MDNews - Mid Penn

Exploring the Value of BY K ATE STEINMETZ PATIENT NAVIGATION CAN BENEFIT BOTH PATIENTS MANEUVERING COMPLE X HE ALTH SYSTEMS AND THE HE ALTH SYSTEMS THEMSELVES, WHICH OF TEN E XPERIENCE A HIGH RE TURN ON INVESTMENT FROM NAVIGATION SERVICES. P A T I E N T N A V I G A T I O N MEDICAL ADVANCE S IN the 20th centur y brought a greater need for subspecia lization. With new medica l knowledge and the development of innovative treatments a nd technologies, physicia ns na rrowed their focus to better ser ve patients. As a result, hea lth systems must ma ke a world of multifaceted specia lists a nd subspecia lists more integ rated a nd acces- sible. Patient navigation proves to be a n excellent solution not only for patients but a lso for hea lth systems that invest in the prog ra ms. CREATING VALUE FOR PATIENTS Patient navigation is a support strategy that assists in education, addresses barriers to care and enhances shared decision-making between patients and providers. Patient navigators walk alongside a patient from the initial outreach and prevention that takes place in the community through navigating survivorship and end-of-life care. Sharon Gentry, MSN, RN, HON ONN-CG, AOCN, CBCN, serves as the Program Director of the Academy of Oncology Nurse & Patient Navigators (AONN), which currently includes more than 9,000 nurse and patient navigators. Gentry has helped grow more than 30 Navigator Networks throughout the country. She stresses the importance of patient navigation in the complex world of cancer treatment. "Navigating the cancer continuum requires a team of profes- sionals to communicate seamlessly and effectively," Gentry says. "Silos in care can lead to complexities and mistrust instead of timely treatment. Oncology navigators guide patients through cancer with the goal of eliminating barriers and ensuring each patient has access to care, education on treatment, opportunities to participate in clinical trials, care coordination, psychosocial support and support for palliative care." Nonclinical licensed patient navigators have direct knowledge of the community to assist patients with overcoming obstacles to treatment, such as lack of transportation, childcare, medical leave and insurance coverage. Clinically licensed navigators coordinate all components of care plans. Both types of patient navigators can be a trustworthy resource to provide continuous support and assistance. Navigators have become valuable to cancer care programs, but they aren't limited to the oncology field. In fact, most patients with complex conditions can benefit from having a "point person" to guide them through ch ronic disea se. HEALTHCARE RETURN ON INVESTMENT FOR SYSTEMS Despite upfront costs, several studies demonstrate a long-term payoff for health systems. The MetroHealth Cancer Center in Ohio initiated a year-long pilot using two full-time navigators to decrease the patient no-show rate. In three months, the reduction in no-shows for patients receiving radiation therapy equaled a navigator's annual salary. The overall return on investment was $5 for every $1 spent. High-risk hospital admissions were reduced by half, and readmissions and emergency room visits declined by a third. The Intermountain Southwest Cancer Center in Utah real- ized annual cost savings of $277,953 by medical oncologists and a 24-minute reduction in clinical visit time with newly diagnosed breast cancer patients when the patient had received an educational visit with a nurse navigator prior to meeting with the oncologist. Also, the medical oncologist was able to see an additional new clinic patient each day. The revenue generated from four oncologists seeing one new patient daily totalled $207,360. This plus the annual costs savings had the potential to bring in nearly $500,000 to the system annually — more than covering the salary of a clinical patient navigator. THE FUTURE OF PATIENT NAVIGATION With the onset of the COVID-19 pandemic, many navigators were furloughed. While it may be difficult to reassemble navigation teams after cutbacks, the pandemic also reaffirmed the value of navigation and its role in the future of patient care: + Navigators with skills in community engagement gained trust of vulnerable communities during the COVID-19 pandemic and addressed needs in the community. + Due to delays in cancer screening and treatment, provid- ers expect a n inf lux of patients in the coming months. Navigators and social workers will be essential to manage the patient volume. + Navigation proved to be a core, evidence-based strategy to address health inequities in communities. "As medicine ... has grown more complex over time, the need for navigators has grown with it," Gentry says. "Navigation will continue to foster a positive working atmosphere, one of mutual respect, dignity, diversity, ethical integrity and trust." n M D N E W S . C O M /// M D N E W S M I D - P E N N ■ 2 0 21 0 5

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