As shown in our previous blog, “Understanding and navigating saturated referral landscapes,” the number of navigation systems is exploding. But, not all navigation systems are created equal. In this blog, we evaluate four common navigation designs and inspect the implications of each respective design.
Recall from our last blog: Navigation systems are organizational arrangements designed to support individuals in locating and obtaining valuable benefits, programs, and services. These Navigation systems are comprised of three core elements–human navigators, referral platforms, and intervention efforts.
Human navigators are the call center operators, social workers, community health navigators/workers, community outreach advocates, coordination center employees, and other contributors that help individuals chart the path to care and guide individuals to the appropriate services. Some human navigators are specially trained employees, and others are local community members.
Referral platforms are technological systems that typically include searchable and regularly updated resource directories of community-based organizations and agencies providing service and care. Referral platforms also involve management systems that send referrals and track referral outcomes.
Intervention efforts help identify the needs of individuals seeking care, match these individuals to providers, aid in the enrollment process, and generally support clients receiving help throughout the entire process.
Navigation design refers to the specific way these human navigators, referral platforms, and intervention efforts come together, which is unique to each navigation system. The publication “Mapping the Navigation Systems of Pennsylvania: Opportunities for The Future” provides an in-depth analysis of the four primary navigation designs which compose the larger navigation system landscape. The four primary navigation designs are community connectors, demanded directories, healthcare developers, and system integrators.
- Community Connectors
Navigation systems with the community connector design model prioritize human navigators, using a local and community-based focus. Community connectors take a client-centered goals approach and work with clients personally throughout the help-seeking process.
Advantages: The first advantage of community connectors is that they typically elicit a higher degree of trust in marginalized and oppressed communities than institutions. A second advantage is that the personalized model of community connectors allows for more individualized care—culturally, linguistically, or otherwise.
Disadvantages: Community connectors are disadvantaged by their lack of technology and data systems to track their referrals and hold the institution’s providing care accountable. Community connectors also cannot evaluate their practices which can inhibit the growth and adaptation of care practices.
- Demanded Directories
Demanded directories create, cultivate, and maintain complete, up-to-date resource directories that include every available program, benefit, or service in a geographical location. These systems then match clients to the appropriate service. On-hand human navigators are available to aid this matching and to troubleshoot problems.
Advantages: The advantages of demanded directories are their ability to provide immediate help at all hours, address a high volume of clients at once, and ensure quality interactions through the collection and analysis of quality assurance metrics.
Disadvantages: Two disadvantages of this design type are that demanded directories provide less support on the tail-end of the help-seeking process and do not track referral outcomes to ensure a closed-loop.
- Healthcare Developers
Healthcare developers aid clients in overcoming the social determinants of health through the joint efforts of screening for health information and providing proper human service to address relevant needs. An electronic, ongoing medical record then stores each referral and related data.
Advantages: The advantage of healthcare developers is that they screen patients for any unreported human service needs, and they collect the most data, specifically on how human service organizations reduce the cost of care.
Disadvantages: Healthcare developers are disadvantaged because all their referrals must originate from healthcare providers. Their systems are sometimes incompatible with human service organizations’ systems causing referral follow-through information disclosure to depend upon whether the provider is willing to use a separate system to report.
- System Integrators
The system integrator navigation design utilizes a closed network and referral platforms to close the referral loop. System integrators are present throughout the entire client-to-care referral process and contain in-depth analytics on referral outcomes.
Advantages: Some advantages of this design are that clients receive comprehensive support through the entirety of the help-seeking process, and this system’s use of advanced analytics tracks referrals for outcomes, accuracy, and efficiency. Additionally, system integrators uniquely allow clients to access services from any organization within their network.
Disadvantages: The disadvantage of system integrators is that the entire network must participate for effective outcomes. Additionally, these systems may neglect community-based efforts and foster an unintentionally exclusive environment. Finally, these systems are expensive.
Among these four distinct system types, there is no one “ideal” navigation design. Each navigation system—community connectors, demanded directories, healthcare developers, and system integrators—embodies a uniquely critical set of assets. For example, community connecters display increased trust with marginalized and oppressed communities. Systems integrators are better suited for ensuring closed-loop referral to care and holding providers accountable for their role in the care-seeking process. Demanded directories have the most up-to-date and comprehensive resource directories. Healthcare developers uniquely combine human service needs with medical needs. And, each design has disadvantages as well as advantages. Community connectors cannot track referrals on a large scale, and systems integrators are expensive and require extra effort from community-based organizations. Demanded directories do not ensure a closed-loop of referrals, and healthcare developers must constantly collaborate with human service organizations. The goal of this guide is to introduce each of the four design types, demonstrate the value of each, and show that no one design is superior to the others. All four design types must cohabitate in a successful referral landscape.