Patients rewarded

NavaHealth guides residents of British Columbia through the province's health-care maze.

After her 13-year-old daughter Jessica was diagnosed with a rare brain tumour, Marlene Petersen of Kelowna, B.C., felt almost overwhelmed by the demands on her time. New to the province, with four other children at home and as many as six medical appointments for Jessica on just one day, “You can imagine how stressful the situation was,” says Petersen. Fortunately, she was able to make use of a new health service launched in October. NavaHealth, a for-profit, privately owned company, leads B.C. residents through the labyrinthine health-care system by providing support and patient advocacy. With NavaHealth's president Elisabeth Riley helping her to understand Jessica's treatment, Petersen found coping with her daughter's illness far less overwhelming. “There's so much information coming at you, you can't remember it all,” says Petersen. “You have questions that you forget to ask. And your emotions get in the way.”

NavaHealth is the brainchild of Riley, currently dean of the School of Health Sciences at the British Columbia Institute of Technology. Riley began the planning for NavaHealth after she was laid off in the summer of 2002 from her position as president and CEO of the Children's & Women's Health Centre of B.C. in Vancouver. She realized from her long experience in the health sector that a service gap was widening. “The medical system is increasingly complex,” says Riley. “It's not the fault of the system; it's just that medicine is so complex. We had only a doctor and a nurse in the system 50 years ago, and now look at how many health professionals and alternatives there are.”

So Riley laid the groundwork for her new enterprise, including hiring IT professionals to create a database for health information and hiring registered nurses as “health navigators.” With 10 navigators now working throughout British Columbia, NavaHealth provides services in person, by phone and e-mail. Navigators not only will accompany clients to appointments — the doctors are informed first — but can point out a wide range of appropriate services, including directing the client to community support services such as grief counselling, or private services such as contractors to adapt a home for handicap needs.

Riley is the sole owner of NavaHealth. She charges $100 an hour for the services of a navigator, which she splits with the RN. After an initial free consultation, payment is on a fee-for-service basis. Riley says she funded the launch of NavaHealth entirely out of her pocket. She watches her budget carefully: when a reporter calls her long distance on her cellphone, she calls him back on her land line to reduce the charges.

Helping patients comprehend their medical options is a large market, but where Riley might really strike gold is in targeting her services at what she calls the Sandwich Generation: those adults with both aging parents and children at home to care for. It's a market strongly supported by the demographics of the mid-life baby boomers who live in one part of the country while their parents live elsewhere. “Anyone who has had to balance the demands of caring for an aging parent along with demands from their work and their own family, knows how challenging that can be,” Riley says.

While the British Columbia Medical Association doesn't have an official position on patients hiring paid consultants to accompany them to the doctor's office, BCMA president Dr. Jack Burak admits to some concerns. First, it's not a service that all patients can afford equally, and secondly, a patient with a paid advocate may expect a longer appointment with a doctor who has only limited time available. “I don't know how you meld those two concerns,” Burak says.

Riley says the market will decide. Since opening her doors, she's received inquiries for her service from across the country and she estimates NavaHealth will break even within six months. Riley intends to expand her service nationwide with head offices in every province within five years. Now that's a healthy ambition.