It’s not a lack of funding; it’s a lack of navigation.

 In English, News

If your ultrasound spotted a lump, or your small previously-diagnosed lump has grown, that completely manageable cancer could now grow unchecked and threaten your life. This is because the wait times for biopsies is also growing because of COVID-19 and the halt or delay in diagnostic tests and elective surgeries.

In Ontario, the clinically responsible wait time for a Priority 4 biopsy patient is 35 days, and for a Priority 3 patient, it’s 21 days. The most recent report by Health Quality Ontario reveals wait times only for the first three months of this year, from January through March. While wait times were within these limits, there are no numbers for the second quarter, April through June.

I can’t imagine those post-COVID wait times will be as clinically responsible as the pre-COVID ones. How can they be when diagnostic tests and elective surgeries have only begun to open up after being in lock-down for the past three months?

Yes, Ontario created a COVID-19 Surgical and Procedural Planning Committee chaired by Dr. Chris Simpson help hospitals reintroduce surgeries and other procedures.

But we are being deluged with calls from clients who tell us they have to wait six months for a biopsy. That number is not clinically responsible in anyone’s book.

This situation is not only unacceptable; it’s completely preventable.

One short-term solution involves the provinces injecting more money to hire more staff to flatten this curve of backlogged procedures. BC already committed $250 in new funding back in May.

But after a point, wait times are a problem that all the money on earth won’t solve. We know that

because over the past 10 years,  Ottawa has thrown $5.3 billion at shortening wait times “for a generation”. And yet, those waits still persist.

There has to be a better way.

For the past 11 years, we’ve been banging the drum about patient navigation as a solution. In fact, we’ve built a growing business on the idea that navigation can facilitate timely access to quality health-care services by providing patients with advice, advocacy and triage support. Patient navigation works: our clients get treated 220 days sooner on average than Canadians in general; they’re on disability six months less; and their employers have a 420% boost in payroll savings because they’re back to work sooner.

If the idea of patient navigation sounds new, it isn’t. Dr. Harold Freeman started the first patient navigation program in the US in 1990 at the Harlem Hospital Center. He said then: “It’s very easy to get lost in the impersonal health care system, but navigators are like problem-solvers. They coordinate all the disjointed elements and move patients through faster and more efficiently.”

The results of Freeman’s thinking were dramatic: the 5-year survival rates of newly diagnosed breast cancer patients rose from 39% in 1990 to 70% 5 years later. World wide today, hospital-based oncology patient navigation is the rule rather than the exception.

In Canada in the early 2000’s, hospitals started oncology patient navigation programs. Today, virtually all hospitals across the country have these programs, which include not only navigation to oncologists, but complementary elements such as diet, exercise, therapy, etc as well. It’s clear that cancer navigation works.

But where are the patient navigation programs around other ‘big’ maladies like heart disease, diabetes and mental illness?

We believe strongly – and have staked our business on this belief – that patient navigation holds the key not only to significantly reduced wait times for virtually all specialised medical services, but to healthier government funders as well.

It’s time to move on this.

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