Skip to main content

Establishing effective patient navigation programs in oncology

Supportive Care in Cancer volume 27, pages 1985–1996 (2019)Cite this article

Abstract

Purpose

Recent advances in cancer treatment have resulted in greatly improved survival, and yet many patients in the USA have not benefited due to poor access to healthcare and difficulty accessing timely care across the cancer care continuum. Recognizing these issues and the need to facilitate discussions on how to improve navigation services for patients with cancer, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine (NASEM) held a workshop entitled, “Establishing Effective Patient Navigation Programs in Oncology. The purpose of this manuscript is to disseminate the conclusions of this workshop while providing a clinically relevant review of patient navigation in oncology.

Design

Narrative literature review and summary of workshop discussions

Results

Patient navigation has been shown to be effective at improving outcomes throughout the spectrum of cancer care. Work remains to develop consensus on scope of practice and evaluation criteria and to align payment incentives and policy.

Conclusion

Patient navigation plays an essential role in overcoming patient- and system-level barriers to improve access to cancer care and outcomes for those most in need.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

£ 29.95

Price includes VAT (United Kingdom)
Tax calculation will be finalised during checkout.

References

  1. O’Keefe EB, Meltzer JP, Bethea TN (2015) Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000–2010. Front Public Health 3. https://doi.org/10.3389/fpubh.2015.00051

  2. Freeman HP, Rodriguez RL (2011) History and principles of patient navigation. Cancer. 117(S15):3537–3540. https://doi.org/10.1002/cncr.26262

    Article  Google Scholar 

  3. Freeman HP (2006) Patient navigation: a community based strategy to reduce cancer disparities. J Urban Health 83(2):139–141. https://doi.org/10.1007/s11524-006-9030-0

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wells KJ, Battaglia TA, Dudley DJ, Garcia R, Greene A, Calhoun E, Mandelblatt JS, Paskett ED, Raich PC, the Patient Navigation Research Program (2008) Patient navigation: state of the art or is it science? Cancer. 113(8):1999–2010. https://doi.org/10.1002/cncr.23815

    Article  PubMed  PubMed Central  Google Scholar 

  5. National Academies of Sciences, Engineering, and Medicine (2018) Establishing effective patient navigation programs in oncology: proceedings of a workshop. The National Academies Press, Washington, DC. https://doi.org/10.17226/25073

  6. Mokdad AH, Dwyer-Lindgren L, Fitzmaurice C, Stubbs RW, Bertozzi-Villa A, Morozoff C, Charara R, Allen C, Naghavi M, Murray CJL (2017) Trends and patterns of disparities in cancer mortality among US counties, 1980-2014. JAMA. 317(4):388–406. https://doi.org/10.1001/jama.2016.20324

    Article  PubMed  PubMed Central  Google Scholar 

  7. Neal CD, Weaver DT, Raphel TJ, Lietz AP, Flores EJ, Percac-Lima S, Knudsen AB, Pandharipande PV (2018) Patient navigation to improve cancer screening in underserved populations: reported experiences, opportunities, and challenges. J Am Coll Radiol 15:1565–1572. https://doi.org/10.1016/j.jacr.2018.03.001

    Article  PubMed  Google Scholar 

  8. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66(1):7–30. https://doi.org/10.3322/caac.21332

    Article  Google Scholar 

  9. Freeman HP (2004) Poverty, culture, and social injustice: determinants of cancer disparities. CA Cancer J Clin 54(2):72–77. https://doi.org/10.3322/canjclin.54.2.72

    Article  PubMed  Google Scholar 

  10. Oluwole SF, Ali AO, Adu A, Blane BP, Barlow B, Oropeza R, Freeman HP (2003) Impact of a cancer screening program on breast cancer stage at diagnosis in a medically underserved urban community. J Am Coll Surg 196(2):180–188. https://doi.org/10.1016/S1072-7515(02)01765-9

    Article  PubMed  Google Scholar 

  11. Susan G. Komen® launches national patient navigation program to improve breast cancer outcomes for underserved women and men | Susan G. Komen®. http://ww5.komen.org/News/Susan-G%2D%2DKomen®-Launches-National-Patient-Navigation-Program-To-Improve-Breast-Cancer-Outcomes-For-Underserved-Women-And-Men.html. Accessed 3 June 2018

  12. Stanley S, Arriola KJ, Smith S, Hurlbert M, Ricci C, Escoffery C (2013) Reducing barriers to breast cancer care through Avon patient navigation programs. J Public Health Manag Pract 19(5):461–467. https://doi.org/10.1097/PHH.0b013e318276e272

    Article  PubMed  Google Scholar 

  13. Patient navigators help cancer patients manage care. https://www.cancer.org/latest-news/navigators-help-cancer-patients-manage-their-care.html. Accessed 17 Apr 2018

  14. 45 CFR 155.210—navigator program standards. LII / Legal Information Institute. https://www.law.cornell.edu/cfr/text/45/155.210. Accessed 8 Oct 2018

  15. Cancer Program Standards (2016 edn). American College of Surgeons. https://www.facs.org/quality-programs/cancer/coc/standards. Accessed 7 Mar 2018

  16. (2017) Implementing the Commission on Cancer Standard 3.1 Patient Navigation Process. https://cancercenter.gwu.edu/sites/default/files/coc_navigation_standard_road_map.pdf. Accessed 11 May 2018

  17. Freund KM, Battaglia TA, Calhoun E, Dudley DJ, Fiscella K, Paskett E, Raich PC, Roetzheim RG, The Patient Navigation Research Program Group (2008) National Cancer Institute Patient Navigation Research Program. Cancer. 113(12):3391–3399. https://doi.org/10.1002/cncr.23960

    Article  PubMed  PubMed Central  Google Scholar 

  18. DeGroff A, Schroy PC, Morrissey KG et al (2017) Patient navigation for colonoscopy completion: results of an RCT. Am J Prev Med 53(3):363–372. https://doi.org/10.1016/j.amepre.2017.05.010

    Article  PubMed  Google Scholar 

  19. Rohan EA, Slotman B, DeGroff A, Morrissey KG, Murillo J, Schroy P (2016) Refining the patient navigation role in a colorectal cancer screening program: results from an intervention study. J Natl Compr Canc Netw 14(11):1371–1378

    Article  PubMed  PubMed Central  Google Scholar 

  20. Reprinted with permission. Willis A, Reed E, Pratt-Chapman ML, et al (2013) Development of a framework for patient navigation: delineating roles across navigator types. J Oncol Navig Surviv 4:22–24. ©2013 Green Hill Healthcare Communications, LLC

  21. Ali-Faisal SF, Colella TJF, Medina-Jaudes N, Scott LB (2017) The effectiveness of patient navigation to improve healthcare utilization outcomes: a meta-analysis of randomized controlled trials. Patient Educ Couns 100(3):436–448. https://doi.org/10.1016/j.pec.2016.10.014

    Article  PubMed  Google Scholar 

  22. Castaldi M, Safadjou S, Elrafei T, McNelis J (2017) A multidisciplinary patient navigation program improves compliance with adjuvant breast cancer therapy in a public hospital. Am J Med Qual 32(4):406–413. https://doi.org/10.1177/1062860616656250

    Article  PubMed  Google Scholar 

  23. Raich PC, Whitley EM, Thorland W, Valverde P, Fairclough D (2012) Patient navigation improves cancer diagnostic resolution: an individually randomized clinical trial in an underserved population. Cancer Epidemiol Biomarkers Prev 21(10):1629–1638. https://doi.org/10.1158/1055-9965.EPI-12-0513

    Article  PubMed  PubMed Central  Google Scholar 

  24. Jean-Pierre P, Cheng Y, Wells KJ, Freund KM, Snyder FR, Fiscella K, Holden AE, Paskett ED, Dudley DJ, Simon MA, Valverde PA, for the Patient Navigation Research Program (2016) Satisfaction with cancer care among underserved racial-ethnic minorities and lower-income patients receiving patient navigation. Cancer. 122(7):1060–1067. https://doi.org/10.1002/cncr.29902

    Article  PubMed  PubMed Central  Google Scholar 

  25. Paskett ED, Harrop JP, Wells KJ (2011) Patient navigation: an update on the state of the science. CA Cancer J Clin 61(4):237–249. https://doi.org/10.3322/caac.20111

    Article  PubMed  PubMed Central  Google Scholar 

  26. Freund KM, Battaglia TA, Calhoun E, Darnell JS, Dudley DJ, Fiscella K, Hare ML, LaVerda N, Lee JH, Levine P, Murray DM, Patierno SR, Raich PC, Roetzheim RG, Simon M, Snyder FR, Warren-Mears V, Whitley EM, Winters P, Young GS, Paskett ED (2014) Impact of patient navigation on timely cancer care: the patient navigation research program. J Natl Cancer Inst 106(6). https://doi.org/10.1093/jnci/dju115

  27. Percac-Lima S, Ashburner JM, Zai AH, Chang Y, Oo SA, Guimaraes E, Atlas SJ (2016) Patient navigation for comprehensive cancer screening in high-risk patients using a population-based health information technology system: a randomized clinical trial. JAMA Intern Med 176(7):930–937. https://doi.org/10.1001/jamainternmed.2016.0841

    Article  PubMed  Google Scholar 

  28. Ko N, Snyder F, Raich PC, Paskett ED, Dudley D, Lee JH, Levine PH, Freund KM (2015) The impact of patient navigation on racial and ethnic disparities: results from the patient navigation research program. J Clin Oncol 33(15_suppl):6510–6510. https://doi.org/10.1200/jco.2015.33.15_suppl.6510

    Article  Google Scholar 

  29. Ferrante JM, Chen P-H, Kim S (2008) The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health 85(1):114–124. https://doi.org/10.1007/s11524-007-9228-9

    Article  PubMed  Google Scholar 

  30. Gabitova G, Burke NJ (2014) Improving healthcare empowerment through breast cancer patient navigation: a mixed methods evaluation in a safety-net setting. BMC Health Serv Res 14:407. https://doi.org/10.1186/1472-6963-14-407

    Article  PubMed  PubMed Central  Google Scholar 

  31. Phillips CE, Rothstein JD, Beaver K, Sherman BJ, Freund KM, Battaglia TA (2011) Patient navigation to increase mammography screening among inner city women. J Gen Intern Med 26(2):123–129. https://doi.org/10.1007/s11606-010-1527-2

    Article  PubMed  Google Scholar 

  32. Raj A, Ko N, Battaglia TA, Chabner BA, Moy B (2012) Patient navigation for underserved patients diagnosed with breast cancer. Oncologist 17(8):1027–1031. https://doi.org/10.1634/theoncologist.2012-0191

    Article  PubMed  PubMed Central  Google Scholar 

  33. Marshall JK, Mbah OM, Ford JG, Phelan-Emrick D, Ahmed S, Bone L, Wenzel J, Shapiro GR, Howerton M, Johnson L, Brown Q, Ewing A, Pollack CE (2016) Effect of patient navigation on breast Cancer screening among African American Medicare beneficiaries: a randomized controlled trial. J Gen Intern Med 31(1):68–76. https://doi.org/10.1007/s11606-015-3484-2

    Article  PubMed  Google Scholar 

  34. Baik SH, Gallo LC, Wells KJ (2016) Patient navigation in breast cancer treatment and survivorship: a systematic review. J Clin Oncol 34(30):3686–3696. https://doi.org/10.1200/JCO.2016.67.5454

    Article  PubMed  PubMed Central  Google Scholar 

  35. Psooy BJ, Schreuer D, Borgaonkar J, Caines JS (2004) Patient navigation: improving timeliness in the diagnosis of breast abnormalities. Can Assoc Radiol J 55(3):145–150

    PubMed  Google Scholar 

  36. Hoffman HJ, LaVerda NL, Young HA et al (2012) Patient navigation significantly reduces delays in breast cancer diagnosis in the District of Columbia. Cancer Epidemiol Biomarkers Prev 21(10):1655–1663. https://doi.org/10.1158/1055-9965.EPI-12-0479

    Article  PubMed  PubMed Central  Google Scholar 

  37. Donaldson EA, Holtgrave DR, Duffin RA, Feltner F, Funderburk W, Freeman HP (2012) Patient navigation for breast and colorectal cancer in 3 community hospital settings. Cancer. 118(19):4851–4859. https://doi.org/10.1002/cncr.27487

    Article  PubMed  Google Scholar 

  38. Lee J-H, Fulp W, Wells KJ, Meade CD, Calcano E, Roetzheim R (2013) Patient navigation and time to diagnostic resolution: results for a cluster randomized trial evaluating the efficacy of patient navigation among patients with breast cancer screening abnormalities, Tampa, FL. PLoS One 8(9):e74542. https://doi.org/10.1371/journal.pone.0074542

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Wells KJ, Lee J-H, Calcano ER, Meade CD, Rivera M, Fulp WJ, Roetzheim RG (2012) A cluster randomized trial evaluating the efficacy of patient navigation in improving quality of diagnostic care for patients with breast or colorectal cancer abnormalities. Cancer Epidemiol Biomarkers Prev 21(10):1664–1672. https://doi.org/10.1158/1055-9965.EPI-12-0448

    Article  PubMed  PubMed Central  Google Scholar 

  40. Ell K, Vourlekis B, Lee P-J, Xie B (2007) Patient navigation and case management following an abnormal mammogram: a randomized clinical trial. Prev Med 44(1):26–33. https://doi.org/10.1016/j.ypmed.2006.08.001

    Article  PubMed  Google Scholar 

  41. Gabram SGA, Lund MJB, Gardner J, Hatchett N, Bumpers HL, Okoli J, Rizzo M, Johnson BJ, Kirkpatrick GB, Brawley OW (2008) Effects of an outreach and internal navigation program on breast cancer diagnosis in an urban cancer center with a large African-American population. Cancer. 113(3):602–607. https://doi.org/10.1002/cncr.23568

    Article  PubMed  Google Scholar 

  42. Ko NY, Darnell JS, Calhoun E, Freund KM, Wells KJ, Shapiro CL, Dudley DJ, Patierno SR, Fiscella K, Raich P, Battaglia TA (2014) Can patient navigation improve receipt of recommended breast cancer care? Evidence from the National Patient Navigation Research Program. J Clin Oncol 32(25):2758–2764. https://doi.org/10.1200/JCO.2013.53.6037

    Article  PubMed  PubMed Central  Google Scholar 

  43. Guadagnolo BA, Boylan A, Sargent M, Koop D, Brunette D, Kanekar S, Shortbull V, Molloy K, Petereit DG (2011) Patient navigation for American Indians undergoing cancer treatment. Cancer. 117(12):2754–2761. https://doi.org/10.1002/cncr.25823

    Article  PubMed  Google Scholar 

  44. Percac-Lima S, Milosavljevic B, Oo SA, Marable D, Bond B (2012) Patient navigation to improve breast cancer screening in Bosnian refugees and immigrants. J Immigr Minor Health 14(4):727–730. https://doi.org/10.1007/s10903-011-9539-5

    Article  PubMed  Google Scholar 

  45. Jandorf L, Gutierrez Y, Lopez J, Christie J, Itzkowitz SH (2005) Use of a patient navigator to increase colorectal cancer screening in an urban neighborhood health clinic. J Urban Health 82(2):216–224. https://doi.org/10.1093/jurban/jti046

    Article  PubMed  PubMed Central  Google Scholar 

  46. Honeycutt S, Green R, Ballard D, Hermstad A, Brueder A, Haardörfer R, Yam J, Arriola KJ (2013) Evaluation of a patient navigation program to promote colorectal cancer screening in rural Georgia, USA. Cancer. 119(16):3059–3066. https://doi.org/10.1002/cncr.28033

    Article  PubMed  Google Scholar 

  47. Lasser KE, Murillo J, Lisboa S, Casimir AN, Valley-Shah L, Emmons KM, Fletcher RH, Ayanian JZ (2011) Colorectal Cancer screening among ethnically diverse, low-income patients: a randomized controlled trial. Arch Intern Med 171(10):906–912. https://doi.org/10.1001/archinternmed.2011.201

    Article  PubMed  Google Scholar 

  48. Percac-Lima S, Grant RW, Green AR, Ashburner JM, Gamba G, Oo S, Richter JM, Atlas SJ (2009) A culturally tailored navigator program for colorectal cancer screening in a community health center: a randomized, controlled trial. J Gen Intern Med 24(2):211–217. https://doi.org/10.1007/s11606-008-0864-x

    Article  PubMed  Google Scholar 

  49. Naylor K, Ward J, Polite BN (2012) Interventions to improve care related to colorectal cancer among racial and ethnic minorities: a systematic review. J Gen Intern Med 27(8):1033–1046. https://doi.org/10.1007/s11606-012-2044-2

    Article  PubMed  PubMed Central  Google Scholar 

  50. Horne HN, Phelan-Emrick DF, Pollack CE, Markakis D, Wenzel J, Ahmed S, Garza MA, Shapiro GR, Bone LR, Johnson LB, Ford JG (2015) Effect of patient navigation on colorectal cancer screening in a community-based randomized controlled trial of urban African American adults. Cancer Causes Control 26(2):239–246. https://doi.org/10.1007/s10552-014-0505-0

    Article  PubMed  Google Scholar 

  51. Jandorf L, Braschi C, Ernstoff E, Wong CR, Thelemaque L, Winkel G, Thompson HS, Redd WH, Itzkowitz SH (2013) Culturally targeted patient navigation for increasing African Americans’ adherence to screening colonoscopy: a randomized clinical trial. Cancer Epidemiol Biomarkers Prev 22(9):1577–1587. https://doi.org/10.1158/1055-9965.EPI-12-1275

    Article  PubMed  PubMed Central  Google Scholar 

  52. Percac-Lima S, López L, Ashburner JM, Green AR, Atlas SJ (2014) The longitudinal impact of patient navigation on equity in colorectal cancer screening in a large primary care network. Cancer. 120(13):2025–2031. https://doi.org/10.1002/cncr.28682

    Article  PubMed  Google Scholar 

  53. Gervès-Pinquié C, Girault A, Phillips S, Raskin S, Pratt-Chapman M (2018) Economic evaluation of patient navigation programs in colorectal cancer care, a systematic review. Health Econ Rev 8:12. https://doi.org/10.1186/s13561-018-0196-4

    Article  PubMed  PubMed Central  Google Scholar 

  54. Evidence summary: lung cancer: screening—US Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/Page/SupportingDoc/lung-cancer-screening/evidence-summary4. Accessed 3 June 2018

  55. Percac-Lima S, Ashburner JM, Rigotti N, Park ER, Chang Y, Atlas SJ (2017) Lung cancer screening patient navigation for current smokers in community health centers: a randomized controlled trial. J Clin Oncol 35(15_suppl):1506–1506. https://doi.org/10.1200/JCO.2017.35.15_suppl.1506

    Article  Google Scholar 

  56. Rocque GB, Pisu M, Jackson BE, Kvale EA, Demark-Wahnefried W, Martin MY, Meneses K, Li Y, Taylor RA, Acemgil A, Williams CP, Lisovicz N, Fouad M, Kenzik KM, Partridge EE, for the Patient Care Connect Group (2017) Resource use and Medicare costs during lay navigation for geriatric patients with cancer. JAMA Oncol 3(6):817–825. https://doi.org/10.1001/jamaoncol.2016.6307

    Article  PubMed  PubMed Central  Google Scholar 

  57. Kline RM, Bazell C, Smith E, Schumacher H, Rajkumar R, Conway PH (2015) Centers for Medicare and Medicaid services: using an episode-based payment model to improve oncology care. J Oncol Pract. 11(2):114–116. https://doi.org/10.1200/JOP.2014.002337

    Article  PubMed  Google Scholar 

  58. Medicare reimbursement. https://www.socialworkers.org/Advocacy/Policy-Issues/Medicare-Reimbursement. Accessed 3 June 2018

  59. Cox K, Mortimer L, Schumacher H, York A, Muldoon D (2015) Oncology care model frequently asked questions and application overview webinar. https://innovation.cms.gov/Files/transcripts/OCM-FAQ-App-trans.pdf. Accessed 3 June 2018

  60. Levit L, Balogh E, Nass S (2013) Delivering high quality cancer care: charing a new course for a system in Crisis. Ganz P, ed

  61. Kline RM, Muldoon LD, Schumacher HK, Strawbridge LM, York AW, Mortimer LK, Falb AF, Cox KJ, Bazell C, Lukens EW, Kapp MC, Rajkumar R, Bassano A, Conway PH (2017) Design challenges of an episode-based payment model in oncology: the centers for Medicare & Medicaid Services Oncology Care Model. J Oncol Pract 13(7):e632–e645. https://doi.org/10.1200/JOP.2016.015834

    Article  PubMed  PubMed Central  Google Scholar 

  62. Altman SH (2012) The lessons of Medicare’s prospective payment system show that the bundled payment program faces challenges. Health Aff (Millwood) 31(9):1923–1930. https://doi.org/10.1377/hlthaff.2012.0323

    Article  Google Scholar 

  63. Beyond utilization: reimagining providers as consumers to promote hospital price competition. https://www.healthaffairs.org/do/10.1377/hblog20180515.520870/full/?utm_term=Beyond%20Utilization%3A%20Reimagining%20Providers%20As%20Consumers%20To%20Promote%20Hospital%20Price%20Competition&utm_campaign=Health%20Affairs%20Sunday%20Update&utm_content=email&utm_source=2018-05-06&utm_medium=email&cm_mmc=Act-On%20Software-_-email-_-Prescription%20Drug%20Pricing%3B%20Lack%20Of%20Diversity%20In%20Genomic%20Databases%3B%20Hospital%20Price%20Competition-_-Beyond%20Utilization%3A%20Reimagining%20Providers%20As%20Consumers%20To%20Promote%20Hospital%20Price%20Competition. Accessed 3 June 2018

  64. Schroeder SA, Frist W (2013) Phasing out fee-for-service payment. N Engl J Med 368(21):2029–2032. https://doi.org/10.1056/NEJMsb1302322

    Article  CAS  PubMed  Google Scholar 

  65. Sprandio JD (2012) Oncology patient–centered medical home. J Oncol Pract. 8(3S):47s–49s. https://doi.org/10.1200/JOP.2012.000590

    Article  PubMed  PubMed Central  Google Scholar 

  66. Press MJ, Rajkumar R, Conway PH (2016) Medicare’s new bundled payments: design, strategy, and evolution. JAMA. 315(2):131–132. https://doi.org/10.1001/jama.2015.18161

    Article  CAS  PubMed  Google Scholar 

  67. McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES (2010) A national strategy to put accountable care into practice. Health Aff (Millwood). 29(5):982–990. https://doi.org/10.1377/hlthaff.2010.0194

    Article  PubMed  Google Scholar 

  68. Medicare coverage determination process (2018) https://www.cms.gov/Medicare/Coverage/DeterminationProcess/. Accessed 8 Jul 2018

  69. 2019 Medicare Advantage and part D rate announcement and call letter. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-04-02-2.html. Accessed 8 July 2018

  70. Pratt-Chapman ML, Willis A, Masselink L (2015) Core competencies for oncology patient navigators. J Oncol Navig Surviv 6(2):16–21 http://www.jons-online.com/issue-archive/2015-issues/april-2015-vol-6-no-2/core-competencies-for-oncology-patient-navigators/. Accessed 7 Mar 2018

    Google Scholar 

  71. Core competencies. ONS. https://www.ons.org/practice-resources/competencies. Published February 24, 2015. Accessed 6 Mar 2018

  72. Pratt-Chapman ML, Burhansstipanov L (2018) Navigation training, tools and resources. In: Shockney L (ed) Team-based oncology care. Springer International, New York

    Google Scholar 

  73. Hatzenbuehler ML, Phelan JC, Link BG (2013) Stigma as a fundamental cause of population health inequalities. Am J Public Health 103(5):813–821. https://doi.org/10.2105/AJPH.2012.301069

    Article  PubMed  PubMed Central  Google Scholar 

  74. Liu C, Mason R, Roubal AM, Ojo E, Calhoun EA, Patierno SR (2018) Consensus support for the role of patient navigation in the nation’s healthcare system. In: Patient navigation. Springer, New York, pp 119–140. https://doi.org/10.1007/978-1-4939-6979-1_7

    Chapter  Google Scholar 

  75. Paskett ED, Krok-Schoen JL, Gray DM (2017) Patient navigation—an effective strategy to reduce health care costs and improve health outcomes. JAMA Oncol. 3(6):825–826. https://doi.org/10.1001/jamaoncol.2016.6107

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge the staff team of the National Cancer Policy Forum (Erin Balogh, Cyndi Trang, Natalie Lubin, and Sharyl Nass) for organizing the patient navigation workshop and spearheading this effort.

Funding source statement

No sources of funding were obtained for the preparation of this manuscript. The National Cancer Policy Forum workshop was supported by the Centers for Disease Control and Prevention, the National Cancer Institute/National Institutes of Health, the American Association for Cancer Research, American Cancer Society, American College of Radiology, American Society of Clinical Oncology, American Society of Hematology, Association of American Cancer Institutes, Bristol-Myers Squibb, Cancer Support Community, CEO Roundtable on Cancer, Flatiron Health, Helsinn Therapeutics (USA), Inc., LIVESTRONG Foundation, Merck, National Comprehensive Cancer Network, Novartis Oncology, Oncology Nursing Society, and Pfizer Inc.

Author information

Affiliations

  1. Harvard Medical School, Boston, MA, USA

    Diego Lopez

  2. The George Washington University Cancer Center, Washington, DC, USA

    Mandi L. Pratt-Chapman

  3. Centers for Disease Control and Prevention, Chamblee, GA, USA

    Elizabeth A. Rohan

  4. Oncology Nursing Society, Pittsburgh, PA, USA

    Lisa Kennedy Sheldon

  5. University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    Karen Basen-Engquist

  6. Centers for Medicare & Medicaid Innovation, Baltimore, MD, USA

    Ron Kline

  7. University of Pennsylvania Abramson Cancer Center, Philadelphia, PA, USA

    Lawrence N. Shulman

  8. Massachusetts General Hospital, 55 Fruit St, Boston, MA, USA

    Efren J. Flores

Authors
  1. Diego Lopez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mandi L. Pratt-Chapman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth A. Rohan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lisa Kennedy Sheldon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Karen Basen-Engquist
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ron Kline
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lawrence N. Shulman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Efren J. Flores
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Efren J. Flores.

Ethics declarations

Conflict of interest statement

The authors declare that they have no conflict of interest.

Disclaimers

The authors are responsible for the content of this article, which does not necessarily represent the views of the National Academies of Sciences, Engineering, and Medicine nor the official position of the Centers for Disease Control and Prevention.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lopez, D., Pratt-Chapman, M.L., Rohan, E.A. et al. Establishing effective patient navigation programs in oncology. Support Care Cancer 27, 1985–1996 (2019). https://doi.org/10.1007/s00520-019-04739-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-019-04739-8

Keywords

  • Cancer care barriers
  • Oncology
  • Patient navigation