Health Navigators: the Core of TeleHelp Ukraine
By Melody Chang
TeleHelp Ukraine is a nonprofit organization started by Stanford students that provides free, quality telemedicine services to Ukrainians affected by the war. Within TeleHelp Ukraine, Health Navigators are volunteers on the Patient Services team that directly communicate with patients and ensure they are able to join appointments. We tagged along with one of TeleHelp Ukraine’s Health Navigators to learn more about their work.
TeleHelp Ukraine Health Navigator Team during one of their bi-weekly huddles.
Ten minutes before the telehealth appointment starts, Health Navigator Julia Minkevitch logs onto Cliniko (the online telehealth platform utilized by Telehelp Ukraine) and awaits the arrival of the patient, interpreter, and provider. Once they log on, she conducts one final check that everything is running smoothly – troubleshooting any last-minute technical difficulties and ensuring that the provider has access to necessary patient documents – before logging off, as her role in the appointment is complete.
However, Minkevitch’s job as a Health Navigator extends far beyond her minimal role in these live appointments. In fact, Health Navigators do all the behind-the-scenes work to prepare for these appointments; in Minkevitch’s words, health navigators are the “roots” of how TeleHelp Ukraine runs. When a patient comes to TeleHelp Ukraine for help, their very first communication is with a Health Navigator, who learns about the patient’s concerns and preferences, then matches them with a language interpreter and healthcare provider specific to their needs. In the weeks leading up to their appointment, Health Navigators teach patients how to use the online telehealth platform, as well as how to upload their documents to be translated and sent to their provider. Health Navigators also send appointment reminders to patients, and in the case that patients miss their appointment, Health Navigators reach out to find out what happened and reschedule them. After each appointment, Health Navigators follow up with patients to schedule future appointments or connect them with additional resources.
Not only do Health Navigators ensure a positive experience for patients, but they also strive to ensure that providers and interpreters have an equally positive experience volunteering with TeleHelp Ukraine. By meticulously managing the Cliniko platform, Health Navigators streamline patient and appointment information, making it easy for providers and interpreters to access. Additionally, by monitoring the group chats on Viber and Telegram (their communication platforms), Health Navigators create a space where interpreters and providers can post their questions and concerns and have them addressed as quickly as possible.
Minkevitch expressed that one of the most special parts about being a Health Navigator is the meaningful relationships she gets to build with patients and their family members. Health Navigators are usually re-assigned to the same patients and thus get to know them very well, allowing them to offer more personalized support and care. Health Navigators also get to know patients’ family members, who oftentimes respond to messages on behalf of the patient or accompany them to appointments. Minkevitch recounted a touching anecdote about a patient whom she worked with for a long time; she managed his appointments with TeleHelp Ukraine’s general practitioner and oncologist, and she had placed him on the waitlist to see a gastroenterologist once one became available. When TeleHelp Ukraine finally recruited a gastroenterologist, Minkevitch excitedly messaged him, but she unexpectedly received a response from his wife saying that he passed away. Minkevitch immediately offered her condolences to his wife and booked her an appointment with TeleHelp Ukraine’s grief counselor, anticipating that she may need additional support dealing with her husband’s death.
Minkevitch believes that there are two keys to success as a Health Navigator: being emotionally receptive and resourceful. Firstly, Health Navigators must be very empathetic when communicating with patients in order to make them feel heard and cared for. Additionally, Health Navigators must be able to gauge patients’ mental state, which Minkevitch attests is especially difficult over the Internet. TeleHelp Ukraine values patients’ mental health equally as much as their physical health, so if a patient shares information that gives Health Navigators reason to believe they are struggling mentally, the Health Navigator will proactively connect them to resources and get them the help they need. Moreover, Health Navigators will often receive messages from patients located outside of Ukraine or Poland, whom TeleHelp Ukraine legally cannot offer appointments to due to limitations of their medical jurisdiction. However, instead of turning these patients away, TeleHelp Ukraine’s Health Navigators do their best to offer these patients support in a different way, most commonly by referring them to healthcare resources in their own country or to the “Resources” page on TeleHelp Ukraine’s website. As a result, Minkevitch states that Health Navigators must be very knowledgeable about TeleHelp Ukraine’s partnerships and resources, so they can refer patients to other organizations if they cannot treat the patients themselves.
According to Minkevitch, the Health Navigator team is extremely close and tight-knit. She shares that everyone is “very encouraging” and learns so much from each other, as she fondly describes the constant Discord communication and late-night Zoom meetings she has with her fellow Health Navigators. Within TeleHelp Ukraine, the Health Navigators work most closely with the Provider Services team; when a new provider or specialist is onboarded, Provider Services communicates this to the Health Navigators, so they can start taking patients off the waitlist.
A current medical student and aspiring physician, Minkevitch was initially compelled to volunteer as a Health Navigator because she wanted to contribute her fluency in both Ukrainian and Russian, and she wanted a role working with both patients and providers that would allow her to witness first-hand how a clinic or hospital is actually run. Her experience as a Health Navigator has exceeded her expectations and provided her with invaluable perspectives on the fields of medicine and public health. She sees many parallels between her current work as a Health Navigator and her future work as a physician. For example, as a Health Navigator, she must be able to pick up on subtle cues that patients are struggling with their mental health and take initiative to connect them with resources accordingly; similarly, as a physician, if she suspects that a patient is struggling with mental health or even abuse, she must be able to quickly identify the signs and connect the patient to proper help, even if they do not explicitly ask for it. Furthermore, as a Health Navigator, Minkevitch not only interacts directly with patients, but she also maintains a close relationship with providers and develops a thorough understanding about the patient’s living circumstances and social determinants of health (environmental factors outside of their control that cause or contribute to their illness). Similarly, she states that “being a doctor is not just seeing A and giving them B – you have to look at the patient’s entire life and know [the full picture of] what’s going on.” Minkevitch believes that being a Health Navigator is the “best role to teach someone how practicing medicine works outside of the actual diagnosis” and that this volunteer role fills an important gap in her holistic medical education.
