Enhancing the care navigation model: potential roles for health sciences librarians

Clinical informationist educational needs and goals: A scoping review

Clinical informationist (CI) is one of the current trends in the field of medical librarianship and information science. CIs are members of clinical care teams, and their main duty is to fill the gap in the information needs of health-care workers and patients using information sources. They need an official and standard education. This study aims to identify the educational goals and needs of CIs. To this end, a scoping review was conducted using the Preferred Reporting Item for Systematic Reviews and Meta-analyses guidelines. The ISI Web of Science, Scopus, Proquest (MEDLINE), Science Direct, Emerald, ERIC, Cochrane, and Library, Information Science and Technology Abstracts were searched. The Journal of the European Association for Health Information and Libraries was hand searched for relevant studies. A total of 1026 studies were extracted, and 38 studies were selected for the final review. The review resulted in identifying 18 goals in cognitive, emotional, and psychomotor areas. Furthermore, the educational needs were identified in eight educational needs including research method and statistics, education, medical knowledge, information and librarianship science, clinical environment knowledge, evidence-based knowledge, information technologies and systems, management, and leadership. Although part of these educational needs can be met through general medical librarianship and information science education, further specialized education for CIs requires specific aims and curriculum. Thus, the results of this study can be the basis for future studies regarding the competencies of CI in order to provide a more precise and detailed curriculum based on these educational needs.

Exploring the roles, functions, and background of patient navigators and case managers: A scoping review

BACKGROUND

Patient navigators and case managers are health care workers who aim to provide individualized assistance to patients facing significant health concerns. Although these roles emerged from distinct historical need, the terms are often used interchangeably in the literature and are described to have overlapping functions. Differences in the way that these roles are conceptualized across countries has led to a lack of clarity regarding the exact functions that each offer to patients, caregivers, and the health care system.

OBJECTIVES

To differentiate the functions and backgrounds of patient navigators and case managers across settings and disease contexts.

DESIGN

This review was guided based on the PRISMA extension for scoping reviews using a five-step review process: identify the research questions; search and identify relevant studies; select studies based on a priori criterion; chart the data; and collate, summarize and report the results.

DATA SOURCES

A search of the literature was undertaken in peer-reviewed databases (Medline, CINAHL, and PubMed) and the grey literature (Google and unpublished articles in online repositories).

REVIEW METHODS

Extracted data included information on patient navigators and/or case managers related to their reported background, training, and/or knowledge; roles and/or specific functions; clinical setting; and targeted condition or disease type.

RESULTS

The search strategy resulted in 10,523 articles. After applying the eligibility criteria during title and abstract evaluation, 468 full-text articles were reviewed, resulting in a total of 160 articles. Functions of patient navigators and case managers were organized into nine emerging categories: (1) advocacy; (2) care coordination; (3) case monitoring and patient needs assessment; (4) community engagement; (5) education; (6) administration and research activities; (7) psychosocial support; (8) navigation of services; and (9) reduction of barriers. The background and knowledge areas of each role were compared and contrasted, and three categories related to the practice context of each role were identified: (1) typical setting and care trajectory; (2) target patient population; and (3) mode of service delivery.

CONCLUSIONS

The current study identified important differences in the functions between patient navigators and case managers. However, there remains significant ambiguity between the functions of these two roles. Standardized definitions detailing scope of practice, and allowing for inherent flexibility across different settings, are needed to improve service delivery.

Understanding Care Navigation by Older Adults With Multimorbidity: Mixed-Methods Study Using Social Network and Framework Analyses

Background

Health and social care systems were designed to be used primarily by people with single and acute diseases. However, a growing number of older adults are diagnosed with multiple long-term conditions (LTCs). The process of navigating the intricacies of health and social care systems to receive appropriate care presents significant challenges for older people living with multiple LTCs, which in turn can negatively influence their well-being and quality of life.

Objective

The long-term goal of this work is to design technology to assist people with LTCs in navigating health and social care systems. To do so, we must first understand how older people living with LTCs currently engage with and navigate their care networks. No published research describes and analyses the structure of formal and informal care networks of older adults with multiple LTCs, the frequency of interactions with each type of care service, and the problems that typically arise in these interactions.

Methods

We conducted a mixed-methods study and recruited 62 participants aged ≥55 years who were living in England, had ≥2 LTCs, and had completed a social network analysis questionnaire. Semistructured interviews were conducted with roughly a 10% subsample of the questionnaire sample: 4 women and 3 men. On average, interviewees aged 70 years and had 4 LTCs.

Results

Personal care networks were complex and adapted to each individual. The task of building and subsequently navigating one’s personal care network rested mainly on patients’ shoulders. It was frequently the patients’ task to bridge and connect the different parts of the system. The major factor leading to a satisfying navigation experience was found to be patients’ assertive, determined, and proactive approaches. Furthermore, smooth communication and interaction between different parts of the care system led to more satisfying navigation experiences.

Conclusions

Technology to support care navigation for older adults with multiple LTCs needs to support patients in managing complex health and social care systems by effectively integrating the management of multiple conditions and facilitating communication among multiple stakeholders, while also offering flexibility to adapt to individual situations. Quality of care seems to be dependent on the determination and ability of patients. Those with less determination and fewer organization skills experience worse care. Thus, technology must aim to fulfill these coordination functions to ensure care is equitable across those who need it.

Characteristics of personal health information management groups: findings from an online survey using Amazon's mTurk

Objective:

The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy.

Methods:

A total of 202 survey participants were recruited using Amazon’s Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic.

Results:

The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test.

Conclusions:

For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records–specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.

Examining care navigation: librarian participation in a team-based approach?

OBJECTIVE

This study investigated responsibilities, skill sets, degrees, and certifications required of health care navigators in order to identify areas of potential overlap with health sciences librarianship.

METHOD

The authors conducted a content analysis of health care navigator position announcements and developed and assigned forty-eight category terms to represent the sample's responsibilities and skill sets.

RESULTS

Coordination of patient care and a bachelor's degree were the most common responsibility and degree requirements, respectively. Results also suggest that managing and providing health information resources is an area of overlap between health care navigators and health sciences librarians, and that librarians are well suited to serve on navigation teams.

CONCLUSION

Such overlap may provide an avenue for collaboration between navigators and health sciences librarians.