Barriers and opportunities to measuring oncology patient navigation impact: Results from the National Navigation Roundtable survey

Abstract

Background Patient navigation improves cancer care delivery for those most at risk for poor outcomes. Lack of sustainable funding threatens the full integration of navigation services into health care delivery systems. Standardized navigation metrics that document impact and identify best practices are necessary to support sustainability. Methods The National Navigation Roundtable administered a web‐based, cross‐sectional survey to oncology patient navigation programs to identify barriers and facilitators to the use of navigation metrics. The 38‐item survey asked about data‐collection practices and specific navigation metrics used by the program. Exploratory and descriptive statistics were used to identify factors associated with data collection and reporting. Results Seven hundred fifty respondents from across the country represented navigation programs across the continuum of care. Although 538 respondents (72%) reported participating in routine data collection, only one‐half of them used data for reporting purposes. For the 374 programs that used electronic health records, only 40% had discrete, reportable navigation fields, and 25% had an identifier for navigated patients. Program funding was identified as the only characteristic associated with data collection, whereas the type of data collected was associated with work setting, participation in alternative payment models, and where on the continuum navigation services are provided. Respondents participating in an oncology accreditation program were more likely to collect specific outcome metrics across the continuum and to use those data for reporting purposes. The most common barriers to data collection were time (55%) and lack of support for complex data systems and/or platforms (50%). Conclusions Inconsistent data collection and reporting of oncology navigation programs remain a threat to sustainability. Aligning data collection with oncology accreditation, funding, and reimbursement is a viable path forward.

Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

“…Evaluating the effect of patient navigator services in cancer care is an important requirement within a value‐based care system. Battaglia and colleagues 150 surveyed 538 patient navigation programs across the continuum of care in the United States, highlighting that only one half of these programs used data for reporting purposes. Of the 538 programs, 374 used electronic medical records, and only 25% of those 374 had an identifier for navigated patients using their service.…”

“…Lack of time (55%) and lack of support (50%) for complex data system/platforms were the most common barriers to outcome data collection/reporting. In the survey used by Battaglia and colleagues, 150 there were useful metrics for consideration in future data‐collection and reporting activities. These metrics covered screening (eight items), cancer treatment (five items), survivorship (five items), and end‐of‐life care (five items).…”

Components and effectiveness of patient navigation programmes to increase participation to breast, cervical and colorectal cancer screening: A systematic review

“…Therefore, bearing in mind the great variation in the definition of patient navigation, we recommend a standardized reporting of its components that would allow comparison between studies, external validity, replication in different settings and ultimately a better measure of its impact on cancer screening participation. The better reporting of navigation programmes together with a consistent data collection would facilitate sustainability 67 …”

“…The better reporting of navigation programmes together with a consistent data collection would facilitate sustainability. 67 A positive finding was that over 84% of studies reported 9 or more components out of 14, being supervision and addressing of social and emotional barriers the least reported. As in a previous review, 68 the duration of training on patient navigation was quite diverse.…”

Flexibility, adaptation, and roles of patient navigators in oncology during COVID‐19

“…The survey was also disseminated through national, state, and local listservs, such as the membership of the Association of Oncology Nurse and Patient Navigators (AONN+) membership, the Oncology Nursing Society, the National Breast and Cervical Cancer Early Detection Program, and the Association of State Chronic Disease Directors. This recruitment method mirrored the method used in a previous NNRT cancer navigator national survey conducted in 2019 24 …”