Breast cancer navigation, our experience at Avon breast center at Hopkins

The concept of patient navigation was founded in 1990 by Dr. Harold Freeman at Harlem Hospital Center in New York City. His program was an intervention to address late stage breast cancer presentations among minority and poor women in the Harlem community. Navigators were utilized to work with low income patients or with populations that did not tend to get the medical care they needed. Patient navigation focused on identifying and eliminating barriers to care that could result in delays to timely cancer screening, diagnosis, and treatment (Vargas, Ryan, Jackson, Rodriguez & Freeman, 2008). Most navigators were non-healthcare professionals, who were members of the community and were trained to provide culturally sensitive care coordination and disease management principles to improve access to care for underserved people (Vargas, Ryan, Jackson, Rodriguez & Freeman, 2008). Dr. Freeman’s initial program demonstrated that patients with suspicious cancer screening findings were significantly more likely to complete their diagnostic evaluation in a timely fashion when paired with a navigator Due to the success of the Harlem Hospital model, patient navigator programs have become established in many healthcare centers throughout the United States. What began as a pioneering program was recognized nationally in 2005 when the Patient Navigator, Outreach and Chronic Disease Prevention Act was signed into federal law. This program funded patient navigation demonstration sites throughout the United States and was created to help ensure patients with cancer received high quality coordinated care. Since then, patient navigation has shown repeatedly to improve rates and timeliness of follow up cancer screening abnormalities in various populations (Paskett, Harrop & Wells, 2011).