A 2-year pilot program that began on June 1 is paving the way for patient navigation in the field of orthotics and prosthetics. Orthologix, based in Trevose, Pa. and Voorhees, N.J., launched the program in an effort to boost outcomes while improving the overall health of patients.
“Our practice has evolved into a patient-centered practice, so we are looking to treat the patient as a whole,” Eileen Levis, HCA, Orthologix president, told O&P News. “We say here that the patient is not the sum of their parts. The ultimate goal is to provide a higher outcome for that patient.”
Levis was inspired to implement a patient navigation program after reading about the success of similar programs, including a trial at Harlem Hospital Center that increased the patient survival rate from 39% to 70%.
“I was taken aback by that,” she said. “I began reading more and looking at various models. Of course, many of them were focused on cancer care, but I could find nothing in rehabilitation or orthotics and prosthetics.”
Levis eventually found a promising program through AstraZeneca that included multiple partnerships.
“I started to envision the promise of a program like that for O&P. So I decided that we were going to pilot a program,” she said. “We used [patient navigation pioneer, Harold P. Freeman, MD]’s model as our baseline and kind of contoured the model as it would work within our practice.”
Orthologix is starting out with three navigators who all completed a 6-month training program in patient navigation through the University of Colorado’s College of Public Health. The lead navigator will hold the role full-time, whereas the company’s other two navigators are also trained in other areas.
The first year of the program will focus solely on patients with prostheses. Patients with orthoses will be added in year 2. All patients with prostheses will be added into the program automatically but will not be required to utilize it, according to Levis.
“The lead navigator will be working with all of the prosthetics patients,” Levis said. “What starts the whole process is the introduction of the patient navigator to the patient, and then the navigator conducts an in-depth needs assessment. From there we are establishing a relationship [between] the patient and the navigator. Then we have an idea where some of the barriers can be.”
Levis said a number of barriers can prevent patients from achieving optimal outcomes. The program will address barriers to communication and the medical system, as well as psychological and transportation barriers.
Sometimes a barrier as simple as a lack of understanding about the concept of rehabilitation can inhibit a patient’s growth, whereas in other instances, trouble finding a ride to an appointment is the problem, Levis said.
“We want to make sure [patients] are getting to their appointments and they are following all of the rehab protocols to help them get that outcome,” she said. “We have a whole toolbox full of resources to help with all of these kinds of barriers.”
The program also will help patients who seek information about topics such as nutrition.
“Nutritional education is a big part of [the practice]. We started a program this year called Healthy Happenings, and we work in conjunction with Whole Foods Markets. That helps people to get a better understanding of good nutritional choices,” Levis said. “It is a great thing for some of our diabetic patients.”
The barriers the program will focus on were identified through a needs assessment.
“The needs assessment development helped point us in the right direction [toward] the kinds of tools we need to put in our toolbox,” Levis said.
The greatest tools the program offers are its partnerships, according to Levis.
For example, the program is partnering with Uber — an app that connects users with taxis, private cars and rideshare programs — to help “bridge the gap” between patients and their appointments.
Orthologix has also formed a number of education partnerships with groups including the Amputee Coalition, the American Cancer Society and the American Diabetes Association.
“We have gathered all kinds of information from all of these groups, and we have that at our fingertips to be able to provide that to our patients,” Levis said.
Partnerships also have been formed with five major insurers, as well as two large, nearby hospitals. Insurance company partnerships allow the navigators to help patients understand their coverage.
“The navigators work with case managers, nurses and sometimes automated systems to help the patients with the barriers they may encounter in the insurance process,” Levis said.
Through these partnerships, patients learn about how their benefits work, as well as about how they can obtain care based on their benefits, she said.
Orthologix is working with the rehabilitation teams at local hospitals to spread awareness about the program and to give patients a smooth transition.
“As our patients come through their rehabilitation system, everyone is keenly aware of the navigation program. That is one of the starting points to the care,” Levis said. “We will know ahead of time if there are issues that need to be addressed to help the patient succeed through the rehab continuum.”
Levis said the pilot program will be challenging, “but meeting those challenges gives us the opportunity to implement continued quality improvement. The goal of this program is to ultimately increase outcomes and good health. As we look to other navigation programs and the metrics that are being developed, we hope to be able to quantify the success of the program by the end of the 2-year pilot.”
Levis has been pleased by the positive response so far in the O&P community.
“I think this type of program will become a staple in the orthotics and prosthetics industry in a short time,” she said. – by Amanda Alexander
Disclosure: Levis reports no relevant financial disclosures.