Patient Navigators in Primary Care

Hello all, my first blog post!

I did a significant amount of research on Patient Navigators in primary care, general care, and Latino specific care. Here is a quick summary of some of my findings.

http://www.jabfm.org/content/23/6/736.long
The one article I found that pertained to patient navigators in primary care discussed how the main role of the patient navigators was to provide information about resources, make phone calls to arrange appointments, enhance physician- patient communication, and various other office work. It was found that patient navigators would not be necessary in the actual clinic. This study also found that the biggest barrier to adopting a patient navigator program in clinics would be the upfront cost. In relation to our study, it is interesting to see how having patient navigators specifically for Latino community members could be adopted.

http://www.innovations.ahrq.gov/content.aspx?id=2564
Another article discussed the concept of a culturally competent community health worker serving low income Latinos. This study mainly focused on helping to connect "low-income Latinos to insurance and affordable health care services by delivering personalized education and assistance designed to improve participants' knowledge and attitudes about health insurance, health care access, and preventive services." The program was successful in increasing enrollment in health care insurance and increasing access to follow up care. Although this article did not specify their program for primary care, it seems as though this program could compliment the patient navigator's role in primary care clinics.

http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No2-May-2012/Transformacion-Para-Salud-Patient-Navigation-Model.html

The transformacion para salud is a patient navigation model that was developed to be a culturally specific patient navigation program. The patient navigator was trained with cultural sensitivity in mind to provide support and guidance throughout care.  There was a 91.7% reduction in ER visits and a 50% reduction in inpatient stay. One way in which health care delivery will be meaningful to recipients of care is by first providing a context of the care to be delivered, and then that this contextual approach should be individualized to the patient. Use of the TFH framework integrates the social determinants that have to be dealt with before one can focus on those demands. The TPS program which delivers care using that framework has achieved significant outcomes in terms of facilitating and sustaining behavioral changes needed for chronic disease self-management. With such success observed in chronic disease management, one can see the efficacy of a similar program for individuals needing primary care.

In general, the patient navigation programs were generally successful. All of the articles showed the efficacy of the program and suggested there were many avenues to go with it. It is certainly possible to think Latino patient navigation in primary care will save countless dollars and less congestion in the emergency department. Furthermore, patient navigation in primary care can provide Latino community members with a trusted culturally competent liason between the community and clinic. A patient navigator to help provide support and guidance as well as facilitate in assessing financial barriers could be a critical component in the next generation of primary care.

On another note, we had a firestorm of interviews today! We went to the Church of Incarnation, and our contact their was so nice. She made a great introduction for us, and Vianca followed up with an excellent introduction of our research goals.

I am excited for where this project can go and am fortunate to be part of such a great group of individuals!