Blueprint for Breakthroughs is a LinkedIn newsletter published by Adrienne B. Mendoza, MHA, SVP BioBridge Global and Chief Operating Officer (COO), BBG Advanced Therapies
Originally published on LinkedIn on January 28, 2025
Introduction: A Role That’s More Important Than Ever
The healthcare system can be overwhelming, especially for patients navigating complex treatments like cell and gene therapies. Historically, patient navigators and care coordinators have played distinct but complementary roles in helping patients overcome barriers to care. Patient navigators focus on guiding individuals through the healthcare system, offering emotional support, education, and advocacy to ensure they understand their diagnosis and treatment options. In contrast, care coordinators concentrate on the operational side, managing logistics like scheduling appointments, coordinating with multiple providers, and resolving insurance issues. Together, they work to ensure patients have the clarity and support needed to efficiently access the care they require.
But the stakes are higher in the era of advanced therapies. These treatments require navigating new layers of complexity, from eligibility criteria and logistics for cell collection to insurance approvals and post-treatment care.
In this article, I’ve teamed up with Nick Fabrizio, PhD., Senior Lecturer, Jeb E. Brooks School of Public Policy at Cornell University, whose experience spans 25 years working with private medical groups, hospitals, and health systems, to (i) take a look back at the origins of patient navigation and coordination programs, (ii) share real-world examples of how technology is reshaping these roles, and (iii) explore the business case for healthcare organizations to invest in these critical functions.
The Origins of Patient Navigation
The concept of patient navigation isn’t new. It emerged in the 1990s, pioneered by Dr. Harold Freeman, who saw how social and logistical barriers prevented underserved cancer patients from receiving timely care.
Dr. Fabrizio, who has experience with these early programs shared about the challenges navigators faced back then:
“We were focused on things like making sure patients had transportation to and from their appointments or help understanding their insurance paperwork. But even then, we knew that one-on-one support made a huge difference in whether patients completed their care.”
While the original focus of these roles was on breaking down non-clinical barriers, the need for patient navigation has only grown as treatments have become more complex. Dr. Fabrizio highlighted that there is also an overdependence on technology to improve the patient experience.
Patient Navigation Challenges in Advanced Therapies
Advanced therapies, such as CAR T-cell treatments, TIL Therapies, and MSC-based regenerative medicines, introduce new layers of complexity that go beyond traditional patient care. While technology plays a critical role in streamlining processes and providing tools for efficiency, it should supplement, not replace, the personalized support provided by care coordinators and patient navigators.
Patients navigating the advanced therapy process face unique barriers:
- Eligibility confusion: Patients often don’t know if they qualify for a therapy or trial.
- Referral delays: Providers in community settings may be unaware of the referral pathways for advanced therapies.
- Logistical hurdles: The process involves cell collection, shipping, manufacturing, and re-infusion, all of which require precise coordination.
This is where care coordinators or patient navigators can make a significant impact, and technology can also help scale their efforts.
A Case Study in Modern Patient Navigation: The Mayo Clinic
One example of a modern patient navigation program is implemented at Mayo Clinic which is renowned for its innovative approach to care coordination and patient navigation, particularly for patients requiring specialized or advanced therapies. Their programs emphasize integrating human navigators with cutting-edge technology platforms to reduce barriers to care.
Key Elements of Mayo Clinic’s Model of Integrated Care Teams and Personalized Navigation:
Mayo Clinic assigns dedicated care teams to guide patients through complex diagnoses, treatment plans, and follow-ups.
Navigators manage everything from scheduling specialist consultations to explaining financial options and ensuring patients stay on track throughout their care journey.
Mayo Clinic Care Coordination System (CCS) integrates EHR data with predictive analytics, enabling care teams to:
- Identify gaps in a patient’s care journey.
- Anticipate potential delays or barriers (e.g., insurance, transportation).
- Provide real-time updates to patients about their next steps.
- Telemedicine and Virtual Navigation:
Mayo was an early adopter of telehealth to bridge geographic disparities. For patients needing advanced therapies, telehealth consults with navigators allow for initial eligibility screenings for therapies, and coordination with local hospitals for follow-up care or monitoring.
The result?
Improved Patient Outcomes: Patients undergoing complex treatments, at the Mayo Clinic, like CAR-T or organ transplants, have reported better adherence to treatment plans and higher satisfaction scores.
Reduced Treatment Delays: The use of predictive analytics has enabled care teams to identify and resolve logistical barriers earlier in the process, leading to more timely treatments.
Higher Patient Retention Rates: Mayo Clinic’s commitment to personalized, coordinated care builds patient loyalty and boosts retention, especially in specialized fields like oncology and advanced therapies.
Cost Savings for Patients and Providers: Centralized scheduling and real-time communication tools minimize unnecessary visits and streamline care delivery, reducing inefficiencies and administrative costs for both patients and the organization.
How Can Technology Enhance Patient Navigation?
Technology can’t replace human navigators, but it can empower them to manage more patients efficiently and reduce administrative burdens.
Here are a few ways technology can support patient navigation programs for advanced therapies:
💡 Patient Tracking Platforms
Patient navigators can use digital tracking tools to monitor where patients are in the therapy process, whether they’re waiting for cell collection, insurance approvals, or post-treatment follow-up.
Example:
Platforms like Philips‘ Patient Navigation Manager are intended to provide real-time visibility into patient progress, ensuring no one falls through the cracks, and Patient Navigation Manager indicates that it has demonstrated significant positive outcomes, such as up to an 80% reduction in same-day cancellations, a 55% reduction in no-shows, a 35% increase in referral conversion efficiency and a 92 NPS score.
💡 Smart Referral Systems & Virtual Navigation Programs
Instead of relying on manual referral processes, healthcare organizations can use smart referral platforms that automatically match patients to the right treatment centers based on eligibility criteria.
Virtual navigation programs provide an essential link to care for patients in rural or underserved areas. Using telehealth, patient navigators can guide patients remotely, answering questions, coordinating appointments, and providing emotional support.
Example (of both of the above):
The Dana-Farber Cancer Institute envisions a Comprehensive Patient Supportive Services Model that includes virtual navigation programs and telehealth for oncology patients. This model would ensure that patients outside major cities could still receive high-quality care and support without excessive travel.
💡 AI-Driven Risk Identification
Predictive analytics can help navigators prioritize patients who are most at risk of delays or dropouts. For example, AI can flag patients facing financial barriers, transportation challenges, or care coordination gaps, allowing navigators to intervene early.
Example:
At Cleveland Clinic, AI tools are being used to identify patients at risk of non-compliance for post-surgical follow-ups. This same approach could be applied to help patients complete the advanced therapy process.
💡 Payor-Provider Platforms
Software-enabled payer-provider collaboration platforms streamline healthcare administration by offering a unified hub. This centralized access point boosts efficiency, eliminating the need for providers to juggle multiple portals or engage in time-consuming phone calls.
Example:
NantHealth‘s NaviNet® has been credited with huge efficiency gains and according to NantHealth’s website, the platform’s widespread adoption could potentially save the healthcare industry approximately $25 billion annually by fully adopting electronic administrative transactions
The Business Case for Investing in Patient Navigation
Given his extensive background in financial strategy and operations management, I asked Dr. Fabrizio whether investing in patient navigation programs is a sound financial decision for hospitals and clinics. He acknowledged that while many hospitals have taken cost-cutting measures in recent years, patient navigators and care coordinators represent a strategic investment rather than an expense.
“Patient navigators don’t just improve outcomes, they create efficiencies. By reducing preventable delays and supporting patients through their care, they help hospitals avoid costly readmissions, improve patient retention, and maximize reimbursement opportunities,” Dr. Fabrizio explained.
Here are four compelling reasons why patient navigation programs make financial sense for healthcare organizations:
1. Reduced Readmissions and Avoidable Costs
Patient navigators keep patients on track with their treatment plans, reducing the likelihood of missed appointments, treatment delays, and costly hospital readmissions. For advanced therapies, where disruptions can lead to serious health risks or treatment failure, this can result in significant savings.
2. Improved Patient Retention
Patients who feel supported throughout their care journey are more likely to complete their treatment and recommend the facility to others. In a value-based care model, this not only improves patient outcomes but also strengthens the hospital’s reputation and long-term revenue.
3. Enhanced Operational Efficiency
With the help of technology, patient navigators can handle larger patient volumes while maintaining personalized care. Tools like digital referral platforms, automated scheduling systems, and patient tracking dashboards streamline workflows, enabling navigators to focus on high-value tasks and reducing administrative burdens.
4. Increased Reimbursement Opportunities
Payers are increasingly offering incentives for care coordination programs, particularly those aimed at addressing health disparities and improving access to advanced therapies. Patient navigation programs can also align with reimbursement models tied to outcomes-based contracts, ensuring both patients and providers benefit financially.
Dr. Fabrizio highlighted these value propositions:
“Patient navigation is more than just a value-add – it’s a foundational element for scaling complex therapies. Hospitals that invest in this infrastructure today will be better equipped to handle tomorrow’s innovations.”
This makes patient navigation not just a humanitarian effort, but also a business imperative and a clinical responsibility in the era of advanced therapies and technology.
The Path Forward: Supporting Navigators for a New Era of Medicine
The role of patient navigators and care coordinators has never been more important. But scaling these programs for advanced therapies requires a combination of human connection and technology-driven support.
If healthcare organizations embrace these solutions, they can:
- Improve access and equity for patients.
- Build infrastructure to support the growing complexity of advanced therapies.
- Drive better outcomes for patients and better efficiency for providers.
Dr. Fabrizio summed up what is needed when these solutions come together, remarking that:
“It’s crucial that we leverage technology to enhance the coordination of care, from hospital discharge to physician offices, and between physician offices themselves.
Currently, patients are often left to navigate this complex process on their own, with minimal support from clinical staff in either setting. Despite significant advancements in technology, it is unfortunate that medical record systems remain fragmented, with limited sharing and accessibility of information across disparate systems.”
Join the Conversation and Provide Your Thoughts!
What are your thoughts on the evolving role of patient navigators? Have you seen programs like these implemented in your organization or community? Or do you have ideas for how we can better support patients through the complexities of advanced therapies?
I’d love to hear from you in the comments.
Let’s Collaborate!
If your organization is developing or delivering Advanced Therapies and needs support with starting materials, leukapheresis services, process and analytical development, cell therapy testing, biomanufacturing, or clinical research, the team at BBG Advanced Therapies is here to help. Let’s work together to scale solutions and ensure these transformative treatments reach more patients, faster. Feel free to reach out to me directly or connect with us through our website, bbgat.org
