Download Linda B Presentation

“A Tool to Improve Evaluation of
Patient Navigation Services in
Underserved Populations”
(PI: Burhansstipanov, 1R43 MD011350-01)
Linda Burhansstipanov, MSPH, DrPH
(Cherokee Nation of Oklahoma)
Native American Cancer Initiatives, Inc. (NACI)
3022 South Nova Road
Pine, CO 80470-7830
Phone: 303-838-9359; 1-800-537-8295
http://www.NatAmCancerInitiatives.org
http://www.NatAmCancer.org
1
Native American Cancer Research
Corporation (NACR) PN History
1994 staff = 1st funded Patient Navigation
study
Robert Woods Johnson Foundation
1997-2015 Eight sequential PN studies
3 from Susan G. Komen for the Cure®
5 from National Institutes of Health
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
2
SBIR based on NACR’s existing online
evaluation program
http://www.natamcancer.org/nacreval/nacrev
al.html
Created 2005 via Mayo Clinic’s “Spirit of
E.A.G.L.E.S Community Network Programs1)” (PI: Kaur; NCI U01 CA 114609)
Expanded PN data fields during “Native
Navigators and the Cancer Continuum
(PI: Burhansstipanov; R24 MD 002811)
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
3
Small Business Innovative Research
(SBIR) Grant
National Institutes of Health
National Institute of Minority Health and
Health Disparities
Phase I: 09/27/2016 – 08/31/2017
Limited to “Survivorship” phase of the
cancer continuum
Phase II will include full cancer continuum
outreach,
prevention,
detection,
“A Tool to Improve
Evaluation of Patientscreening
Navigation Services/in early
Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
diagnosis,
palliative
and end-of-life care4
Native Americantreatment,
Cancer Initiatives, Inc.
(NACI); http://www.NatAmCancer.org/
Username: train
Password: choochoo
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
5
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
6
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
7
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
8
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
9
Challenges with web-based (online)
evaluation program
Steep learning curve
Initially requires 1-2 hours per month per
patient until PN learns how to use the
program
Tailored reports required assistance from
NACI staff
NOTE: NACR is non-profit 501(c)(3)
NACI is small business partner to NACR
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
10
Rationale for moving from web-based
program to tablet app
Tablet advantages
Easier to use while in the field
Does not require Internet access (offline)
More maneuverable (pull-down menus)
Easier and more options for tailoring
report functions
app almost always is the best choice for
interactivity since it is more efficient.
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
11
Tablet app versus web-based
(a) portable
(b) data input easier and more accurate
(c) real-time data entry and summaries
specific to individual patients
(d) program administrators to monitor PN
interactions to document PN value
(e) provides billing documentation
(f) patient perspectives on navigation services.
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
12
Small Business Innovative
Research (SBIR) Grant
Phase I
13
SBIR Research Team
Linda Burhansstipanov, MSPH, DrPH (CO)
Linda U. Krebs, RN, PhD, AOCN, FAAN (CO)
Sheikh Iqbal Ahamed, PhD, Ubitrix (WI)
Mark Dignan, PhD (KY)
Lisa Harjo, MEd (CO)
Corrie Santos, PhD (CO)
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
14
SBIR Research Question
“Can an existing online patient navigation
documentation and evaluation program be
modified to create an easy to use tablet
app that can track a PN’s activities with
cancer survivors, function in multiple
settings, and produce data that can be
used for the Commission on Cancer and
other appropriate navigation accreditation?”
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
15
Expert Advisory Panel
Multi-disciplinary and multi-cultural experts
Conducted successful navigation projects
Kathleen Braun, PhD (‘Imi Hale Native Hawaiian
Cancer Network)
Daniel Petereit, M.D. (Walking Forward)
Sora Tanjasiri, PhD (Asian PN)
Patricia Valverde, PhD (PN Training Collaborative)
Dawn Wiatrek, PhD (ACS PN Steering Committee)
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
16
Patient Navigator Advisory Committee
Functioned as PNs for at least 4 years
Experience using NACR’s online program
Florence (Tinka) Duran (GPTCHB)
Denise Lindstrom (NACR)
Vickie Marsh (SEAIC)
Katie Ragan (SEAIC and NACI)
Kimberly Crawford (WF)
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
17
Tasks
6 interactions with EAP and PNAC
Guidance from Mary Buller as needed
10 informant interviews
2 PN focus groups
Usability Test with PN
Usability Test with PN Administrators
Usability Test with app IT experts
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
18
Prototype – PN Actions
Phase I
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3 Perspectives of the PN Evaluation Tablet app
START
PN Administrator
PN
Review existing patient or create “new” patient
III. Patient
Experience (AONN)
IV. Clinic Outcomes
(AONN)
V. Return on
Investment (AONN)
Evaluation of PN (or group of PNs)
[reports]
C. Professionalism
PN Actions direct data load
3. Phase of Cancer
Care
D. Patient Load
4. Patient Intake
E. Interval / Pt care
F. Referral
VI. Interval
5. Communication
6. Tracking
Interactions
G. Education
VII. Phase
(Survivorship)
VIII. Barriers /
Solutions
H. Communication
I. Planning
7. Barriers /
Solutions
8. Education
9. Paperwork
IX. Referral /
Appointments
J. Implementation
K. Evaluation
X. Budget
L. Other (tailored)
XI. Research
Quality /
Performance
Improvement
IX. Other
10. Referrals /
Appointments
11. Satisfaction with
care
12. Timeliness
13. Other
Everything on PN Actions “side” is Patient-focused
Evaluation of PN Program [reports]
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
21
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
22
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
23
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
24
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
25
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
26
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
27
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
28
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
29
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
30
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
31
Prototype – Evaluating
individual or group of
Patient Navigators
Phase I
32
Working Draft 04/04/2017
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
33
Prototype – Evaluating
the entire PN Program
Phase I
34
“A Tool to Improve Evaluation of Patient Navigation Services in Underserved
Populations” (PI: Burhansstipanov, 1R43 MD011350-01);
Native American Cancer Initiatives, Inc. (NACI); http://www.NatAmCancer.org/
35
Thank you for
inviting me and
allowing me to
share information
about the evolution
of the PN tablet
app
36