Lay-navigators are being used to break communication boundaries and ease the burden of health care coordination for patients with cancer. A novel program offers the services of a lay-navigator in the form of senior-year university students participating in a 2-year fellowship.
“A lay navigator program is a huge advantage for patients that might be so overwhelmed with the gravity of their illness as well as the complexity of the multiple clinic appointments and physicians they are scheduled to see. Having a support system is not only helpful for the patient, but also for their care team as well,” Brandi R. Page, MD, assistant professor Radiation Oncology and Molecular Sciences at Johns Hopkins School of Medicine, explained to Oncology Nurse Advisor (written communication, September 2015). Some patients have a difficult time with the situation, and they may forget to ask questions. A lay-navigator can facilitate getting the most out of each doctors’ appointment. “In terms of the health care system, lay-navigators are a huge benefit to helping make sure patients are also getting the most out of their visit as well,” Page said.
Navigating through our complex and often fragmented health care system can be challenging. A lay-navigation system aims to help the patient and family members coordinate care, provide education, access community resources, and navigate the health care system with a one-on-one relationship whilst providing psychosocial and logistical support.1
One such program aimed at providing lay-navigator support, referring to them as strategists, for cancer patients is the TaketheFight organization. Strategists with Take the Fight are undergraduate students or recent graduates who focus on supporting the patient and their care team with the goal of improved adherence to care.2
The strategists commit to 2 years of service in addition to onsite training at the organization’s Summer Oncology Academy of Excellence (SO-AX). TaketheFight pays for travel plus 2 meals per day for strategist candidates, who must attend the entire training event in person.
In the first year of service, strategists function as lay-navigators, attending doctor’s appointments and treatments with their patients. Furthermore, while complying with HIPAA regulations, the patient agrees to allow the strategist access to their medical records “which makes all details of the patient’s history easily retrievable, for efficiency and expediency in care.”2 Strategists are in their final year of college during their service year, which is an unpaid fellowship year.
The second year involves the strategist identifying a problem they experienced as a lay-navigator, such as educational barriers, disparities in clinical trial enrollment, and nonadherence, and they focus on ways to correct the problem.2 In this second year, strategists are fulltime employees of TaketheFight at its headquarters in New York City.
“The patients benefit through receiving an extra pair of eyes who are dedicated to just them, and their needs as a patient. Our strategists become caring, passionate lay-navigators for their patients. We strategize to make appointments more efficient in order to maximize the time spent with physicians. We can help ensure that all of the patient’s concerns and questions are brought to the doctor. We support patients to execute the doctor’s treatment strategy more efficiently, and we facilitate the exchange of medical information to increase patient understanding. Additionally, we act as a layer of support, providing patients confidence and stability in what can be a very destabilizing environment,” noted Hannah Montague, a student at Wake Forest University and Take the Fight strategist (personal communication, September 2015).