Issue link: https://viewer.e-digitaledition.com/i/1442007
Exploring the Value of BY K ATE ANASTAS 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 M E D I C A L A D VA N C E S I N the 20th cent u r y brou g ht a g reat er need for subspecia lization. With new medica l k nowled ge a nd t he development of innovative treatments and technologies, physicians couldn't be skilled in every area of medicine. Instead, they needed to narrow their focus to better serve patients. As a result, health systems must make a world of multifaceted specialists and subspecialists more integrated and acces- sible. Patient navigation proves to be an excellent solution not only for patients but also to health systems that invest in the programs. VALUE FOR PATIENTS Patient navigation is a support strategy that a ssists in education, addresses barriers to care and enhances shared decision-making between patients and providers. Patient navigators walk along- side a patient from the initial outreach and prevention that takes place in the community through navigating survivor- ship and end-of-life care. S h a r on G ent r y, M S N, R N, HON ONN-CG, AOCN, CBCN, serves as the Progra m Director of the Academy of Oncolog y Nurse & Patient Navigators (AONN), which currently includes more than 9,000 nurse and patient navigators. Gentry has helped grow more than 30 Nav igator Net works throughout the countr y. She stresses t he impor ta nce of pat ient nav i gat ion i n t he complex world of ca ncer treatment . " Nav igati ng t he ca ncer conti nuum requires a tea m of professiona ls to com- municate sea m lessly a nd ef fectively," G entr y says. "Si los in ca re ca n lead to complex ities a nd m istr ust instead of timely treatment. Oncolog y navigators g uide patients through ca ncer with the goa l of eliminating ba rriers a nd ensur- i n g ea ch pat ient h a s a cces s t o ca re, education on treatment, oppor tunities to pa r ticipate i n cl i n ica l t r ia ls, ca re coord i n at ion , ps ychosocia l suppor t a nd suppor t for pa l liative ca re." Noncl i n ica l l icensed patient nav i- gat ors have d i rec t k nowled ge of t he community to assist patients with over- com i n g obst a cles to t reat ment , such a s la ck of t ra n spor t at ion , ch i ldca re, medica l leave a nd insura nce covera ge. Cl i n ica l ly l icen sed nav i gat ors coor- d i nate a l l component s of ca re pla ns. Bot h t y pes of patient nav igators ca n be a tr ust wor t hy resource to prov ide continuous suppor t a nd a ssista nce. Nav i gat or s h ave become va lua ble t o c a n c er c a r e pr o g r a m s , b ut t h e y a ren't l i m it ed t o t he oncolog y f ield . I n fa c t , mos t pat ient s w it h complex conditions ca n benef it f rom hav ing a "point person" to g uide t hem t h roug h ch ronic disea se. HEALTHCARE RETURN ON INVESTMENT FOR SYSTEMS There are upfront costs for implementing a patient navigation program. However, 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 realized annual cost sav- ings 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 naviga- tor 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 almost $500,000 to the system annu- ally — more than covering the salary of a clinical patient navigator. 2 4