Pre-GPS, navigating sailing ships was enormously complex. A navigator used the sun, moon, stars, and a sextant to locate latitude and had to determine current local time and the time of a fixed reference point for a longitudinal fix, all to avoid running aground on reefs or running out of food before their destination was reached.
Plus, it had to be done aboard a pitching, heaving ship.
Healthcare challenges heave and pitch families’ lives when a loved one’s health is at stake. Cancer alone affects one out of every three American families and is one of the leading causes of bankruptcy. Plus, the healthcare system is increasingly complex.
The system is also strained, with 78 million Baby Boomers needing more and more healthcare. The Boomers are a generation that visits doctors more and consumes more services than prior generations. There simply aren’t enough doctors and nurses in the pipeline to meet this ever-rising need.
Consequently, the average physician today has 15 minutes or less to tend to patients. It used to be that a family’s primary care physician had the time to guide a patient and family through a healthcare challenge. Now many patients are referred to specialists, each in their own time vises.
Help is coming in the form of professionals trained to help individuals and families navigate the waves of medical bills, insurance company requirements, and essential follow-up care. To avoid the reefs of bankruptcy and financial deprivation, the health navigator might help patients negotiate discounts and establish payment plans for large medical bills.
Health navigators might also schedule doctors visits as well as lab and imaging appointments, helping patients to receive the best coordinated care possible. There won’t just be one generic variant of health navigator. A large healthcare system might have cancer care navigators, financial navigators, discharge navigators and others, all charged with making the incomprehensible comprehensible and easing problematic journeys. Navigators won’t be limited to hospitals, as a county health department or clinic might have its own navigator on staff.
Training the navigators
CVTC is launching a program to train these health navigators.
Shelly Olson, CVTC’s Executive Dean-Health, Emergency Services and River Falls Campus, said, “We have written a grant to have this funded. If it isn’t funded, we’re still going to run this program. We think it’s solid and expect funding, but either way, we’re committed.”
CVTC is renowned for graduating students needed by local employers.
“The healthcare providers are excited about our training and graduating students with the navigator skillset,” Olson said. “They’ve told us, ‘We will hire these people. We need them.’ We don’t create programming unless there will be a return on the investment.”
The healthcare dynamics of the Chippewa Valley mirror the nationwide trend of evermore older people trying to navigate an increasingly complex system.
“We have an expanding need to help the aging population. It is so complex when patients receive a new diagnosis, are dealing with an illness, or are being discharged from the hospitals,” Olson said.
A health navigator’s role might include keeping patients from avoiding re-admittance, she said.
“Hospitals need people to help patients from being readmitted,” Olson said. “Many patients will fare better if they have someone to help them tap the resources that keep them at home.”
When health navigators help to keep people at home, it’s both where they prefer to be and where the cost of care is considerably cheaper.
“An aging parent might not yet need a nursing home, but still needs someone to help them understand a complex healthcare system,” Olson said.
Because health navigator is a relatively new position, the public they’ll serve might not be aware of what they’ll offer.
“It’s not a job with the same name recognition like nurse,” she said.
It is, however, a job that can keep nurses nursing.
“There is a nursing shortage and there are nurses being removed from patient care to teach and train patients. The navigators can keep the nurses on the floor,” Olson said.
Positive health outcomes increasingly involves patient participation.
“Diseases are ever more treatable,” Olson said, “but patients need to have an ever greater understanding on their part for treatment to be successful.”
For the new health navigator program to be attuned to local needs, CVTC consulted with area providers.
“We brought in area employers: Marshfield, HSHS, Eau Claire City County Health Department, insurance agency representation, and long-term care settings,” she said. “We did a focus group and discussed unmet needs and target outcomes.”
And CVTC clarified that there would be jobs for its health navigator grads.
“We confirmed that there were jobs forecasted in five to seven years,” she said.
About the program
CVTC’s health navigator program is a 60-credit, two-year, online Associate Degree program that includes courses such as Introduction to Public Health, Prevention and Community Health, and Human Diseases for Health Professions, which will prepare students to interpret clinical documentation that they will encounter in a variety of healthcare settings.
Julie Furst Bowe, VP of Instruction at CVTC, said: “Graduates from this program will enhance the quality of health care services, as well as the patient experience, in the Chippewa Valley.”
Their training will enable the health navigators to deliver a panoply of services.
“Responsibilities of navigators may include organizing schedules and managing appointments; facilitating communication between patients, family members and health care providers; linking patients to financial and community resources; and ensuring continuation of care,” Bowe said.
Bowe, CVTC, and the Valley’s healthcare providers are well aware of how daunting a healthcare challenge can be.
“There is a need for trained individuals to serve as guides for patients to help them navigate through increasingly complex health care systems to ensure their health care needs are being met,” she said. “Instead of dealing with their local doctor or hospital as they may have done in the past, patients are having to interact with large health care systems with facilities in multiple states — Mayo, HSHS, etc. — as well as a wide array of insurance providers.”
This is why the coming launch of the program is welcomed by direct care providers.
“Area health care providers agreed with the need for this program and some of these providers already employ health care navigators, or navigators in specialty areas, such as cancer care,” Bowe said.
In the field
HSHS Sacred Heart Hospital has been using health navigators in its cancer center since 2011.
Georgia Smith, MSN, MHA, RN, OCN, Executive Director, Cancer Care Services for HSHS/Prevea, said, “The cancer nurse navigator helps explain medical jargon in clear terms for patients, helps them find transportation to care, assists them in managing their numerous appointments, assists them in finding assistance with the cost of medications, refers them for counseling and emotional support, and may other needed forms of help.”
Due to its efficacy, it’s a service that’s offered to all of Sacred Heart’s cancer care patients.
“HSHS Sacred Heart Hospital did a study in 2010 that showed us that many of our patients lacked the knowledge or the means to access quality cancer care, and, as a result, we hired our first navigator in the spring of 2011,” Smith said. “Today, 100 percent of our patients meet with a navigator, who assist 86.4 percent of our patients with some item of care.”
And Sacred Heart is placing navigators beyond cancer care.
“Since we hired our first navigator in 2011, our program has continued to grow and expand,” Smith said. “The complexities of the Affordable Care Act, as well as the high cost of cancer care, led us to expand our program. In 2016, we added a Financial Navigator, whose responsibility is to help patients understand the cost of care and maximize their insurance benefits to cover care. She also enrolls patients in drug reimbursement plans, as well as helping them seek out supplemental coverage, medical assistance, and other needs.”
Then another nurse navigator was added.
“This past July, we added a second nurse navigator, who specializes in breast cancer care, leukemias and lymphomas, as these patients have some of the most complex needs,” Smith said.
Expansion of the navigator model will continue.
“We are already discussing how the model we use in our cancer center could be expanded to assist patient with chronic heart conditions, COPD, diabetes, and other ailments,” Smith said.
Thus, Sacred Heart anticipates hiring CVTC’s health navigators down the pike.
“We are excited at the new crop of Health Care Navigators coming out of CVTC,” Smith said. “Many of the duties our navigators perform do not necessarily require a registered nurse. These new graduates will be able to assume many of the non-clinical duties to free up our nurses navigators to help more patients.”
Sacred Heart has seen an uptick in health outcomes with its health navigators.
“Our program has shown we can deliver much better outcomes and improve the likelihood of patients overcoming their disease,” Smith said. “If having a pipeline for additional health navigators allows us to leverage what we have learned to other clinics within our system, we can meet our vision of bringing ‘exceptional care, centered on the whole person.’”
Navigating makes all the difference.
If you’ve ever stood outside at night far from a bright city, you can be overwhelmed by the number of points of light. A celestial navigator knew which particular point of light was key and could steer accordingly. Likewise, a health navigator knows which information is germane for a particular patient and can translate the complex into the applicable, easing a demanding journey for the Valley’s patients and their families.