Patient Navigation Support Backed

NASW coordinated a Capitol Hill briefing in April to help legislators understand the importance of community-based patient navigation programs and the need to fund them.

NASW partnered with C-Change, a national cancer coalition composed of key national leaders from government, business and nonprofit sectors, to produce the Cancer Patient Navigation Toolkit.

NASW Executive Director Elizabeth J. Clark is among the 130 members of C-Change and serves on its Access Team. "It's important social workers have a strong voice in the conversation about patient navigation because many social workers are serving as navigators with clients," she said.

The Capitol Hill event highlighted the need to develop more community-based cancer patient navigation programs, to showcase the success stories of some patient navigators already in place and to advocate for fully funding the Patient Navigator Outreach and Chronic Disease Prevention Act of 2005.

Besides Clark, speakers included Harold Freeman, medical director of the Ralph Lauren Center for Cancer Care and Prevention; Fran Feltner, director of Kentucky Homeplace; and Tom Kean, executive director of C-Change.

Freeman said that the Patient Navigator Act was signed into law by President Bush in 2005 with a request to supplement the act with $25 million over five years in order to develop demonstration programs. However, those federal funds have yet to materialize. Freeman said it's important that lawmakers follow through with their promise to support the act in order for the program to prosper.

Freeman explained that the idea for a cancer patient navigation program came to him while he was a surgeon at the Harlem Hospital Center. Cancer patients — especially those who were in poor neighborhoods — often waited until it was too late to treat their conditions, he said. Because of this, he helped devise a cancer screening clinic with navigators who reached out to the community.

The pilot program proved successful in helping people treat their cancer sooner. The program compared five-year survival rates of breast cancer patients who were "navigated" and those who were not. Results showed that 87 percent of those with navigation assistance — versus 56 percent of those without it — completed biopsies, and in less time.

"We teach Americans to get the test, but we don't teach them what to do if the test reveals a problem," Freeman said.

Patient navigation in cancer care refers to the individualized assistance offered to patients, families and caregivers to help overcome health care system barriers and to facilitate timely access to quality medical and psychological care from pre-diagnosis through all the phases of the cancer experience.

"We believe the model should be a universal model," Freeman said, noting there are around 350 patient navigation sites in the U.S. However, considering there are around 5,000 hospitals in the country, the lack of programming is evident.

"The bottom line is, we need to apply all we know despite the ability of the patient to pay," said Freeman.

Clark noted that NASW received a grant from C-Change to produce the Cancer Patient Navigation Toolkit, which includes information materials, a Website, collateral materials and two DVDs showcasing patient navigation programs already helping cancer patients. The videos highlight three different communities that developed population-specific patient navigation programs with a variety of funding sources.

The audience at the briefing was shown the patient navigation effort being conducted through the Kentucky Homeplace assistance program, which is led by Feltner. Residents of rural Kentucky have unusually high levels of certain diseases, and the Kentucky Homeplace program addresses ways to improve residents' lives. Feltner said patient navigation is important because it can interconnect health professionals to better address a patient's needs, and it offers an opportunity for all parties to work toward a solution to a specific problem.

Clark said it's paramount that community groups become informed about the value of navigation programs in their communities. "We're trying to let people know this is an important concept, so we need to get community groups interested in spreading the word," she said.

C-Change's Kean said lawmakers need to support the Cancer Patient Navigation Act's full $25 million in funding in fiscal year 2009. C-Change's other main goals for this initiative are to educate providers and advocates in the cancer community about the importance of cancer patient navigation programs and to increase the number of community-based cancer patient navigation programs throughout the country.