Receiving a cancer diagnosis is undoubtedly difficult and often unexpected for anyone. For many of Boston Medical Center’s patients, taking the necessary steps to receive treatment are eclipsed by insurmountable hardships of daily life—housing instability, food insecurity and lack of transportation quickly float to the top of the list of challenges. When treating cancer, mitigating such barriers to care is imperative to adhering to a treatment plan so a patient achieves the best outcome possible—it’s especially important since cancer is the leading cause of premature mortality in Boston.
BMC’s Oncology Patient Navigation Program, embedded within the Cancer Care Center, consists of seven patient navigators and a program manager who “focus on identifying and overcoming barriers that prevent patients from getting the treatment they need in a timely manner.” For patients who are already burdened with the trials of everyday life, patient navigation is an invaluable resource with a history of improving outcomes.
To provide a closer look on how patient navigation impacts cancer care, BMC sat down with Program Manager Katie Finn.
Boston Medical Center: What is the role of patient navigation, especially when it comes to cancer care?
Katie Finn: Patient navigators are integrated in the clinic and as part of the care team. We’re there to be extra support for patients along their cancer journey and help to identify and address barriers to care. Our objective is to improve adherence to treatment plans and decrease delays in accessing timely care. It’s not always about addressing a problem once it exists. It’s also about being proactive and identifying issues that could come up because it’s so important to keep appointments and stay on track with treatment. For our patients, that often means addressing financial and food insecurities and arranging transportation to and from the hospital. We have established relationships with the providers and can liaise between them and patients, whether that’s asking questions or supporting conversations.
BMC: One of BMC’s hallmarks is a whole-person care approach. What is your role in a comprehensive care paradigm?
KF: Caring for the entire person is a significant part of the cancer and recovery journey. Being part of a patient’s care team affords us the ability to build trust and establish relationships with patients. We want patients to feel comfortable reaching out and being open with us so we can find a solution. That translates into helping patients stay compliant with appointments or giving them a platform for asking questions—these things really add up.
BMC: How would you describe our patient navigators?
KF: Compassionate, reliable and dedicated to our patients. We’re reaching out to patients to see how they’re doing after treatment, making sure they have everything they need ahead of an appointment, arranging transportation and more. We’re always adapting to different situations and the changing needs of our patients.
We come from a place of understanding. We’re not walking in the patient’s shoes and experiencing their challenges firsthand. It’s absolutely necessary that we respect where they’re coming from, lead with empathy and never judge. We’re there to advocate for them.
BMC: What are common challenges and barriers our patients face?
KF: We have a number of patients who are struggling financially and facing hardships with food insecurity and transportation. There are also language barriers, varying levels of health literacy and patients who have immigrated and might not be familiar with our health care system. We certainly have a larger population of patients who need more support compared to other institutions. That’s why we have such a robust program. By comparison, a lot of organizations might have one or two patient navigators.
When we address needs, it’s through very high-touch care. For example, instead of giving information on a resource, we will call that program with the patient on the line. We’ll schedule transportation on the patient’s behalf. We’ll call MassHealth with the patients because maybe they need help relaying information and understanding what information is needed.
BMC: How has COVID-19 impacted your team and your patients?
KF: Our patients have been dealing with a lot of fears. The fears associated with a cancer diagnosis have been compounded by the ones around COVID, especially because their immune systems and health are already in a compromised state. As navigators, we have been educating patients on what BMC is doing overall to keep everyone safe and sharing patient concerns with physicians. If a patient is wanting to put off an appointment, we’ll relay that information to the physician to see if it’s safe to do so or whether other options like telemedicine are appropriate.
COVID has placed even greater strains on finances, food and transportation. We’re helping limit the amount of time spent in public spaces. That involves distributing more cab vouchers so patients don’t have to take public transportation. We’ve also been giving out more gas cards and grocery cards. If a patient doesn’t have a car, the gas card can make it easier to ask a friend or loved one for a ride.
Some patients have expressed they feel more comfortable coming to BMC’s Food Pantry rather than the grocery store so we coordinate those visits. We also set them up with meal delivery services so they don’t need to go to the grocery store as much. Or, we might advise a patient to give the grocery card to someone who can do their shopping so they don’t have to go into such a public space. The cards help patients feel less guilty asking for assistance. We have also distributed CVS cards to cover copays and purchase medical equipment.
Our response to their needs is a testament to the trusting relationship our patients have with us. I’m glad they know they can turn to us. And, because of philanthropic support, we have the resources to assist them and bring some relief during an incredibly stressful time.
BMC: What is the most rewarding part of being a patient navigator?
KF: We’re always receiving such positive feedback from providers. Just the other day, a provider who is retiring reached out to say how proud he is of all of us and the amazing work we do.
What really gets me is when a patient or family member tells us about the impact we’ve had on them. This profession can be really hard at times, especially when we’re working with terminal patients. The moments when you’re told you’ve made a difference in someone’s life—especially during such a difficult time—is a powerful reminder of the value of patient navigation. It makes it all worth it.
