Understanding the Distinction Between Care Navigation and Care Coordination

Executive Summary: In the face of increasing complexity within the healthcare system, care navigation and care coordination have emerged as pivotal solutions to guide patients through their healthcare journeys, ensuring they receive personalized and timely care. While care navigation and care coordination share similarities, it’s helpful to distinguish between the two:

• Care navigation centers on keeping individual patients on the right clinical pathways for their unique needs. It’s a protocol-driven, patient-facing function that provides clinical guidance and support, with care navigators acting as knowledgeable guides through the medical system and treatment management plan.
• Care coordination focuses on the administrative and logistical aspects of healthcare, where care coordinators work to ensure that a patient’s care is well-organized and coordinated across various providers and settings.

In this blog, we’ll explore care navigation and how solutions like Preveta’s care navigation platform can enable organizations to deliver tailored support to drive better outcomes.

What is Care Navigation?

Care navigation involves guiding patients through evidence-based clinical care pathways, ensuring they receive the right interventions and care at the right time. It is about keeping individual patients on track through customized protocols based on their unique physiology and disease progression.

Care navigators act as knowledgeable guides, steering patients through the often-confusing medical system and care protocols associated with cancer care, chronic disease management, and other complex medical cases. Navigators advocate for patients, help address barriers, and provide targeted support driven by clinical guidelines and the individual’s response to treatment.

Common activities undertaken by a care navigator include:

• Helping patients understand their condition and their care plans, including assisting with interpreting test results and ‘translating’ complex medical terminology.
• Identifying gaps in a patient’s care and issues that require intervention so that the patient can stay on their care pathway.
• Arranging follow-up appointments, lab work, referrals, and other activities as part of the patient’s care plan.
• Monitoring patient-reported side effects and symptoms, including between provider visits, which is associated with increased survival.
• Liaising with physicians to support any adjustment to treatment based on a patient’s symptoms or side effects, for example, changing chemotherapy dosing, which can help patients tolerate and continue treatment.
• Providing emotional support and a knowledgeable listening ear to patients.

Care navigation can significantly impact the survival rate for common cancers, with Harvard Business Review finding that care navigation increased 5-year prostate cancer survival rates by an impressive 31%.

As well as being great news for patients, care navigation also has significant benefits for providers and physicians, including:

• Generating additional revenue of approximately $150k per care navigator per year.
• Ensuring physicians have access to the data they need by identifying missing lab results, scans, and other data ahead of appointments so they can be obtained, or appointments rescheduled if needed.
• Proactively engaging patients so that they can meet their health goals.
• Reducing no-show and cancellation rates to ensure fewer patients are lost to follow-up.

 What is Care Coordination?

On the other hand, care coordination focuses on the administrative and logistical aspects of healthcare to help ensure healthcare professionals can deliver integrated, patient-centered care.

Some common care coordination activities include:

• Coordinating a patient’s care across multiple providers and settings and managing the transition of care from one setting to another, such as when a patient is discharged from hospital.
• Sharing health records and care plans across providers and sites.
• Providing patient and family education for self-care.
• Linking patients with community resources and support services.

The primary focus of care coordination is on optimizing the healthcare system’s efficiency, minimizing redundancies, and providing better integrative care. While it is crucial in improving healthcare outcomes, it predominantly focuses on the system’s operational aspects.

Why is this Distinction Important?

The distinction between care navigation and care coordination is crucial because it recognizes the multifaceted nature of patient care. Moreover, by clearly differentiating care navigation from care coordination, the healthcare industry can unlock new possibilities. It paves the way for technology platforms like Preveta to create a significant impact, revolutionizing the patient journey.

How Technology Can Help with Care Navigation

While many practices are aware of the benefits of care navigation, recruiting, training, and managing care navigators can be challenging. That’s why Preveta has developed a ground-breaking digital care navigation platform that combines technology with a human touch to improve outcomes. By using Preveta, practices can empower Medical Assistants and other staff to become care navigators, significantly enhancing patient experience and outcomes while also adding an additional revenue stream.

Preveta allows practices to make care truly patient-centric by offering:

• Proactive Outreach and Follow-Up: Preveta enables navigators to proactively monitor patients at scale and intervene when care plans fall off track before issues escalate. The system automatically tracks critical data events and care milestones to prompt outreach. Patients receive a caring human touch made possible by giving the navigator full technical support and direction.
• A Holistic, Patient-Centered Approach: Preveta supports patient navigators to take a patient-centered approach by providing them with comprehensive data and systemized, evidence-backed support to enable them to address any obstacles to a patient’s care pathway that may arise.
• Cross-Continuum Connectivity: Preveta centralizes data points from multiple sources, previously siloed, to identify gaps and put in motion additional orders. This eliminates bottlenecks between navigators and clinicians.
• Improved Access and Compliance: Preveta leverages AI and advanced analytics to identify at-risk patients, predict needs, and drive timely interventions for better compliance and outcomes.

By blending compassionate human relationships with data-driven technology, Preveta enables organizations to scale high-touch care navigation that engages patients, resolves barriers, and drives better health outcomes.

Learn more about Preveta today or schedule a free demo to see how you can add care navigation to your practice.