory. Before Treatment Starts was built specifically to close that gap.

See it work

See a full session before you commit to anything.

Walk through a complete sample session, the same one a patient runs. It adapts to where they are and ends in the structured brief the care team receives. This is the clearest way to evaluate what it does.

A sample session with a fictional patient. Educational only, not medical advice.

Seen enough? Run it yourself on a cancer type common in your program. Request full access

What the platform does

A structured decision-readiness layer before treatment discussions.

Patient preparation

Guides patients through diagnosis, treatment context, concerns, priorities, goals, and upcoming decisions, using language designed for comprehension and action.

Identification of potential gaps

Surfaces areas that may warrant further discussion, including testing considerations, unresolved questions, logistical barriers, and patient concerns.

Structured clinical summary

Generates a concise, patient-controlled summary: clinical context, priorities and concerns, questions identified for discussion, and topics requiring clarification. The patient determines whether, when, and with whom it is shared.

Potential impact

How preparation becomes operational impact.

Each effect traces from a concrete input to the metrics it bears on, the outcomes every program already measures.

Encounter efficiency
Input

Better-prepared patients

Effect

Less contextual reconstruction

Metric

Visit efficiency, throughput, patient experience

Navigation capacity
Input

Structured intake before navigator engagement

Effect

Less time spent gathering history

Metric

Navigator caseload leverage, PIN utilization

Shared decision-making
Input

Questions and priorities surfaced earlier

Effect

Better-informed treatment discussions

Metric

Experience scores, quality measures, guideline concordance

PIN: Principal Illness Navigation (CMS codes G0023 and G0024), separately reimbursable under Medicare since 2024. These are mechanisms and the measures they bear on, not guaranteed outcomes.

Why it's different

Built specifically for oncology, not adapted to it.

Most patient-facing AI tools answer questions. Before Treatment Starts focuses on preparation. The objective is not to replace clinical expertise, but to help patients arrive ready to benefit from it.

It is designed around how oncology decisions are actually made:

Biomarker testing Treatment sequencing Clinical trial discussions Quality-of-life tradeoffs Caregiver involvement Financial and logistical barriers

The system focuses on helping patients recognize what still requires attention before decisions are finalized.

Security and governance

What it is, and what it isn't.

What it is not

Not medical adviceIt does not diagnose, recommend therapies, or provide clinical guidance. It surfaces questions; the care team answers them.
Not a replacement for the care teamIt prepares patients. Clinical judgment stays with the navigators and physicians.
Not a billing or EHR toolNo time logs, no documentation for billing, no EHR overlay or data-aggregation layer.
Not a validated distress instrumentIt captures psychosocial context but does not produce a validated distress score.

What it is

HIPAA-grade security architecturePatient conversations are encrypted and are not used to train third-party AI models. Institutional deployments are governed under a Business Associate Agreement, executed as part of partnership onboarding.
Patient-controlledThe patient owns their documents and chooses what to share, and with whom. Nothing is transmitted automatically.
Grounded in current evidenceClinical content is drawn from a curated, continuously updated base of published oncology literature and guidelines, specific to the patient's cancer type, and built and maintained with expert clinical oversight.
Request full access

Evaluate the full platform.

You've seen a session. Access is to the complete platform, not a limited trial. Evaluate it on a cancer type common in your program, then record your clinical assessment.

1
Request access. Each request is reviewed individually before access is granted.
2
Run a session as a patient would. About ten minutes, on a cancer type common in your program.
3
Record your clinical evaluation in the form that follows.

Request platform access

For navigators, clinicians, quality and experience teams, and partnership leads at health systems and cancer centers.

Credentials are sent here.

Your details are used only to set up your access.

Request received.

We'll review and send platform credentials to the email you provided, typically within one business day.

Clinical evaluation

The clinical evaluation.

Any deployment turns on one question first: is it clinically sound and appropriate for patients? The evaluation is scoped to that, and is best completed by a qualified clinician. It saves as you go.

Section 1 · About you

A little about you.

So we can follow up with the right context.

Step 1 of 6
Section 2 · Shared decision making

How does it align with shared decision making?

1 = strongly disagree · 5 = strongly agree

Surfaces patient priorities and values in actionable clinical language
The patient conversation feels supportive, not intimidating
Augments rather than replaces the care team's clinical role
Step 2 of 6
Section 3 · Clinical content

Is the clinical content sound?

Your judgment on what the tool produces for the cancer type you evaluated.

Clinical accuracy for the cancer type evaluated1 = inaccurate · 5 = accurate
Testing-gap identification is appropriate and complete1 = inappropriate · 5 = appropriate
The clinical brief is useful before a visit1 = not useful · 5 = very useful
Step 3 of 6
Section 4 · Fit in care

Where would this fit in care?

From a clinical standpoint, where is it appropriate, and who benefits most?

Step 4 of 6
Section 5 · Concerns

What concerns surfaced?

Select all that apply, and add anything you'd want raised.

Step 5 of 6
Section 6 · Recommendation

Your clinical recommendation.

Would you vouch for this clinically and bring it to the right people in your organization?

→ Together4Cancer

Evaluation received.

Thank you. We'll follow up directly to discuss your findings and next steps.

About Together4Cancer

Together4Cancer is a patient decision-readiness platform developed by NeedleSpotter, an oncology-focused company founded by Shruti Agarwal, PhD. The platform was developed through experience across medical affairs, commercialization, patient engagement, and cancer caregiving, and is designed to help patients participate more effectively in treatment decisions.

Learn more about NeedleSpotter →