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Patient Navigators
The RPCI Patient Navigation Program will initially be focused in the Breast Center assisting medically underserved patients diagnosed with breast cancer. Patient navigators are trained, culturally competent health care workers who work with patients, families, physicians and the health care system to ensure cancer patients’ needs are appropriately and effectively addressed. Patient navigators will help cancer patients “navigate” the health care system and access appropriate services. Assistance will include:
Providing emotional support and information on what to expect; - Helping patients understand their diagnosis;
- Coordinating appointments to ensure that patients with suspicious findings receive timely diagnosis and treatment;
- Helping to arrange transportation and/or child/elder care to enhance patients’ abilities to keep appointments for cancer treatments;
- Helping patients and their families access support systems;
- Facilitating access to available financial support and assisting with related paperwork;
- Helping to coordinate follow-ups with community outreach support services.
The Navigation Program, pioneered in 1990 by Harold P. Freeman, MD, former national President of the American Cancer Society, has grown to more than 200 locations throughout the United States. As a cancer surgeon at Harlem Hospital in New York City, Dr. Freeman discovered that half the women who were seen there for breast and cervical cancer could not be cured, because their cancer was discovered too late. In most cases, a tangle of financial, educational and social disadvantages kept them from getting the screening and care they needed.
Inspired by that example, in May 2007 Roswell Park launched a similar program to assist at-risk patients with breast cancer. It was spearheaded by Roswell Park breast physicians Drs. Stephen Edge, Swati Kulkarni and Tracey O’Connor out of concern for patients who abruptly stopped coming for treatment.
Navigators Mildred Kelly and Dee Johnson currently assist 25 women in the program, most with “the same major problem—they can’t afford to stay in treatment once they begin,” says Johnson.
Kelly clarifies that it’s not the cost of the treatment itself that stands in their way: “If they don’t have medical coverage, Medicare or Medicaid or some state fund will kick in to pay; that’s not such a big issue. But nine times out of ten, their employers don’t provide paid medical leave, so they can’t miss even one day of work, or they won’t get paid. They say, ‘What am I going to do?
I have to feed my family.’”
When members of the Roswell Park medical team alert Kelly and Johnson that a patient is “missing in action,” or may require special help, the navigators contact her to evaluate her needs, explains Deborah Erwin, PhD, Director of Health Disparities. The patient may not know about the range of services available to her; if she can’t read, she may need verbal reminders about appointments, or simplified explanations of instructions provided by her doctor; or she may need to have appointments grouped closely together to minimize the time she has to take off from work.
Because some patients find it hard to communicate with medical professionals, Erwin adds, navigators also serve as go-betweens. “Often the patients will open up and ask questions or say things to the navigator that maybe they don’t want to bother the doctor with,” she says. The navigation services are coordinated with other educational support services at the Institute.
