Research suggests Pennsylvania could benefit from defining patient navigation for cancer care

Pennsylvania could benefit from implementing statewide guidelines for defining patient navigation and specifying the roles and responsibilities of patient navigators, according to Penn State College of Medicine researchers.

Patient navigation programs guide patients through the health care system.

This study focused on patient navigators who help cancer patients access and manage their treatment options. They educate people about cancer prevention and screening, connect patients to health care providers, recommend financial and community resources and navigate patients through the system.

Strengthening patient navigation program standards could minimize barriers to cancer treatment, increase cancer screening rates and reduce emergency and recurrent admissions costs. Pennsylvania currently offers no statewide guidelines for professionals in these roles.

Pennsylvania has the third-highest cancer incidence rate nationally and the second-highest among northeast states. Patient navigation can be an effective and scalable solution to addressing barriers to Pennsylvania residents getting the care they need. Barriers prevent not only the treatment of cancer, but diagnosis, and could lead to poor health outcomes. One example of a barrier is a lack of transportation in rural sections of the state.

Researchers reviewed scientific journal articles to understand the evolution, efficacy and cost-effectiveness of patient navigation in the United States. First, researchers searched online databases to find peer-reviewed articles published in English. Second, they categorized articles based on their subject focus. Searches were limited to articles published in the last 30 years. Researchers published their results in the Journal of Cancer Policy.

The researchers reported that patient navigation programs increased since 1990 and demonstrate effectiveness in increasing cancer screening and addressing barriers to diagnosis and care. Research also showed that navigation programs make care more manageable for patients, increase rates of treatment, increase patient satisfaction and improve the underrepresentation of racial and ethnic minorities in clinical trials. Navigation programs also potentially save money by providing more consistent screening and appointment attendance and fewer emergency room visits.

Because of the growth and documented effectiveness in patient navigation programs, the researchers suggest that Pennsylvania could benefit from adopting statewide guidelines, starting with the need to define patient navigator and patient navigation formally.

“People who practice patient navigation are known by various names, including, but not limited to, patient navigator, nurse navigator, social worker, outreach worker, community health worker and promotora, the Spanish term for community health worker,” the researchers reported. “Additionally, patient navigation is not a standardized and a recognized profession in Pennsylvania and hence a variety of different individuals fill the navigator roles. Although these individuals practicing patient navigation may possess different sets of skills, training and education, each one has valuable expertise to offer patients.”

The researchers suggest one option is for Pennsylvania to define the terms “patient navigation” and “patient navigator” based on the definition provided under the Patient Navigator Outreach & Chronic Disease Prevention Act of 2005, 109, P.L. 18, 119 Stat. 340.

“Formal recognition of patient navigators in Pennsylvania could potentially encourage hospitals and organizations to recruit a navigator workforce to serve the patients,” researchers wrote. “This initiative could not only benefit the patients but could also provide a positive return of investments to the hospitals through the increased screening rates and reductions in emergency and recurrent admissions costs.”

Researchers on this project were Ahuja A. Nirmal, a student in Penn State College of Medicine’s Doctor of Public Health program; Sol M. Rodríguez-Colón, project manager, Penn State Cancer Institute; Sara Costalas, a 2019 graduate of the Master of Public Health program at the College of Medicine; and Eugene J. Lengerich, professor of public health sciences, Penn State College of Medicine.

National Center for Advancing Translational Science, through Penn State Clinical and Translational Science Institute’s support of Lengerich, funded this research.

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