Navigator Program Improves Continuity of Care for Patients With Skin of Color

Early results of a navigator program for underserved patients with skin of color demonstrated improved patient support and continuity of care.¹ The results were shared at Fall Clinical Dermatology 2023.

Dermatologic conditions can appear differently on skin of color, which can cause diagnostic delays.

Image credit: Elle Bramble/Cultura Creative - stock.adobe.com

Patients with diverse skin types often experience diagnostic delays because provider education focuses on how skin diseases present in lightly pigmented skin.² Patients with skin of color also seem to experience a higher burden on quality of life.² For psoriasis, the presentation in patients with skin of color may look like other diseases.³

In addition to diagnostic delays, patients of color in general have lower access to specialty care and specialty treatment.² To address this, SUNY Downstate Health Sciences University created the Determi-Nation Patient Navigator Program, which pairs underserved patients with skin of color with medical students to serve as liaisons with the medical care team.

The program was launched in 2021 with 6 second-year students with the goal of preparing them to deliver equitable conscientious care as health care professionals.⁴ The navigators check in with patients who miss appointments, remind them to pick up prescriptions, and provide educational materials in multiple languages.

The poster presented at the conference shared the results for the first set of patients who were enrolled in the program.¹ The median duration of patient participation in the program was approximately 4 months.

A total of 20 patients were enrolled; 18 were Black/African American and 2 were Afro-Caribbean. The majority were female (85%) and spoke English (80%). Three patients spoke Creole/French as their primary language and 1 patient spoke Spanish.

The most common dermatologic diagnosis was hidradenitis suppurativa (60%), followed by psoriasis and cutaneous lupus erythematosus (both 15%), stasis dermatitis (5%), and both hidradenitis suppurative and psoriasis (5%).

Patients had a total of 38 encounters, with the majority (63%) being by text and the majority (63%) being initiated by the navigator. The most common purpose for the encounter was scheduling an appointment (34%), followed by refilling prescriptions (26%).

The benefits of the program, according to the early results, were:

• Support in navigating complexities around insurance and pharmacy encounters
• Appointment reminders and future appointment scheduling assistance
• Patient-focused resources for more information on diagnosis, treatment plans, and general health literacy
• Addressing language barriers and social needs

“While the program is still in its early stages, it demonstrates the potential value of tangible interactions between patients and dedicated navigators to improve patient support and continuity of care,” the researchers concluded.

References

1. Glick SA, 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. Presented at: Fall Clinical Dermatology 2023; Las Vegas, Nevada; October 19-22, 2023. Poster 12.

2. Joszt L. Providers need to be educated about how conditions may vary in skin of color, says Dr Andrew Alexis. The American Journal of Managed Care® website. April 18, 2023. Accessed November 17, 2023. https://www.ajmc.com/view/providers-need-to-be-educated-about-how-conditions-may-vary-in-skin-of-color-says-dr-andrew-alexis

3. Klein HE, Steinzor P. Dr Mona Shahriari talks unique challenges in treating psoriasis in patients with skin of color. The American Journal of Managed Care website. November 4, 2023. Accessed November 17, 2023. https://www.ajmc.com/view/dr-mona-shahriari-talks-unique-challenges-in-treating-psoriasis-in-patients-with-skin-of-color

4. SUNY Downstate to launch patient navigator program in partnership with Brooklyn Free Clinic and Brooklyn Center for Health Disparities. News release. SUNY Downstate Health Sciences University. July 19, 2021. Accessed November 17, 2023. https://www.downstate.edu/news-events/news/2021/07-19-2021.html