Health navigators guide patients through health care maze

Health navigator Cassidy Winchip on the phone at her deskBy Jan Stapleman | Office of Communications
“We don’t live single-issue lives,” said Cassidy Winchip, patient advocate at the Boulder Valley Women’s Health Center. “Women come in for one issue, and we end up dealing with multiple issues.”
The father of a teen diagnosed with a sexually transmitted infection said his daughter couldn’t receive treatment because taking medicine was against the family’s religion. After intervention by Child Protective Services, the clinic was able to treat the teen, preventing permanent damage to her reproductive system. 

The clinic determined that a homeless woman in her 60s, who hadn’t seen a doctor for several years, was eligible for free testing through the Women’s Wellness Connection. After helping her get routine tests, the clinic also referred her to a mental health provider because she was anxious about an increased risk for cervical cancer.

A patient in her early teens came in requesting long-term birth control. She said she didn’t want to get pregnant but answered “no” when asked if she was sexually active. Turns out she wasn’t, at least not by choice. A member of her extended family was routinely raping her.
The Boulder Valley Women’s Health Center, with locations in Boulder and Longmont, treats women of all ages, from teenagers to seniors. Patients who come in for a breast exam or Pap smear also may need a primary care doctor or crisis counseling. How do busy health care providers have time to find additional services for their patients? They don’t. That’s where Cassidy Winchip comes in.
Consulting her “Beautiful Wonderful Comprehensive Majestic Referral List” of providers, Winchip works through a long list of variables to identify the best matches between providers and patients:
  • Does a particular doctor take Medicaid? Maybe. He did last month, but that could have changed.
  • If the patient hasn’t applied for Medicaid, would she qualify? Does she know how to apply, or does she need help?
  • If a patient has insurance, has she met the deductible? And does she understand how her deductible works?
  • Is a particular doctor “trauma-informed”? If not, the doctor might not be able to understand trauma-triggered behaviors that are damaging a patient’s health.
  • Does the patient have transportation, or does she need a bus ticket from RTD’s nonprofit program to make it to her appointment?
Winchip does most of this matchmaking on the phone, following up on referrals requested by the clinic’s doctor or nurse practitioners. Her soothing voice and opening pleasantries disarm patients, insurance representatives and medical schedulers alike. When she refers patients to other providers, she leaves the door open for additional help. “Call me back if this isn’t a good fit,” she tells them.
“Sometimes we are the first interaction people have with the health care system, so I try to make it a good one,” she said.
If a patient arrives in crisis, however, Winchip stops what she’s doing and provides in-person crisis counseling. She credits patient navigator training for teaching her many of her skills, including motivational interviewing. She knows she can’t motivate patients to take care of their health, because motivation must come from within. But sometimes rephrasing their own statements reveals powerful motivators, such as a desire to have a family someday, or to watch grandchildren grow up, or to remain independent while aging.
“I take a collaborative approach,” she said. “I respect the autonomy of patients to make their own decisions.”
Navigating the complex interactions among health care systems, private insurance, Medicare or Medicaid can be bewildering, even for savvy consumers. But for those with limited resources, education and experience, the challenges can become roadblocks. Health navigators can help negotiate those systems. The Colorado Department of Public Health and Environment recently implemented a voluntary credentialing process and Health Navigator Registry to help more people become health navigators in Colorado.
Winchip’s career path included training from the department-funded Patient Navigator Training Collaborative and continued on an upward trajectory. She started her career in medicine as a medical assistant, and then an X-ray technician. She became a certified nursing assistant, working on a transplant team at the University of Colorado Hospital. There, interest in the social work side of medicine was ignited by witnessing the barriers and gaps that prevent people from getting care. So she set her sights on earning a bachelor’s degree in social work and is now completing a social work master’s degree.
This year, by the end of July, Winchip connected 777 women with other providers, from primary care to imaging, herbalists to acupuncture, fertility counseling to mental health services. Yes, there were barriers and gaps, but she forged through on behalf of her patients.
“I don’t want to have a job where I help people through a broken system, but until that’s fixed …” her voice trails off. She’s in for the long haul. “But I reflect on this question at the end of every workday: What did I do that made a difference?”
And with that, she picks up the phone to work on Referral No. 778.
Interested in helping other people get health care? Being a health navigator doesn’t require advanced degrees. Learn more from the health navigator workforce development web page.
Access the Women’s Wellness Connection, offered through the Colorado Department of Public Health and Environment, to find out if you’re eligible for free testing.