© 2011 Asian Americans for Community Involvement

1Wednesday, August 7, 2013

Patient Navigation Center

Page

Presented by AACI’s Patient Navigation TeamEvanthia Antonakopoulou

Steve ChoyAnna Ng

Elisa Orona

© 2011 Asian Americans for Community Involvement

2Page

• Asian Americans for Community Involvement (www.aaci.org)

• 40 year old service, education and advocacy non-profit serving Santa Clara County, California

• 9 programs, 165 staff, 13,800 users, 35,000 visits (2012)

• ‘a lookalike health center with lots of out-of-scope services’

• We build customer-facing safety net programs in first generation communities

Who is AACI?

© 2011 Asian Americans for Community Involvement

3Page

• As health care reform drives providers toward better health, better care and lower cost, we are building patient centered health homes that integrate our behavioral health, clinical and enabling services

• Reinventing enabling services using two proven technologies

• Reinvention’s 3 year ROI – 1.3X

What Are We Up To?

© 2011 Asian Americans for Community Involvement

4Page

• Proven interventions: community health workers and career advancement academies

• Disruption at the low end, not the high end: integrated primary care, not inpatient care coordination

• Patient, not provider focus: visit enhancement, not case management

• Technology tricks (we’re in Silicon Valley….)

Innovation

© 2011 Asian Americans for Community Involvement

5Page

• Clinician refers patient for specialty/lab/radiology consult

• Software matches patient language/time needs, texts appropriate patient navigator (PN)

• PN meets patient, accompanies her to referral service, checks in, interprets/explains, checks out

• App records non-clinical activities. • After checkout, clinical supervisor reviews before posting.

Instant electronic payment.

How We Roll

© 2011 Asian Americans for Community Involvement

6Page

• July 2012 CMS award• January 2013 – first cohort enrolled at San Jose

City College• September 2013 – second City College cohort;

first Cañada College cohort• September 2014 – cohorts at City College,

Cañada and Skyline• FY 2013-14 tasks – workflow redesign, internship

placement, job counseling

Where Are We Now?

© 2011 Asian Americans for Community Involvement

7Page

Two goals1. Community empowerment through education2. Great customer service

StrategyImprove the health outcomes in vulnerable populations by eliminating barriers to timely diagnosis and treatment of cancer and other chronic diseases.

What is Patient Navigation?

© 2011 Asian Americans for Community Involvement

8Page

History of Patient NavigationThe Harlem Model

Freeman, H. P. & Rodriguez, R. L. (2011). History and principles of patient navigation. Cancer, 117(15), 3539-3542.

© 2011 Asian Americans for Community Involvement

9Page

Model of Patient Navigation

Smith Center for Healing and the Arts . (n.d.). Our integrative navigation model. Retrieved from http://www.smithcenter.org/integrative-patient-navigation/our-integrative-navigation-model.html

© 2011 Asian Americans for Community Involvement

10Page

• Asian and Hispanic community members

• Educated/trained at local community colleges

• Cohort-based, contextual education• Career ladders

AACI’s Flavor of Patient Navigation

© 2011 Asian Americans for Community Involvement

11Page

1. Navigate the health care system• Coordinate referral appointments• Provide checklists and reminders

2. Accompany patients to referral visits• Improve communication • Anticipate and overcome cultural differences• Help patient identify resources• Assist patient in developing a self-care plan• Document activities accurately and efficiently• Participate on the healthcare team

Expectations of a Patient Navigator

© 2011 Asian Americans for Community Involvement

12Page

Questions?