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Care guidance: A tech enabled, human activated solution that extends beyond mere patient navigation

November 20, 2023
Business Affairs
Craig Parker
By Craig Parker

Healthcare experts highlight the need for an expanded support service solution for hospitals and provider groups that have increased capabilities to promptly and effectively resolve non-clinical factors -- which account for 80% of patient issues. The problem is that most “patient navigation” programs are failing to address these factors because they don’t achieve meaningful patient activation. While they may focus on engagement, they fall short in identifying the right patients or talking about the right things for the right amount of time.

Because they are so good at clinical care, hospitals and health systems are always tempted to try to build non-clinical patient interaction programs because of the close connection to clinical care. After all, the whole point is to try to get the patients to be more aware of what they need to be doing and to be more compliant.

However, having too great an emphasis on the clinical side of this kind of patient interaction can be counterproductive. Patients can be intimidated by clinical staff, and therefore reluctant to share issues centered in the social determinants of health. Having clinical staff work on social determinants and non-clinical issues is, by definition, below top of license.

This is precisely where an outsourced “care guidance” program and partner can be of such value. Using the right personnel, trained and supported by structured workflows can increase bilateral patient communication, better identify barriers, produce effective resolution and provide curated information to the clinical team when escalation is necessary.

A structured and scaled care guidance program that goes beyond mere patient navigation provides an effective support service that is moving the needle forward. By extending the services of existing clinical staff and strengthening patient management outside the walls of the hospital, healthcare organizations more effectively address the challenges during the continuation of care.

Addressing social determinants of health
Care guidance takes into account the role of social determinants of health (SDoH), with personalized services provided by skilled and trained care guides that recognize these non-clinical factors that influence an individual’s ability to access care and adhere to treatment. It’s this “human touch” that supports patients who are at-risk based upon SDoH characteristics and frequently require amplified levels of activation and monitoring that cannot be addressed within the typical hospital’s resource capacity and clinical scope limitations.

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