Addressing Healthcare Disparities and Improving Care for People with Skin of Color With Patient Navigators

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In the US, individuals with skin of color (SOC) often face significant disparities in dermatological care, including limited access to dermatologists, diagnostic delays, and reduced availability of advanced therapies. These disparities can lead to a greater burden on quality of life for affected individuals. Various factors, such as differences in education, language proficiency, health literacy, insurance coverage, socioeconomic status, and the complexity of the healthcare system, contribute to these challenges.

The Determi-Nation Patient Navigator Program, initiated by SUNY Downstate Health Sciences University, aims to bridge this gap by identifying and supporting underserved patients with SOC. The program accomplishes this by pairing medical students with patients, creating a vital link between individuals and their medical care teams. Preliminary results from the study were presented in a poster session “Addressing Healthcare Disparities And Improving Care For People With Skin Of Color: Preliminary Results From The Determi-Nation Suny Downstate Student-Based Patient Navigator Project” at the 2023 Fall Clinical Dermatology Conference in Las Vegas, Nevada.

Patients were enrolled in the study based on specific needs, including assistance with appointment adherence, medication management, prescription refills, insurance issues, health education, and language barriers. Seven second-year medical students were recruited as patient navigators for this approximately nine-month pilot program. Navigators played a crucial role in ensuring patients’ 6 major dermatology care needs were met by facilitating communication before and after appointments, overseeing prescription fulfillment, scheduling follow-up appointments, and addressing social and health-related concerns.

Among the 20 enrolled patients, 18 were Black/African American and 2 were Afro-Caribbean, with the majority being female (85%). Early findings have demonstrated significant benefits:

1. Insurance Challenges: Navigators worked directly with insurance companies and pharmacies to resolve challenges, ensuring patients had access to necessary medications.

2. Prescription Fill/Refill Difficulties: Navigators provided essential guidance on medication instructions, storage, and transportation. They also addressed stock-related delays directly with pharmacies.

3. Appointment Scheduling: Patients were assisted in navigating referral processes and scheduling necessary appointments.

4. Health Literacy: Navigators offered vital information regarding treatment instructions, patient-network resources, and addressed specific questions related to pain management. They also supported patients in preparing for appointments.

5. English-Language Proficiency: Navigators identified family members or caregivers who could act as translators, facilitating effective communication during appointments.

6. Social Needs: Discussions regarding mental health support and addressing discomfort with new physicians were conducted. Additional support needs were also identified and addressed.

The Determi-Nation Medical Student-Patient Navigator Program is a promising initiative aimed at improving continuity of care for underserved patients with SOC. Although still in its early stages, the program showcases the potential value of tangible interactions between dedicated navigators and patients in enhancing support and continuity of care. Ongoing efforts in both dermatology and rheumatology clinics are set to further refine and expand the program’s impact.

Reference

Glick S, Jakus J, Kabir S, et al. Addressing Healthcare Disparities And Improving Care For People With Skin Of Color: Preliminary Results From The Determi-Nation Suny Downstate Student-Based Patient Navigator Project. Poster presented at: 2023 Fall Clinical Dermatology Conference; October 19-22, 2023; Las Vegas, Nevada.

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