Breaking Down Barriers: Access to Healthcare

Barriers to accessing healthcare have long plagued the American Healthcare System and have prevented millions of individuals nationwide from seeking out and receiving the care they need. These barriers result in untreated health needs, postponements to receiving appropriate care, inaccessibility to preventative services, and preventable hospitalizations. As a Patient Healthcare Navigator currently serving at the UPMC St. Margaret Lawrenceville Family Health Center, I have been able to attain a meaningful experience in clinical care by helping knock down some of these barriers for patients and allowing them to access quality healthcare. In the following, I will discuss some of the specific barriers to accessing healthcare and how the responsibilities of my role help tackle these issues. I will close by examining the impact of my role and suggest why this position is crucial to future National Health Corps cohorts.

The Allegheny County Health Department has identified barriers that affect access to care including (but not limited to): health insurance, transportation, trust in providers, and linguistics and cultural competency. Transportation and linguistics and cultural competency represent the key barriers that my responsibilities, as a patient healthcare navigator, tackle. Transportation or the lack thereof, is one of the main barriers to accessing healthcare. In fact, the inability to access transportation means that an individual in need of care cannot get to a location where that care can be provided. Lack of transportation can come in a variety of different forms. Not owning a personal vehicle, the inability to take public transportation, and transportation costs are just some ways in which it manifests. In my position, one of my responsibilities is connecting patients with resources. In Allegheny County, there are some transportation resources that patients can utilize for getting to and from their appointments including ACCESS and MATP. In some cases, patients have chronic conditions that render them unable to ride public transportation. In these situations, ACCESS can pick up patients directly from their homes. Or, if it’s a matter of being unable to afford public transportation, MATP can provide bus passes and tokens at a reduced fare. Whatever the situation, patients must apply to take advantage of these resources. Through my role, I have sat down with patients and helped them apply for transportation assistance.

Linguistics and cultural competency is another huge barrier affecting the population that the UPMC Lawrenceville Family Health Center serves. A significant percentage of our patients are immigrants and do not speak any English. For these patients, receiving care, understanding their care, and accessing higher levels of care is virtually impossible without assistance. At our health center, the availability and utilization of on-demand translator phones are essential for these patients to receive care. However, during their visits with their PCP, it may be determined that a patient needs testing performed or needs higher-level care from a specialist. Being unable to speak English, it can be challenging for these patients to call different doctor’s offices themselves to get scheduled for appointments. With my patient navigator tools at my disposal, I am able to get these appointments scheduled for them and am able to coordinate their care to them using translator phones.

I believe that patient healthcare navigators are integral parts of the healthcare system and play a crucial role in primary care. Many doctor’s offices, especially in primary care, do not have a dedicated position to patient navigation. Instead, other clinical professionals such as social workers try to fill this gap but have other obligations and duties, they must attend to including providing care to their own patients. With resources being limited, specifically time, having a patient healthcare navigator to solely focus on addressing barriers to care improves and provides equitable, quality healthcare. Furthermore, given the importance and need, patient navigator service positions through organizations, such as the National Health Corps, are ideal. Future National Health Corps cohort members filling roles as patient navigators, or positions that function similarly, can help the current healthcare system be more accessible. Additionally, service members can gain invaluable experiences in these roles by directly interacting with patients and developing relationships with PCPs and community agencies.

This post was written by NHC Pittsburgh member Roopesh Kumar. Roopesh serves at the UPMC St. Margaret Lawrenceville Family Health Center as a Patient Healthcare Navigator.