Implementation Science as the Secret Sauce for Integrating Exercise Screening and Triage Pathways in Oncology

Oncology rehabilitation and exercise (ORE) exist along a continuum of care, providing essential services for patients with cancer to improve health outcomes. Although oncology rehabilitation, typically delivered by licensed medical professionals, is often covered by third-party payers, exercise oncology remains largely unfunded despite its strong evidence base. Research indicates that exercise interventions improve cancer-related fatigue, physical function, mental health, and quality of life, yet referral and implementation remain limited. A geospatial analysis highlights disparity in program availability, particularly in rural and underserved areas. Effective ORE programs require systematic planning, institutional support, clinical workflow integration, and sustainable funding. Case analyses suggest that program adoption depends on leadership buy-in, organizational readiness, and structured referral pathways. Implementation science (IS) provides a framework to address real-world barriers, ensuring efficient integration of exercise services into oncology care. Screening and triage models can aid in patient assessment, streamlining referrals to appropriate levels of exercise intervention. Despite growing policy efforts, widespread third-party reimbursement remains elusive. Leveraging IS strategies can facilitate the adoption and sustainability of ORE programs, bridging the gap between research and practice. Future directions should focus on improving clinician education, expanding access through policy initiatives, and integrating exercise interventions into standard oncology care to optimize patient outcomes.