Presenters Takeaways from PNI 2019
-- watch the conference video --
Thank you to all of the amazing experts who gave empowering presentations to build the case for navigation services. Without the work of these leaders, the future of Patient Navigation would be a little less bright.
Our presenters Left to Right: Linda Tantawi CEO, Dr. Lisa Newman, Karen Mandel, Jo Anne Jaravata, Dr. Janet Yeh, Mandi Pratt-Chapman, Dr. Jennifer Klemp, Monica Dean, Dr. Tracy Battaglia, Stewart McKeough Senior Advisor for Komen Greater NYC
Lisa Newman, MD: The Value of Patient Navigation
Dr. Lisa Newman perfectly summed up the importance navigators have in helping women through a diagnosis. Without their unwavering support, true survivorship is difficult to achieve. “Patient navigators help to get us through more than just the diagnosis of breast cancer...they help us to become our full selves again.”
Karen Mandel, LMSW and Yanira Padilla-Cruz: Navigation Across the Continuum of Care (download presentation)
Karen Mandel and Yanira Padilla-Cruz got a hearty laugh out of the audience when they compared patient navigators to walking, talking google services. They discussed the model for Patient Navigation services used at their Federally Qualified Health Center to ensure that everyone who passes through their Open Door receives the assistance they need. “The work our navigators do goes beyond the clinic - they work on the social determinants of health and address all patients barriers to care,” says Karen. Although Open Door Family Medical Center does not bill for any navigation services and receives no reimbursement for services, their board feels it is vital to put money behind navigation. Karen drove home why Patient Navigation needs to become a standardized reimbursable expense in three easy takeaways:
It is the right thing to do for our patients.
It can help to reduce the cost of care.
It improves communication among providers.
Karen Mandel and Yanira Padilla-Cruz
Janet Yeh, MD and Jo Anne Jaravata, RN: The Importance of Patient Navigation in Building and Growing a Breast Program: Our Experience in Brooklyn, NY (download presentation)
Dr. Janet Yeh and her nurse navigator Jo Anne Jaravata, RN gave a compelling presentation on how they build a breast program at NYU Langone-Brooklyn from scratch. Previously breast cancer care had been fragmented in Brooklyn but with the assistance of a $100,000 Pilot Patient Navigation Grant from Komen NYC, Dr. Yeh hired Jo Anne and together they brought dedicated providers and standardized care to the area. “Prior to Jo Anne, the doctors were the main coordinators for breast cancer patients, but we saw a need to have the right navigator.” As a navigator, Jo Anne is able to understand what each patient’s individual needs are and can assist in tailoring care to their challenges. Since the implementation of the navigation program, Dr. Yeh and Jo Anne have noticed less intense breast cancer diagnosis, have seen new and first-time patients at appointments, have had quicker turn-around times and shorter follow-ups, and altogether noticed improved patient satisfaction!
Jo Anne Jaravata and Dr. Janet Yeh
Jennifer Klemp, PhD, MPH: Improving Quality Care and Navigation Through Metrics and Risk Stratification (download presentation)
Dr. Jennifer Klemp started her presentation with a reminder to all of us, that until we can show a change in how Patient Navigation is improving healthcare and has a positive ROI, it will be difficult to standardize any form of reimbursement. In order to move forward with better breast cancer outcomes, we need to collectively move to a shared decision-making model between clients and patients where we are educating in the most impactful way. Dr. Klemp argues for the value of patient navigators when it comes to providing genetic and genomic testing. “Germline mutation and Somatic Mutations have completely different workflows and that is right where Patient Navigation fits. We need point of services testing and education that goes beyond the surgeon and oncologist so that the right tests are happening at the right time for the right patients.”
Dr. Jennifer Klemp and Dr. Lisa Newman
Mandi Pratt-Chapman, MA: Valuing Patient Navigation for Sustainment (download presentation)
Mandi Pratt-Chapman, the new, hip Harold P. Freeman, challenged everyone in the audience to rethink how they view Patient Navigation. Through her thoughtful examination, she discussed the challenges of standardizing navigation. “We are not always clear about what we want to measure and we cannot move forward without having a clear definition of what Patient Navigation is and who is providing which services,” Mandi says. She defines the five main navigators as community healthcare workers, social workers, lay navigators, nurse navigators, and chaplains and discussed the importance of using an appropriate fit to context model. “By using navigators who fit the type of practice needed,” she argues “we can document the value and metrics of each. This can lead to potential avenues of sustainable financing.”
Mike Ruiz de Somocurrcio: Aetna’s Provider and Patient Engagement Approach (download presentation)
Mike Ruiz de Somocurcio helped to bring the payers voice to life in this PNI conference. As a representative of Aetna, he cued us in on their Per Member Per Month model of reimbursement to help illustrate how navigation services are billable through their plan. Mike went on to expressed the benefits associated with value-based programs and how programs such as this can provide better overall care, improved patient outcomes, and satisfaction, all while lowering costs. He says that as more payers become involved in navigation reimbursement plans, they (the payers) will want to see date-driven changes showing the sustainability and positive investment of these programs.
Tracy Battaglia, MD, MPH: Translating Research Into Practice: A Community-Engaged Implementation Study Across Boston (download presentation)
Dr. Tracy Battaglia is as pretty darn close to Wonder Woman as possible. At our PNI conference, she discussed how she has brought together six competing health systems in Boston to deploy a cross-system patient navigation network, in the Translating Research Into Practice (TRIP) study. Her study is truly one of a kind and much needed in order to provide evidence on the beneficial impact of Patient Navigation. “By creating a community engagement program such as TRIP, we can look at implementing standards of care from system to system and see whether or not it was effective across multiple healthcare systems,” says Dr. Battaglia. Through large scale programming such as this Dr. Battaglia is helping to create a network of standardized navigation so that all of the population is cared for.
Monica Dean: The National Navigation Roundtable: Collective Action to Advance Patient Navigation (download presentation)
Monica Dean helped to bring all the other conversations together by talking about the next steps in moving comprehensive Patient Navigation forward. The National Navigation Roundtable has provided a collective body that brings together multiple stakeholders in the navigation conversation. Through a collective body Monica, organizations such as Komen Greater NYC, and others, are able to have candid conversations on defining navigation, creating standardized training programs, and standardize the measures of navigation practices. So what are Monica’s suggestions for next steps? Create basic level metrics across the continuum of care that are agreed upon. This includes the scope of work, implementation challenges, and working on policy changes. Secondly, she recommends improving workforce development and creating training programs with a set of competencies that need to be met to be considered a certified patient navigator.
Lily Tang, PhD: Radiation Therapy: My experience on preserving a healthy heart for left-sided breast cancer patients. (download special presentation)
Lily gave a wonderful and educational presentation on the use of Deep Inspiration Breath Hold (DIBH) for left-sided breast cancer. During radiation therapy for left-sided breast cancer the heart is at risk of radiation exposure but through the motion management of DIBH and Vision RT's new technology radiation therapy is becoming safer.
