Patient navigation programs—despite extra costs—narrow disparities in underserved populations
Advancements in cancer screening and access to insurance have led to improved detection and treatment. But underserved populations, including racial and ethnic minorities and or those with limited English proficiency, remain most vulnerable to experiencing disparities in care.
To narrow these disparities, patient navigation programs are being integrated into more healthcare systems, according to an article published online April 20 in the Journal of the American College of Radiology.
"What sets navigation programs apart from other community-based outreach programs or interventions is that they are operationally centered within the healthcare system, rather than within the community,” wrote lead author Chrishanae Neal, BA, from Massachusetts General Hospital, and colleagues. “In this way, navigation programs act as a liaison between the patient and the healthcare system and offer a more durable solution to real-time barriers that present and evolve over the course of patient care.”
Neal and colleagues highlighted that patient navigation programs are worth the provider's effort and patient costs due to their success in improving screening rates and treatment outcomes for breast and colorectal cancer patients.
Navigation is costly and can limit widespread implementation, the authors wrote. To ensure the greatest impact, additional research is needed to identify different types navigation services that will best address different patient populations—and it starts with recognizing patient barriers, the authors wrote.
Identifying lack of health insurance or transportation, limited health literacy or English proficiency, and pin pointing the geographic settings and socio-economic disparities of various patient populations will improve screening rates and guideline adherence through patient navigation, Neal et al wrote.
Additionally, active participation and collaboration amongst radiology practices in urban and rural settings will also support the success of patient navigation programs.
"[Program] success will uniformly require interdisciplinary collaboration between navigators, primary care physicians, radiologists and other specialists, regardless of the specific care setting. In particular, strong relationships and open lines of communication with referring physicians are likely to sustain effective and durable navigation programs," the authors wrote. "Such determinations will be particularly important to guide future research that will provide the necessary evidence for insurance coverage of patient navigation services and promote widespread adoption of navigation programs."
Overall, the authors believe that greater dissemination of research regarding patient navigation programs will be essential to determining its success.
"Ideally, such reports would allow health care centers and organizations across the United States to utilize such experiences as reference points to build economically viable programs for their own vulnerable populations," Neal et al. concluded. "In addition, given that published knowledge in this field remains sparse, we feel that qualitative research will be of great benefit to understand issues that may not be easily exposed by more standard research designs (i.e., randomized controlled trials)."
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.