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Clinician assessment of adverse events in oncology systematically underestimates the severity and frequency of symptoms that patients actually experience, creating risks in both drug development and routine care. Electronic patient-reported outcome (ePRO) systems help to address this gap by enabling frequent remote symptom monitoring, bringing the patient voice into the care pathway between clinic visits. Published studies confirm that automated data-driven alerting in response to ePRO data entries can drive better patient outcomes including reduced emergency department visits, delayed physical function deterioration, and improved symptom control, with early intervention the likely mechanism. Translating this evidence into practice demands deliberate attention to how data are visualized, communicated, and acted upon. This perspectives article examines, primarily in the context of oncology clinical trials, the tools and design principles that translate ePRO data into timely clinical action, including heatmap visualizations that reveal symptom trajectories at a glance, predefined alert thresholds that trigger proactive responses, and patient-facing self-management support delivered at the moment of reporting. The regulatory, ethical and methodological case for embedding active monitoring within oncology trial design is also considered.