Dr. Freeman answers some frequently asked questions…

What is patient navigation?
Patient navigation is a patient-centric healthcare service delivery model. It is a patient-centric concept that concentrates on the movement of patients along the continuum of medical care. It is a comprehensive term, to include all steps through this broad and diverse continuum, beginning in the community and continuing on through testing, diagnosis, and survivorship to the end of life.

What is a Patient Navigator? And how do their job functions differ from those of Nurse Navigators?
Patient Navigators are people who take individual patients through the continuum of healthcare as it pertains to their specific disease, ensuring that any and all barriers to that care are resolved and that each stage of care is as quick and seamless as possible. Patient Navigators should be performing at the level they are trained for. Nurse Navigators should not be doing what laypeople can do, such as financial and logistical care, so that they can focus, rather, on the medical treatment of the individual. In Harlem right now we are seeing no need to assign nurses to financial tasks. They tend to concentrate on people with Cancer who need a high level of treatment. People can apply the principles of Patient Navigation no matter what capacity they work in, be it medical or administrative or social work.

What is the difference between Patient Advocacy and Patient Navigation?
I’m reminded of Jay-Z’s interpretation of the difference between rap and hip-hop. He aptly likens rap to “what you say” and hip-hop to “what you do.” The comparison is similar here. Patient Advocacy, an extremely important segment of the patient-centric focus, is ultimately what you say. Patient Navigation, however, is what you do… It’s the guiding force promoting the timely movement of the patient through a complex system of care.

What are the different types (phases) of patient navigation?
Optimally, Patient Navigation should start where people live—in the community. Therefore, Community Navigation, if you will, is where it all begins. It’s where testing is championed as information on guidelines for who should be tested for what, and when.

The next phase would be one of Diagnostic Navigation. Once an individual goes in for testing, a suspicious finding would necessitate navigation to their biopsy (in the case of Cancer) and diagnosis.

Then comes Treatment Navigation where, upon diagnosis, the patient needs navigation through all of the treatment options and medical care. Which brings us finally to Survivorship Navigation. A good example would be with something like Diabetes, which is a chronic disease with no endpoint. Navigation will occur in well-defined areas for the duration of the patient’s life, to include complications, economics, logistics, and so forth.

I often give the example of a Mile Relay Team. It’s a simple example, but it’s one that works. Here you have four runners (navigators) and a coach (navigation). The main concerns here are: Did you improve the time? Did you pass the baton at exactly the right time? Were you right there to get the baton? Were you there to perform at your highest level while the baton was in your hand?

Who is best suited to take this HPFPNI course?
All types of people go to and are sent to the HP Freeman Patient Navigation Institute to become champions within their own specialized group. Whether you’re a layperson who wants to truly make a lifesaving difference in your community; a hospital administrator who wants to get a deep look at how patient navigation can be implemented within their hospital to ultimately save time and costs; or a nurse who wants to lend his/her medical background to the navigation momentum. They will all gain the knowledge they need to move forward with a great perspective on and knowledge of the fundamentals of Patient Navigation.

What’s the difference between certification and a certificate of completion?
When you go to the HP Freeman Patient Navigation Institute, you are coming to the place of origin. We give the broadest education on Patient Navigation… one that takes a genuine, deep look at navigation and its background, development, and applications to our communities and our current healthcare system. After successfully completing the course, you will receive a certificate of completion. This is not to be confused with certification, for which there currently exists no national standardization.

Overall, what hand will Patient Navigation play in terms of the current systems of care?

Navigation has the great power of marrying… of integrating a fragmented healthcare system for the individual patient. Navigators work to connect the myriad specialists within the varied systems of care, such as primary care sites and tertiary care sites, so that each can do their job at their most efficient and highest level of training. Individuals not only require, but desire expediency and communication. There should be no barriers to the highest level of care and compassion for any and all patients, and navigation is powerful and smart enough to bridge the gaps and ensure quality of care throughout its continuum. This is something that will not change, and the future for Patient Navigation is limitless… Which brings us to:

What is the future of Patient Navigation?
To look toward the future, perhaps it’s a good idea we take a look at the past. Historically, the growth of tumor registrars and the American College of Surgeons (ACS) requirement in 1956 of cancer registry for approved cancer programs led to the establishment of a National Program of Cancer Registries and state laws making cancer a reportable disease. Just this summer, the ACS Commission on Cancer (COC) established new accreditation standards to include patient navigation process to address health care disparities and barriers to care. There are currently more than 1,500 CoC accredited hospitals in the US and Puerto Rico, representing only 30% of all institutions, but more than 79% of all new cancer cases diagnosed annually. The future is looking bright for Patient Navigation and its implementation in hospitals nationwide, ultimately driving hospitals in the future to hire more and more PNs.

Give one HP Freeman PNI example as it pertains to real-life job opportunities (within a community, region, employment sphere) upon completion of coursework:
The Institute has strong ties with the Cleveland Clinic. Just recently, a Patient Navigation team from HPFPNI was invited to give a course at the Cleveland Clinic. Rian Rodriguez (Lead Lecturer) and I led that course September 26-28 for 30 trainees to coincide with the opening of their Stephanie Tubbs Jones Health Center (a new outpatient center). It was while I was there that I met up with the CEO of the Cleveland Clinic, Dr. Delos Cosgrove, at a first-class, Hollywood-type event broadcast live to 40,000 people worldwide—as far-reaching as Abu Dhabi. This speaks volumes to how seriously this world renowned hospital is taking the concept of Patient Navigation.

The Institute has combined forces with Accenture and will train 400 unemployed workers in Patient Navigation, supplying them with the skills to succeed in this area. Accenture will ultimately place 100 of them in PN jobs in and around the Cleveland area, paying half of each of their salaries for one year.

People need personal help to get through this life ~ Dr. Harold P. Freeman