The health care system is complex, both on the provider and payer sides. For patients, especially patients with chronic illnesses and older patients whose cognitive skills may be diminishing, it can be very hard to figure out both the treatment and reimbursement issues they are faced with. And having a health care need typically evokes emotional reactions that may make it harder to understand those issues and make sound decisions. Because of this, both software tools and human assistance is increasingly being offered to help patients navigate the health system. A report from the Center for Health Affairs focuses on patient navigation opportunities. (Center for Health Affairs Report) The report was written by a hospital-affiliated group, and one of the values of patient navigation for large health systems is that it can create a kind of stickiness that keeps patients coming back to the health system and as these systems encompass more and more kinds of care, it can ensure referrals for all the care stay in the system. But the report does a good job of defining patient navigation needs and possibilities.
Patient navigation is ill-defined, but bears a strong resemblance to care coordination. Some common aspects of a patient navigation service include dealing with barriers to care, helping with disease and treatment research and decision-making, finding providers, managing paperwork and insurance interactions, and interacting with family members and informal caregivers. Some of the benefits which can flow from patient-navigation include better health outcomes, fewer missed appointments, reduction of health disparities as minorities often have more difficulty in encounters with the health system and greater patient satisfaction. Some payers are beginning to add patient navigation tools and services as well. This is a concept that likely can be very helpful for those who have frequent interactions with the health system.