Patient navigation is an intervention that can help increase treatment adherence and improve health outcomes for cancer patients. Cancer patients and their caregivers often experience barriers to timely, high-quality cancer treatment. These barriers can include lack of experience with the healthcare system, inadequate health insurance, and challenges with day-to-day activities such as transportation to treatment and taking time off from work. Patient navigators can help reduce disparities in cancer care, increase patient satisfaction, and improve health outcomes. This paper describes the benefits of patient navigation with a focus on the value of the nonclinical patient navigator and will also highlight the evidence base for patient navigation as an effective intervention in the clinical setting.
The Benefits of Patient Navigation
Coping with cancer is an immense and complicated burden for cancer patients and their loved ones. When someone hears the words, “You have cancer,” the most imminent need is information—about the specific diagnosis, the treatment options, treatment side effects, available resources, insurance coverage, and so much more. The complexity of the cancer care journey, coupled with the life-threatening nature of cancer and its emotional repercussions, makes it difficult for people with cancer to make decisions about their care. Whereas information can offer hope and serve as a very empowering tool for newly diagnosed cancer patients, they and their families are often overwhelmed by the avalanche of materials, resources, forms, procedures, and complex medical information they receive in the days and weeks after the initial diagnosis.
While some newly diagnosed patients may feel overwhelmed with information, others may feel that they haven’t received enough clear or adequate information about treatment plans, options, and resources available to them. In addition, patients may experience barriers that impede or even prevent them from accessing the resources, treatment, and care they need. These barriers can include, but are not limited too, insufficient health insurance, transportation, geographic isolation, lodging expenses associated with out-of-town treatment, communication, and lack of understanding of or experience with the healthcare system. These barriers may be particularly evident among patients from underserved communities, such as low-income groups or racial or ethnic minorities.
In today’s often overwhelmed healthcare system, patient barriers frequently go unaddressed.1 Many patients don’t understand their cancer diagnosis or treatment plan. There may be additional stressors, such as having to take time off from work, the need for childcare, and the costs of treatment. Without answers or resources to help, some patients just give up.1
Patient navigation is one strategy to help address barriers to accessing timely, high-quality cancer care. We know that patient navigation is an effective intervention not only to help increase cancer screening rates but also to help cancer patients navigate the healthcare system. In recent years, 2 types of navigation have emerged—clinical navigation and nonclinical patient navigation. This article will focus on the nonclinical patient navigation role. The nonclinical navigator is a trained professional who provides individualized assistance to patients, families, and caregivers to help overcome barriers to timely access to quality cancer care.2
The Evidence Base
A recent report, The Emerging Field of Patient Navigation: A Golden Opportunity to Improve Healthcare,3 highlights the importance of patient navigators. The report also shares potential benefits of patient navigators, including improved health outcomes, increased patient satisfaction, decreased no-show rates, and reduced disparities in care.
Benefits extend beyond benefits to patients and their caregivers. Patient navigators can help hospitals avoid revenue loss and even increase revenue, according to another report.4 An example of the benefit to hospital systems was seen in a 6-month Accenture-MetroHealth study recently published in the Harvard Business Review.1 This study shows that the MetroHealth patient navigator program provides a positive return on investment for the health system. It has reduced no-show/cancellation rates by 3% and has saved the system significant revenue.1
A recent review of 29 patient navigation studies showed that patient navigation reduced the time to diagnosis and treatment, improved treatment adherence, improved patient quality of life, and improved patient knowledge regarding their cancer and helped improve their communication with their healthcare team.5 A significant survival benefit was also seen in a recent study with advanced cancer patients, and the greatest survival advantage in this study was seen in African American patients with Medicaid and a diagnosis of either lung or pancreatic cancer.6 So the evidence is there—patient navigation works!
The Benefits of Patient Navigation
As cancer patients and their loved ones face the many difficult challenges associated with a cancer diagnosis, patient navigators are there to help them cope with the many needs that arise. Patient navigators provide evidence-based, unbiased information that helps patients understand their diagnosis and make educated treatment decisions and connect them with programs and services that offer hope, support, and tangible help as they navigate their cancer experience.
Patient navigators can help guide cancer patients, families, and caregivers to personalized and reliable cancer information, resources, and services to improve their quality of life, with the goal of decreasing overall mortality from cancer.
Patient navigation is designed to provide a patient-centered, sustainable service delivery intervention that removes barriers to cancer care throughout the continuum, ensuring access to timely cancer detection, diagnosis, and care and integration into a healthcare system. Navigators are dedicated to assessing patients’ needs and connecting them with appropriate resources. They strive to build relationships with each cancer patient, survivor, and caregiver by providing continual support and resources to meet the evolving needs of the constituents along their cancer journey.
Cancer care is rapidly evolving. Meaningful advances in cancer care—immunotherapy and personalized therapy—have created great promise but also substantial challenges for patients. Research demonstrates that navigation can improve access to the cancer care system by addressing barriers, as well as facilitating quality care. The benefits of patient navigation for improving cancer patient outcomes is considerable.2
Every day, navigators are providing critical support and services to the patients most in need. However, there is still a tremendous opportunity to reach more people by increasing the number of navigators available in cancer centers and hospitals across the country. Patient navigation will continue to evolve to meet the ever-changing needs of cancer patients and their families. The overall navigation function, however, remains the same—helping improve access to timely, high-quality cancer care.
- Harvard Business Review. How Patient Navigation Can Cut Costs and Save Lives. https://hbr.org/2013/03/how-patient-navigation-brings. March 19, 2013.
- Riley S, Riley C. The role of patient navigation in improving the value of oncology care. Journal of Clinical Pathways. 2016;2(1):41-47.
- The Center for Healthcare Affairs. The Emerging Field of Patient Navigation: A Golden Opportunity to Improve Healthcare. https://neohospitals.org/TheCenterForHealthAffairs/MediaCenter/Publications/Issue Briefs/12-12_Patient-Navigation.aspx. 2012.
- Becker’s Hospital Review. Patient Navigators Play Key Role in Improving Quality, Lowering Costs. www.beckershospitalreview.com/quality/patient-navigators-play-key-role-in-improving-quality-lowering-costs.html. January 3, 2018.
- Krok-Schoen JL, Oliveri JM, Paskett ED. Cancer care delivery and women’s health: the role of patient navigation [published online January 28, 2016]. Front Oncol.
- Kowalkowski M, Raghavan D, Blackley K, et al. 12 month survival for oncology patients with versus without patient navigation. J Clin Oncol. 2016;34(suppl). Abstract 6510.