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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

Establishing Effective
Patient Navigation Programs
in Oncology

PROCEEDINGS OF A WORKSHOP

Margie Patlak, Cyndi Trang, and Sharyl J. Nass, Rapporteurs

National Cancer Policy Forum

Board on Health Care Services

Health and Medicine Division

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THE NATIONAL ACADEMIES PRESS
Washington, DC
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by Contract No. 200-2011-38807 (Task Order No. 0061) and Contract No. HHSN263201200074I (Task Order No. HHSN26300120) with the Centers for Disease Control and Prevention and the National Cancer Institute/National Institutes of Health, respectively, and by 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 (U.S.), Inc., LIVESTRONG Foundation, Merck, National Comprehensive Cancer Network, Novartis Oncology, Oncology Nursing Society, and Pfizer Inc. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-47454-2
International Standard Book Number-10: 0-309-47454-X
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2018. Establishing effective patient navigation programs in oncology: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25073.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

WORKSHOP PLANNING COMMITTEE1

LISA KENNEDY SHELDON (Co-Chair), Chief Clinical Officer, Oncology Nursing Society

LAWRENCE N. SHULMAN (Co-Chair), Professor of Medicine, Deputy Director for Clinical Services, and Director, Center for Global Cancer Medicine, Abramson Cancer Center, University of Pennsylvania

LUCILE L. ADAMS-CAMPBELL, Professor of Oncology, Associate Director for Minority Health and Health Disparities Research, Georgetown University Lombardi Cancer Center

KAREN BASEN-ENGQUIST, Annie Laurie Howard Research Distinguished Professor, Professor of Behavioral Science, and Director, Center for Energy Balance in Cancer Prevention and Survivorship, The University of Texas MD Anderson Cancer Center

DARCY BURBAGE, Supportive and Palliative Care Nurse Navigator, Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System

CYNTHIA CANTRIL, Director, Cancer Support Services and Patient Navigation, Sutter Pacific Medical Foundation

EFRÉN J. FLORES, Radiologist, Director, Community Health Improvement, Department of Radiology, Massachusetts General Hospital

ELIZABETH FRANKLIN, Senior Director, Policy and Advocacy, Cancer Support Community

LORI HOFFMAN HŌGG, Veterans Health Administration National Oncology Clinical Advisor and Program Manager, Prevention Policy, Department of Veterans Affairs

RONALD M. KLINE, Medical Officer, Patient Care Models Group, Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services

ADITI NARAYAN, Senior Manager, Patient Support and Research, LIVESTRONG Foundation

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

MANDI PRATT-CHAPMAN, Associate Center Director, Patient-Centered Initiatives and Health Equity, George Washington Cancer Center

ELIZABETH ROHAN, Health Scientist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention

KIRSTEN SLOAN, Vice President, Health Policy, American Cancer Society Cancer Action Network

GEORGE J. WEINER, C.E. Block Chair of Cancer Research, Professor of Internal Medicine, and Director, Holden Comprehensive Cancer Center, The University of Iowa

WENDY A. WOODWARD, Associate Professor and Service Chief, Clinical Breast Radiation, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center

Project Staff

ERIN BALOGH, Senior Program Officer

NATALIE LUBIN, Senior Program Assistant

KELLY SINGEL, Mirzayan Science and Technology Policy Fellow (January 2018–April 2018)

CYNDI TRANG, Research Assistant

SHARYL J. NASS, Director, National Cancer Policy Forum and Board on Health Care Services

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

NATIONAL CANCER POLICY FORUM1

EDWARD J. BENZ, JR. (Chair), President and Chief Executive Officer Emeritus, Dana-Farber Cancer Institute; Richard and Susan Smith Distinguished Professor of Medicine, Genetics and Pediatrics, Harvard Medical School

AMY P. ABERNETHY, Chief Medical Officer, Chief Scientific Officer, and Senior Vice President, Oncology, Flatiron Health

LUCILE L. ADAMS-CAMPBELL, Professor of Oncology, Associate Director for Minority Health and Health Disparities Research, Georgetown University Lombardi Cancer Center

GARNET L. ANDERSON, Senior Vice President and Director, Public Health Sciences Division, Fred Hutchinson Cancer Research Center; Affiliate Professor, Department of Biostatistics, University of Washington

KENNETH ANDERSON, Kraft Family Professor of Medicine, American Cancer Society Clinical Research Director, Jerome Lipper Multiple Myeloma Center, Harvard Medical School, Dana-Farber Cancer Institute

KAREN BASEN-ENGQUIST, Annie Laurie Howard Research Distinguished Professor, Professor of Behavioral Science, and Director, Center for Energy Balance in Cancer Prevention and Survivorship, The University of Texas MD Anderson Cancer Center

CATHY J. BRADLEY, Associate Director, Cancer Prevention and Control, University of Colorado Cancer Center

OTIS W. BRAWLEY, Chief Medical Officer, American Cancer Society

ROBERT W. CARLSON, Chief Executive Officer, National Comprehensive Cancer Network

CHRISTOPHER R. COGLE, Professor of Medicine, Pierre Chagnon Professor of Stem Cell Biology and Bone Marrow Transplant, University of Florida; Scholar in Clinical Research, Leukemia & Lymphoma Society

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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NANCY E. DAVIDSON, President and Executive Director, Seattle Cancer Care Alliance; Senior Vice President, Director, and Full Member, Clinical Research Division, Fred Hutchinson Cancer Research Center; Head, Department of Medicine, Division of Medical Oncology, University of Washington

GEORGE D. DEMETRI, Professor of Medicine and Director, Ludwig Center, Harvard Medical School; Senior Vice President for Experimental Therapeutics, Dana-Farber Cancer Institute; Associate Director for Clinical Sciences, Dana-Farber/Harvard Cancer Center

JAMES H. DOROSHOW, Deputy Director for Clinical and Translational Research, National Cancer Institute

NICOLE F. DOWLING, Associate Director, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention

SCOT W. EBBINGHAUS, Vice President and Therapeutic Area Head, Oncology Clinical Research, Merck Research Laboratories

KOJO S. J. ELENITOBA-JOHNSON, Professor, Perelman School of Medicine; Director, Center for Personalized Diagnostics and Division of Precision and Computational Diagnostics, University of Pennsylvania

STANTON L. GERSON, President, Association of American Cancer Institutes; Director, Case Comprehensive Cancer Center; Professor of Hematological Oncology, Case Western Reserve University; Director, University Hospitals Seidman Cancer Center

LORI HOFFMAN HŌGG, Veterans Health Administration National Oncology Clinical Advisor and Program Manager, Prevention Policy, Department of Veterans Affairs

LINDA HOUSE, President, Cancer Support Community

HEDVIG HRICAK, Chair, Department of Radiology, Memorial Sloan Kettering Cancer Center

LISA KENNEDY SHELDON, Chief Clinical Officer, Oncology Nursing Society

SAMIR N. KHLEIF, Director, Loop Immuno-Oncology Lab, Biomedical Scholar, and Professor of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center

RONALD M. KLINE, Medical Officer, Patient Care Models Group, Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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LEE M. KRUG, Disease Area Head, Lung and Head & Neck Cancer, Immuno-Oncology, Bristol-Myers Squibb

MICHELLE M. LE BEAU, Arthur and Marian Edelstein Professor of Medicine and Director, The University of Chicago Comprehensive Cancer Center

MIA LEVY, Director, Cancer Health Informatics and Strategy; Ingram Associate Professor of Cancer Research; Associate Professor of Biomedical Informatics and Medicine, Vanderbilt-Ingram Cancer Center

MARTIN J. MURPHY, Chief Executive Officer, CEO Roundtable on Cancer

RICHARD PAZDUR, Director, Oncology Center of Excellence; Acting Director, Office of Hematology and Oncology Products, Food and Drug Administration

MACE L. ROTHENBERG, Chief Development Officer, Oncology, Pfizer Global Product Development, Pfizer Inc.

RICHARD L. SCHILSKY, Senior Vice President and Chief Medical Officer, American Society of Clinical Oncology

DEBORAH SCHRAG, Chief, Division of Population Sciences, Professor of Medicine, Department of Medical Oncology, Harvard Medical School, Dana-Farber Cancer Institute

LAWRENCE N. SHULMAN, Professor of Medicine, Deputy Director for Clinical Services, and Director, Center for Global Cancer Medicine, Abramson Cancer Center, University of Pennsylvania

DAN THEODORESCU, Paul A. Bunn, Jr. Endowed Chair in Cancer Research, Professor of Surgery and Pharmacology, and Director, University of Colorado Cancer Center

VERENA VOELTER, Head, United States Oncology Clinical Development & Medical Affairs, Novartis Pharmaceuticals Corporation

GEORGE J. WEINER, C.E. Block Chair of Cancer Research, Professor of Internal Medicine, and Director, Holden Comprehensive Cancer Center, The University of Iowa

ROBERT A. WINN, Associate Vice Chancellor, Community Based-Practice; Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Illinois at Chicago; Director, University of Illinois Health Cancer Center

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

National Cancer Policy Forum Staff

ERIN BALOGH, Senior Program Officer

PATRICK BURKE, Financial Officer

NATALIE LUBIN, Senior Program Assistant

KELLY SINGEL, Mirzayan Science and Technology Policy Fellow (January 2018–April 2018)

CYNDI TRANG, Research Assistant

SHARYL J. NASS, Director, National Cancer Policy Forum and Board on Health Care Services

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

ETHAN BASCH, University of North Carolina at Chapel Hill

LINDA HORN, Patient Advocate and Cancer Survivor

RAYMOND OSAROGIAGBON, Baptist Cancer Center

ANGIE PATTERSON, Georgia Center for Oncology Research and Education

MELISSA SIMON, Northwestern University Feinberg School of Medicine

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by PATRICK DELEON, Uniformed

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
×

Services University of the Health Sciences. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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Acknowledgments

Support from the many sponsors of the National Academies of Sciences, Engineering, and Medicine’s National Cancer Policy Forum is crucial to the work of the forum. Federal sponsors include the Centers for Disease Control and Prevention and the National Cancer Institute/National Institutes of Health. Non-federal sponsors include 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 (U.S.), Inc., LIVESTRONG Foundation, Merck, National Comprehensive Cancer Network, Novartis Oncology, Oncology Nursing Society, and Pfizer Inc.

The forum wishes to express its gratitude to the expert speakers whose presentations helped further the dialogue and advance progress in improving patient navigation for patients with cancer. The forum also wishes to thank the members of the planning committee for their work in developing an excellent workshop agenda.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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Acronyms and Abbreviations

ACA

Patient Protection and Affordable Care Act

ACS

American Cancer Society

AONN+

Academy of Oncology Nurse & Patient Navigators

CMS

Centers for Medicare & Medicaid Services

CoC

Commission on Cancer

CORE

Center for Oncology Research and Education

CPNG

Cancer Patient Navigators of Georgia

DPNC

DuPage Patient Navigation Collaborative

EHR

electronic health record

GATE

Generation and Translation of Evidence

HIV

human immunodeficiency virus

HRSA

Health Resources and Services Administration

MGH

Massachusetts General Hospital

NCI

National Cancer Institute

NNRT

National Navigation Roundtable

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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OCM

Oncology Care Model

ONS

Oncology Nursing Society

PACE

presenting information, asking questions, checking for understanding, and expressing concerns

PCCP

Patient Care Connect Program

PN-BOT

Patient Navigation Barriers and Outcomes Tool

PNRP

Patient Navigation Research Program

PSA

prostate-specific antigen

REDCap

Research Electronic Data Capture

TEAM

Together-Equitable-Accessible-Meaningful

TRIP

Translating Research Into Practice

WWC

Women’s Wellness Connection

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2018. Establishing Effective Patient Navigation Programs in Oncology: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/25073.
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Delivering high-quality cancer care to all patients presents numerous challenges, including difficulties with care coordination and access. Patient navigation is a community-based service delivery intervention designed to promote access to timely diagnosis and treatment of cancer and other chronic diseases by eliminating barriers to care, and has often been proposed and implemented to address these challenges. However, unresolved questions include where patient navigation programs should be deployed, and which patients should be prioritized to receive navigation services when resources are limited.

To address these issues and facilitate discussion on how to improve navigation services for patients with cancer, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop on November 13 and 14, 2017. At this workshop, a broad range of experts and stakeholders, including clinicians, navigators, researchers, and patients, explored which patients need navigation and who should serve as navigators, and the benefits of navigation and current gaps in the evidence base.

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