NCI's Patient Navigator Research Program: Fact Sheet
Key Points
- NCI is addressing unequal patterns of access to standard care by conducting an NCI-sponsored Patient Navigation Research Program at
multiple sites.
- The purpose of the Patient Navigator Research Program is to develop interventions to reduce the time of delivery of standard cancer
services, cancer diagnosis, and treatment after identifying an abnormal finding.
- The patient navigator will assist patients and their families through the cancer care continuum. Examples of navigation services
may include: arranging various forms of financial support; scheduling transportation to appointments; and organizing childcare during
appointments.
Background
Health policymakers have determined that a major disconnect or gap exists between cancer research discovery and the delivery of those
research findings in the form of improved patient care. Unrecognized barriers can prevent many Americans from receiving the best quality care
and health disparities arise when the delivery system does not provide access to timely, standard care to everyone in the nation. The National
Cancer Institute (NCI) has established the goal of eliminating suffering and death due to cancer by 2015. To meet this goal requires immediate
action to address the gap between development and delivery, particularly among underserved populations.
NCI is addressing these unequal patterns of access to standard care by conducting a NCI-sponsored Patient Navigation Research Program (PNRP)
at multiple sites. The NCI's Center to Reduce Cancer Health Disparities is already conducting several pilot patient navigator projects (http://crchd.cancer.gov/attachments/equal_access_volume1_issue4.pdf).
The purpose of the PNRP is to develop interventions to reduce the time of delivery of standard cancer services, cancer diagnosis, and
treatment after identifying an abnormal finding from a cancer detection procedure.
Patient navigator interventions, by identifying innovative methods for overcoming access barriers for people in underserved communities,
should have a substantial impact on reducing cancer health disparities and the burden of cancer within the next decade.
NCI will assess the impact of patient navigators on providing timely quality standard care and encouraging research collaborations and
partnerships across cancer care delivery systems and organizations (e.g., primary care facilities, community health centers, hospitals, and
academic centers).
- What exactly is a patient navigator?
"Patient navigation" in cancer care refers to the assistance offered to
healthcare consumers (patients, survivors, families, and caregivers) to
help them access and then chart a course through the healthcare system and
overcome any barriers to quality care. A patient navigator can be a registered
nurse or a social worker who functions as a "guide." Navigators help their
patients move through the complexities of the healthcare system—getting
them more timely treatment, more information about treatment options and
preventive behaviors. For example, in one community, a navigator's job may
be to coordinate transportation to medical care for patients since some
residents may have to travel more than 100 miles to receive cancer treatment.
The program is designed for the navigator to serve as a reliable ally to
lean on for advice, support and direction. A navigator is someone who understands
the patient's fears and hopes, and who removes barriers to effective care
by coordinating services, increasing a cancer patient's chances for survival
and quality of life.
The patient navigator will assist patients and their families through the
cancer care continuum. Examples of navigation services may include: arranging
various forms of financial support; arranging for transportation to and
childcare during scheduled diagnosis and treatment appointments; identifying
and scheduling appointments with culturally sensitive caregivers; coordinating
care among providers (such as screening clinics, diagnosis centers, and
treatment facilities); arranging for translation/interpretation services;
ensuring coordination of services among medical personnel; ensuring that
medical records are available at each scheduled appointment; and coordinating
other services to overcome access barriers encountered during the cancer
care process. The Patient Navigator will link patients and families with
appropriate follow-up services.
- When does patient navigation begin?
Navigation spans the period from an abnormal finding via a cancer detection
procedure, through necessary cancer diagnostic tests, to completion of cancer
treatment.
- What are the benefits of the Patient Navigator Program?
Evidence shows that in addition to unequal access to health care, racial/ethnic
minorities and underserved populations do not always receive timely, appropriate
advice and care when confronted with a cancer diagnosis. Patient navigators
can make the difference between someone from an underserved population becoming
a cancer survivor or a cancer death. If navigators get involved early enough
after a person has received a cancer diagnosis, they can help steer patients
and their families to appropriate care and treatment that could dramatically
improve patients' chances of getting the best care and have an opportunity
to live with cancer as a manageable disease. By navigating patients around
barriers to quality care, patient navigators actually help ensure that cancer
patients are not shortchanged in their options and their care.
- What are some of the barriers faced by cancer patients from underserved
communities that the Patient Navigator Program can address?
A cancer patient from an underserved population is likely to face a variety
of barriers to quality care and treatment. For example, there are financial
challenges (especially for the uninsured and underinsured); communication
and information problems including language barriers; problems with an inferior
healthcare system within their communities; travel and distance challenges
that can lead to missed doctor appointments; and emotional barriers where
irrational fears lead to cancellation or delay of medical services.
The patient navigator offers disadvantaged cancer patients someone with
whom they can feel comfortable; someone who has the knowledge base and confidence
the patient might not possess.
- Is the patient navigator concept in existence in communities across the
country?
The patient navigator concept has been utilized in several communities
with different variations and is being implemented in some form or fashion
across the country. The Patient Navigator Program is part of a much larger
framework of NCI initiatives focused on overcoming cancer health disparities.
NCI supports three Patient Navigator pilot programs for Native American
communities at three sites of the Indian Health Service in the Portland,
Ore., area. NCI also awarded funding to two hospitals to establish and monitor
Patient Navigator Programs as a component of its Cancer Disparities Research
Partnerships—at the Rapid City, S.D., Regional Hospital that serves 100,000
Native Americans from surrounding communities and reservations, and the
Laredo, Texas, Medical Center, which serves 50 "colonias" communities. The
"colonias" areas historically have been home to an extremely poor segment
of the Hispanic population, whose unclean living conditions generally rival
that of Third World nations.
- Where can one obtain additional information about the Patient Navigator
Program?
Information is available at the NCI Center to Reduce Cancer Health Disparities
Web site, at http://crchd.cancer.gov/, or by calling 301–496–8589.
Equal Access, the newsletter of the NCI Center to Reduce Cancer Health
Disparities:
http://crchd.cancer.gov/attachments/equal_access_volume1_issue4.pdf
http://crchd.cancer.gov/attachments/equal_access_volume1_issue2.pdf
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Related NCI materials and Web pages:
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TTY (toll-free): 1–800–332–8615
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