Breast Cancer Navigation, Our Experience at Avon Breast Center at Hopkins

The concept of patient navigation was founded in۱۹۹۰ by Dr. Harold Freeman at Harlem HospitalCenter in New York City. His program was anintervention to address late stage breast cancerpresentations among minority and poor women inthe Harlem community. Navigators were utilized towork with low income patients or with populationsthat did not tend to get the medical care they needed.Patient navigation focused on identifying andeliminating barriers to care that could result in delaysby timely cancer screening, diagnosis, andtreatment. Most navigators were non-healthcare ۱professionals, who were members of the communityand were trained to provide culturally sensitive carecoordination and disease management principles toimprove access to care for underserved people. Dr. ۱Freeman’s initial program demonstrated thatpatients with suspicious cancer screening findingswere significantly more likely to complete theirdiagnostic evaluation in a timely fashion whenpaired with a navigator.۲Due to the success of the Harlem Hospital model,patient navigator programs have become establishedin many healthcare centers throughout the UnitedStates. What began as a pioneering program wasrecognized nationally in ۲۰۰۵ when the PatientNavigator, Outreach and Chronic DiseasePrevention Act was signed into federal law. Thisprogram funded patient navigation demonstrationsites throughout the United States and was created tohelp ensure patients with cancer received highquality coordinated care. Since then, patientnavigation has shown repeatedly to improve ratesand timeliness of follow up cancer screeningabnormalities in various populations.