Ana Karina Burton has had to get creative in the past several months.
As an outreach patient navigator through UW Health and the Wisconsin Well Woman Program, Burton's job is to educate and guide women through the healthcare system, from preventative screenings for breast and cervical cancer to treatment for each disease at the UW Carbone Cancer Center or elsewhere.
It's a job that normally requires a lot of face time and in-person interaction. And for someone who's used to going out into communities - Burton serves roughly a dozen counties in southwest Wisconsin - the last several months have been challenging.
The onset of COVID-19 in March created something of a double-whammy for patient navigators. Many hospitals and clinics initially delayed or canceled many appointments involving cancer screenings, such as mammograms and pap smears. Some free clinics even temporarily closed their doors altogether, further limiting access to preventative services.
On top of that, the pandemic also forced the cancellation of events throughout the summer, something that patient navigators rely on for face-to-face educational sessions about the importance of cancer prevention.
The concern for Burton is that the women she serves, who are often from underserved communities or do not have health insurance, may fall further behind when it comes to cancer health disparities.
Thus the need for creative action.
A lot of her time in recent months has been spent working the phones. In partnerships with numerous free clinics in southwest Wisconsin, Burton has been calling patients who would normally rely on their services.
"I talk to them about the importance of screening and the programs they can use to get free screening services," she said. "I see what programs are the best for them, help them with the application, and send the application to their home address. They sign it and put it back in the mailbox. That's the easy part."
What's been more challenging, she says, is working with existing patients who had already planned to get screened, only to have COVID-19 complicate those plans.
"Many times, hospitals were calling me or the patients to cancel appointments, and I had to help them to reschedule," she said. "That was the hard part, because many times, these appointments were cancelled several times."
On top of that, many of these individuals are facing additional challenges caused by COVID-19. The pandemic has meant work reduction or job loss for many, leading to things like food insecurity, an inability to pay rent or utilities, and the loss of health care.
So before she even gets to talking about the breast and cervical cancer screenings, Burton guides individuals towards services they may need more in the moment, such as local food banks or rent assistance programs. She also helps people connect to experts that can help with enrolling in new health care plans via the online marketplace (healthcare.gov) through the Affordable Care Act, Medicare or other types of coverage. She also walks people through enrolling in BadgerCare Plus (Medicaid).
"Once these basic needs are met, then they'll take care of their health and they'll go and get the screenings and tests," she said.
When it comes to educational outreach, Burton has formed partnerships with places such as food banks, hospitals, clinics and other locations to help distribute information about screenings. She's also partnering with various breast cancer organizations such as Susan G. Komen, the Wisconsin Women's Health Foundation and ABCD, who may be able to pass her information along to any individuals who could benefit from the services of a patient navigator.
And even though many in-person events are cancelled, there's still room for involvement. In another partnership, Burton worked with a local drive-thru event that distributed free school supplies and backpacks. In addition to things like pens and pencils, families received information about cancer screening in their bags.
Burton says it's all about reaching people where they are, making connections with key individuals in each community and trying to make the best out of the situation.
Individuals seeking more information about breast or cervical cancer screenings, or help navigating the healthcare system, can email Burton or call her at (608) 445-0138. Patients can also call the UW Health Breast Center at 608-266-6400 or the 1 S. Park Street Breast Center at (608) 287-2050.