American Oncology Network scales cancer care across 100 clinics

In a single weekend, the IT team at American Oncology Network (AON) might find itself integrating 18 cancer clinics and 500 users as part of the network's rapid expansion. It's the kind of operation where every system, every account, and every endpoint has to work, because on the other side of that go-live are patients arriving for chemotherapy, drug protocols that can't be delayed, and clinicians who need their tools the moment the doors open.

But before Freshservice, that velocity didn't exist. AON was running on a rigid, expensive legacy platform that required dedicated staff just to maintain — let alone scale with the aggressive growth of a nationwide cancer care network. After implementing Freshservice in under 30 days, AON transformed its service operations, expanding from IT ticketing into a unified enterprise service management platform spanning pharmacy operations, revenue cycle, HR, compliance, and facilities. With a 4.89/5 CSAT score, SLA compliance above 96%, and a single administrator managing the entire operation, a lean team of roughly 40 now delivers always-on support across 140+ cancer care locations.

"Freshservice is really the engine," says William Keeney, AON vice president of IT operations. "Without it, you're not going from point A to point B."

The company

American Oncology Network (AON) is a nationwide managed services organization for community cancer care, supporting roughly 140+ locations across the United States. 

The challenge

When a system goes down at a cancer clinic, human lives are impacted: chemotherapy infusions might pause or drug quality-assurance checks may halt. Electronic medical records could go dark, or clinicians could lose the ability to verify dosages, review patient histories, or document care in real time. For a network like AON where clinics open their doors every morning to people fighting for their lives, IT reliability is a clinical imperative.

That reality made AON's prior IT environment all the more untenable. The team had been using Ivanti, but it was bundled, rigid, and expensive—a legacy platform that required a team of dedicated staff just to keep it running. Building a single ticket template meant manual, one-by-one configuration. Reporting took hours of effort for minutes of insight.

As AON evolved, the IT team faced a startup's timeline with an enterprise's stakes: migrating 300-plus servers, standing up new Azure environments, and onboarding a coast-to-coast workforce, while ensuring the clinics wouldn’t experience a single disruption for patients receiving cancer treatment every day. The team evaluated several alternatives, but most proved either too rigid to customize or too expensive to justify. What AON needed was a platform with real depth—ITSM, ITOM, and enterprise service management on a single foundation—that it could deploy in weeks, not months, and run without a full-time platform team.

The solution

Freshservice was the obvious choice. Within 60 days, AON had integrated a fully outsourced help desk with bi-directional ticket flow. 

Freshservice, powered by AWS, gave AON the scalable backbone for what has become a relentless acquisition pace—roughly 35 new locations onboarded since early 2025 alone. The platform requires fewer than 30 minutes of configuration to bring a new practice online, and from day one, employees land in a unified portal through Okta without a second thought about what system they're using.

The real force multiplier has been the monitoring integration. AON pipes alerts from four separate platforms covering network circuits, servers, and infrastructure health into a single Freshservice triage view monitored by a 24/7 outsourced networks operation center (NOC). When a circuit goes down at a cancer clinic, the NOC is on the phone with the provider within three minutes. Most of the time, clinicians notice nothing more than a brief blip and patient care never stops.

That kind of invisible reliability is what sparked the rest of the organization to come knocking. Pharmacy operations adopted Freshservice first, using it to route temperature-sensor alerts for drug refrigeration cabinets—a use case where a missed notification could mean tens of thousands of dollars in spoiled cancer medication. Then facilities, revenue cycle, HR, compliance, and insurance followed, each department building its own templates and workflows with minimal IT involvement. "Within a four-hour meeting, somebody can be trained and empowered to go get their own templates created," says Keeney. Today, seven departments beyond IT run on the platform.

The ease of ongoing administration has been just as critical as the speed of deployment. A single administrator spends fewer than two hours a week managing the entire Freshservice environment—no dedicated platform team, no outside consultants. "Nobody on our team's full-time job is Freshservice," says Keeney. "We don't have that, and that's awesome for us."

More than 400 knowledge base articles now support employee self-service across the organization, and AON is testing Freddy AI Copilot's ability to surface those articles automatically, an early step toward deflecting routine tickets and freeing agents to focus on the work that keeps clinics running.

Impact

AON maintains a CSAT score of 4.89 out of 5 and SLA compliance above 96%, with an average resolution time of 8.19 hours. Across IT and seven business departments, the AI-powered platform handles 300 to 400 tickets daily for a team of roughly 40 supporting more than 3,000 endpoints.

The ultimate test came during Hurricane Helene in 2024, when the storm tore through western North Carolina and knocked out power and connectivity across an entire region. Freshservice's integrated alerting detected five AON clinic circuits in the Asheville market dropping within minutes of each other, a pattern that immediately signaled something far larger than a routine outage. Within hours, the team had sourced Starlink units and arranged emergency delivery through an existing FedEx contract. By the next day, affected clinics were back online with satellite internet and performance feeds were flowing into Freshservice within three hours of installation. Patients were receiving cancer treatment before the area had running water.

"We've never really questioned another product," says Keeney. "It's worked, and we don't have to throw a lot of time at it. That's the most important thing for us to scale and continue to support the organization's growth."