Patient Navigation

Patient navigation is a proven way to help patients who have an abnormal stool-based colorectal cancer (CRC) screening test result successfully complete a completion (aka “follow-up”) colonoscopy – the gold standard for detecting and removing precancerous polyps.

The Value of Patient Navigation

A systematic review of the 27 studies (Community Preventive Services Task Force) found that patient navigation increased CRC screening by a median of 13.6 percentage points.
Patient navigation increases completion colonoscopy rates by as much as 27% (and as high as 97% in some safety-net settings), according to the New Hampshire Colorectal Cancer Screening Program.
Patient navigation reduces the time to colonoscopy by an average of 16 to 50 days (according to multiple studies), which is a crucial because delays of 9 months or more are linked to a higher risk of advanced-stage cancer.
Patient navigation results in better bowel preparation (according to multiple studies), which is essential for a high-quality exam.
Patient navigation reduces “no-shows” and late-cancellation rates by approximately half, according to a study that appeared in the Journal of Women’s Health.

The patient navigation process is especially important and effective for underserved, low-income and minority populations who face systemic barriers (e.g., language, transportation, complex insurance processes).

Moreover, patient navigators have been credited with lowering mortality and improving survival rates – as patients who delay completion colonoscopies are seven times more likely to die from CRC, according to an investigator at the Kaiser Permanente Center for Health Research.

When it comes to completion colonoscopies, patient navigators help patients by…

Assisting them with scheduling, transportation and childcare.
Explaining the bowel preparation process and colonoscopy procedure.
Working thru the insurance process (if applicable) and/or securing financial assistance.

A study by the Community Preventive Services Task Force placed the average CRC patient navigation costs at $150 per patient, so in addition to saving lives patient navigation represents a good investment for health care professionals and hospitals (e.g., increased volume and fewer wasted slots) and payers (e.g., avoiding higher and longer-term cancer treatment costs).

A standard, step-by-step roadmap that patient navigators can use to ensure consistent, equitable and comprehensive support for patients thru the CRC screening continuum.

A standard medical document that primary care providers can use to request a specialist (e.g., gastroenterologist) to perform a completion colonoscopy.

ASGE developed this resource for physicians, allied health care professionals and their patients

A survey that can be used to identify barriers, measure a screening program’s effectiveness and understand the gaps between clinical recommendations and actual patient behavior.

A phone interview that can be used to identify barriers, measure a screening program’s effectiveness and understand the gaps between clinical recommendations and actual patient behavior.