GPS for health needs, aka patient navigators!

While browsing through my favourite public health blogs, I came across an article on Patient Navigation , by Pamela Fayerman published in the Vancouver Sun. I had never heard of this term before, so naturally I was very curious to see what it was about.

In a nutshell, patient navigators are health care providers specially trained to guide and ease patients’ access to and use of healthcare.  The concept was introduced in 1990 by Dr. Harold Freeman in Harlem Hospital Centre and was focused on cancer patients and since then it is being applied in various hospitals in the United States.  It is, however, more popular in Canada.

Reading about this concept, I couldn’t help but thinking how it could be used to improve  health literacy and decrease social inequalities in health care use. A quick pubmed search provided me with 79 results of articles studying patient navigation, with some promising results. However, not everyone is so enthusiastic about it. For instance, in her article in Journal of Oncology Practice in 2009 (Volume 5, p.264) Dr. Barbara McAneny is sceptical about the necessity of this “new” profession and the avoidable costs it poses to the health care system.

While I agree with Dr. McAneny that the fact that we need someone to navigate us through the health care system is a sign of a flawed system itself that should be changed and that ideally doctors should work together with the patients and their families to overcome any difficulties, I cannot deny the reality; namely that health care professionals do not always have the time to guide patients, patients do not always have families to take care of them and that the health care system cannot change from one day to the other. Attempting a GPS analogy: while it might be a luxury to some, it might be necessary to others.

What is your opinion about the use of patient navigators? Could it really make a difference in health care use or is it an unnecessary cost? Should it, perhaps, be offered for specific populations (immigrants, lonely elderly, illiterate) only? What effects could it have on health literacy and socio economic inequalities in health?  Do you have any first-hand experience of such a service?

* I found the link to Fayerman’s articles at the Covering Health Blog. For those interested in reading more, the whole series of her patient navigation articles can be found here.

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