Patient navigation has always been an essential intervention to improve access to care for vulnerable and underserved patient populations. New data from the Massachusetts General Hospital Cancer Center shows that navigation is also a promising approach to ensure continuity of care during the COVID-19 pandemic.
A new study from Alliance to Advance Patient-Centered Cancer Care program partner, the University of Arizona, dives into financial vulnerability for cancer patients with health insurance, aiming to better understand how health behaviors and psychosocial concerns may be associated with financial burden. Elizabeth Ver Hoeve, MA, from the Department of Psychology at the University of Arizona, is the lead author of the paper, “Patient-Reported Financial Toxicity, Quality of life, and Health Behaviors in Insured US Cancer Survivors,” which was recently published in the journal Supportive Care in Cancer.
Dr. Debra Roter, Johns Hopkins University Distinguished Service Professor in the Department of Health, Behavior, and Society at the Bloomberg School of Public Health, has been working with her team to adapt the intervention so that it can be delivered remotely. All changes will make it much more convenient for patients to participate.
The COVID-19 pandemic has brought many dramatic changes to our everyday life. As millions of Americans have opted to stay at home as much as possible, clinical practices have been expanding telemedicine efforts to reduce the risk of transmission, interacting with patients remotely via technology such as cell phones and other communication applications. While telemedicine has been available for many years, the use of these services has dramatically increased this year. The Cleveland Clinic recently reported logging more than 60,000 telemedicine visits in March. Before the global pandemic, it averaged about 3,400 virtual visits per month.
In a follow-up to their previous publication Oregon’s Familias en Acción replicates benefits for underserved cancer co-survivors through Un Abrazo Para la Familia, the team at the University of Arizona have expanded their Un Abrazo Para La Familia intervention to recruit and deliver the supportive care program to care recipients themselves.
While Abrazo was originally designed to help co-survivors cope with a loved one’s cancer diagnosis, the intervention team decided to expand the program to care recipients themselves. Thirty care recipients from existing cohorts in Tucson & Portland revealed clear benefits for cancer survivors. Data collected show that both cancer knowledge and self-efficacy (confidence in that cancer knowledge) significantly increased within the care recipient group. These results gave researchers the confidence to go forward with the recruitment of survivors as well as co-survivors. More data on the impact of Un Abrazo Para la FamiliaTM should be available soon.
“Just being able to help a patient, even making one appointment is where I get my satisfaction and joy,” Lead Patient Navigator Carmen Benjamin remarked.
The Massachusetts General Hospital Cancer Center navigation intervention is combining electronic health records and human touch to help patients receive the most comprehensive cancer care possible. The center is using TopCare (Technology for Optimizing Population Care in a Resource-limited Environment) software to match patient navigators with newly-diagnosed cancer patients who may require extra support. Navigation services at MGH are rooted in social work, with Lead Patient Navigator Carmen Benjamin and her team working to connect patients with transportation resources, financial services, and offering emotional support during appointments.
We last spoke to Carmen when we filmed the video Massachusetts General Hospital Cancer Center: Patient Navigation as the Cornerstone of Cancer Care. During her interview, she expressed great satisfaction helping cancer patients overcome barriers to care. Since most of Carmen’s patients are underserved, they often present with multiple illnesses to manage in addition to their cancer, and often lack social support: “Just being able to help a patient, even making one appointment is where I get my satisfaction and joy,” she remarked.
A new Alliance to Advance Patient-Centered Cancer Care Webinar
Promoting health equity is an important objective for most oncology and public health researchers; however, developing an intervention designed to move beyond the written word and into clinical practice can be a challenging process. This webinar will explore what it means to work with FQHCs on pragmatic cancer-based interventions, bridging the gap between academic research and the needs of community health centers. Julie Armin, PhD and Nancy Johnson, RN, MSN, MS, PhD will introduce the University of Arizona’s fruitful collaboration with El Rio Health, one of the largest federally qualified health centers in the country. Together, they will share their experiences in developing, implementing, and evaluating interventions that deliver long-lasting community impact.
Nurse navigator Susan Coples is the engine that drives patient-centered cancer care at the Georgia Cancer Center for Excellence at Grady Health System: in just two years, she has both influenced hospital policies and made a real difference in the lives of her patients.
“The health care system is a federation of millions of entrepreneurs with no one in charge. No single entity can command change.”
The National Academies of Sciences, Engineering, and Medicine, recently released a consensus report that outlines several key strategies to implement a comprehensive national cancer control plan. This ambitious program aims to set a precedent that could help inform the control of other diseases. The study was undertaken by the Committee on a National Strategy for Cancer Control in the United States with support from the National Institutes of Health, the Centers for Disease Control and Prevention, and the American Cancer Society. Alliance Co-Principal Investigator Electra Paskett, PhD, served as a member of the cancer control committee.
The Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins University School of Medicine are building a technology-based solution to tackle an ongoing challenge in cancer care delivery: effective transition of care (ToC). As Dr. Ahmed Hassoon, Co-Investigator with the Alliance to Advance Patient-Centered Cancer Care, explains, cancer patients often feel lost when they complete their active treatment; they move from intense monitoring and care to a destabilizing transition into survivorship. Studies have shown that patients in transition have a high risk of being readmitted to the hospital following their discharge, with rates of 26 percent for palliative medicine and 27 percent for general medical oncology.
In January 2019, the Policy Task Group for the National Navigation Roundtable released an issue brief entitled, “Patient Navigation in Cancer Care: Review of Payment Models for a Sustainable Future.” This resource outlines the various ways in which patient navigation services are currently funded. Case examples of short-term, long-term, and alternative funding models are given as well as their respective benefits and challenges. Finally, this document provides several recommendations for policy makers, payers, and stakeholders to improve payment models and to promote the sustainability and expansion of patient navigation in cancer care.