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A Profession to Put on the Map

In many ways, patient navigation has gotten ahead of itself. The relatively modern profession has grown so widely and rapidly that patient navigators now vary in education, skill set, role, responsibility, and even name.

And, despite its clear value, the profession — which guides patients through disease screening, diagnosis, and treatment — is not a reimbursable service in the healthcare system. It also lacks a national training or credentialing standard that would solidify it as a professional field. 

But thanks to a recent meeting hosted by the GW Cancer Institute (GWCI), December 9, the field is closer than ever to catching itself up. For the first time since its creation, members of the National Patient Navigation Collaborative (NPNC), an initiative between GWCI, the American Cancer Society (ACS), and the University of Illinois at Chicago, came together to develop a strategic plan that will help to establish patient navigation as an integral part of the health care system.

The meeting, which brought together several dozen professionals from organizations and universities across the country including ACS, the University of Texas M.D. Anderson Cancer Center, and LIVESTRONG, sought to establish standardized core competencies for patient navigation training programs, develop a phased plan that will meet the goal of NPNC, and devise an approach for implementing the strategic plan through workgroups.

“We’re at a critical point, a transition phase,” said Stephen Patierno, Ph.D., director of the GW Cancer Institute, in his welcoming remarks. “Despite the fact that we come at it from different perspectives, there is a collective will to speak as one voice and work together to further patient navigation for the purpose of patients.”

“We have a role in saving the day,” added Rebecca Kirch, director of Quality of Life and Survivorship, Cancer Control at the American Cancer Society. “We have to show Congress and the world that we can deliver on the promise of patient-centered care.”

Throughout the day, the participants heard from leaders of community health worker and patient navigator training programs in various parts of the country, learned about the history of the field, and worked together to develop short, intermediate, and long-term plans for patient navigation training and certification.

Elizabeth Whitley, Ph.D., RN, director of the Denver Health Community Voices and co-principle investigator on the Colorado Patient Navigation Training Program, explained how Colorado is using multiple training levels and modalities to address the issue that aspiring patient navigators include a broad range of people from laypeople to registered nurses to unlicensed professionals who have moved to the United States after practicing medicine in other countries.  

A highlight of the meeting was the presentation by Harold Freeman, M.D., president and founder of the Harold P Freeman Patient Navigation Institute. Known as the “father” of patient navigation, Freeman reviewed the history of the profession which began in the 1990s when he used patient navigation to reduce cancer disparities among poor women in Harlem, New York. The field has since expanded to cities across the country and helps a wide range of patients with all types of diseases.

Freeman outlined the principles of patient navigation, which emphasize patient-centeredness, the integration of a fragmented healthcare system, access to timely care, and coordination. These principles, said Freeman, “should be applied irrespective of who we are and how we’re trained.”

He compared patient navigators to relay team coaches, who help each team member do his or her job while also ensuring that the “baton” is passed smoothly between each participant.

“Let’s take the evidence we have today to put patient navigation on the map as something that’s appreciated and funded by the government,” he concluded. “The endpoint is to save lives of people who would otherwise die.”