Maine Primary Care Association: Hidden Solution to Health Equity

Project Description

One of the biggest challenges for Maine-based clinics wasn’t reaching at-risk patients, it was knowing how to train the people who could. This story shows how Maine Primary Care Association found a hidden solution to health equity through patient navigation.

  • Skills:

    • platform design
    • licensed curriculum
    • Blended learning
    • learning strategy
    • custom curriculum
  • Client:

    Maine Primary Care Association

Maine Primary Care Association Patient Navigator Training

One of the biggest challenges for Maine-based clinics wasn’t reaching at-risk patients, it was knowing how to train the people who could.

The people at the Maine Primary Care Association (MPCA) knew that they served a large, rural state with many communities at risk for serious health problems such as cancer and heart disease. They also knew that employing a system of patient navigation—like the one pioneered by Harold Freeman of the Patient Navigation Institute—would be a powerful way to connect people to services and detect diseases early. What they weren’t sure about was how to teach patient navigators, their supervisors and their entire health care teams statewide how to work with this new system.

Teaching Patient Navigation

So in 2011, the association partnered with the Maine Centers for Disease Control and Prevention’s Breast and Cervical Health Program to set up an educational program to teach everyone how to work together. They asked Talance, Inc., to adapt the popular program Patient Navigation Training Talance had helped to develop and implement at the Massachusetts Department of Public Health.

The program needed to be wide-reaching so it could include people from all parts of the state—people who might live and work in an isolated coastal town, in an urban area or at top of a mountain pass. It also needed to be accessible regardless of blizzards or road conditions. Remote, inaccessible areas are exactly where people might have the most difficulty getting screened for breast cancer or meeting someone who can explain the most foolproof way to stop smoking, and therefore where a program in patient navigation can have the greatest impact on health equity.

Learning Together, Remotely

To the educators at Talance, the solution was clear: a hybrid in-person and online educational program. This format minimized the amount of time participants spent away from their jobs (just two nonconsecutive days), while also giving them the opportunity to work together online every day over 12 weeks. The program included participants from 27 community health centers around the state.

Participants learned a new topic every week, ranging from documentation skills like properly completing patient intake forms, to the basics of cardiovascular disease and how lifestyle impacts health. They read through the curriculum, discussed new ideas and information with peers through discussion forums, handed in assignments, downloaded resources and used the internal communication system to send messages. The curriculum included multimedia elements such as videos and audio case studies. Skilled facilitators were always on hand to answer questions.

Expanding Health Insurance Knowledge

The MPCA also licensed one of Talance’s most popular on-demand modules: Navigating Health Insurance. That lesson focuses on helping people access health insurance. It covers terms and concepts related to health insurance, the types of insurance available and how costs are structured. Participants can use what they learn to help clients compare plans, set up an appointment and interact with insurance company representatives.
Throughout the process, participants learned what it means to be a patient navigator and how that looks in their home state.

Talance delivered a solution that met the MPCA’s multiple demands. Talance customized a hosted learning management system, provided instructional design and supplied technical support. Talance provided an innovate platform that was easy for learners to use on a variety of devices. The program allowed the MPCA to manage their own learning content so that they could amend or supplement materials at no additional cost.

Health Equity Outcomes

The results of the training program, in combination with other outreach tools including brochures and standardized materials in medical exam rooms, have been notable. From October 2012 to April 2014, colonoscopies increased about 20 percent, pap smears about 10 percent, and mammograms about 7 percent.

Improvement of mammograms, pap smears, colonoscopies

Mammograms, pap smears and colonoscopies increased

The inspiring news is this computer-based training program spurred change in all parts of the state—including those rural places that were difficult to reach. Now that the entire multidisciplinary health care team knows how to work together, it’s a change that can continue to have powerful consequences far into the future.

Quotes from Maine Primary Care Association

“We had participated in free and online training and what this offered was better – more adaptable and had disease-specific modules and the skills taught in the in-person sessions would be useful for a lot of people like nurses and medical assistants in the patient navigator role.”

- Training participant


“Whatever we picked we wanted to be able to mold it to our state.”

- Training participant


“The core modules are a good background for anybody in a clinical setting.  The health specific modules seemed like they were a perfect balance – even if you already knew the information (like nurses) you could work on finding resources for your patients.”

- Training participant