For patients who come from overseas, navigating a complex and foreign health care system often is compounded by language barriers and cultural differences.
But not at UCLA Health, where the Patient Navigation and Business Services department was established to guide patients, primarily international, through the process, from their initial inquiry through treatment and follow-up care.
“When patients are coming from overseas and it’s their first time reaching a health care system like UCLA, they typically don’t know what to expect,” says Sandra Lopez, a patient navigation coordinator in the department for five years. “We do our best to let them know what to expect, and we’ll guide them through the health care system here at UCLA Health.”
The top specialties drawing international patients are oncology, transplant, neurosurgery, orthopaedics and cardiology, adds Lopez, who also facilitates requests from the U.S. and abroad for second opinions via telehealth.
The department also assists patients with transportation and obtaining nearby housing during their stay in L.A., which can extend for several weeks or even months, depending on the complexity of the diagnosis and treatment.
Patient Navigation and Business Services employs a staff that includes navigation coordinators to help patients gather their medical records and authorizations prior to admission; telehealth coordinators to assist patients seeking a second opinion virtually; patient access coordinators to provide interpreter services and accompany patients on appointments; and clinical patient navigators – nurses and certified clinicians who serve as liaisons with the physicians.
Adult and pediatric patients come to UCLA Health from many parts of the world, including the Middle East, China, Mexico, Canada, parts of Europe and Africa. Many are drawn by UCLA Health’s outstanding reputation and world-renowned physicians, Lopez says.
“Our clinical patient navigators assist with reviewing the patient’s records and presenting the case to our physicians,” she says.
The department also employs financial coordinators who verify a patient’s insurance benefits and provide an estimate for treatment and services.
Often, patients face a roadblock in obtaining their medical and imaging records, and Patient Navigation and Business Services can help with that, Lopez says.
“We work with the patients to try to gather all their records from their physician or clinic beforehand,” she says. “That way, we can coordinate their schedules and appointments within their preference and time frame, as well.”
Avoiding language barrier
Care often begins months prior to the patient’s visit, when the patient makes an initial inquiry to UCLA Health, either through a phone call, email or the department’s website. The department receives about 3,000 international inquiries annually, and roughly 50% of those convert into patients, Lopez says. They are supported by bilingual patient navigation coordinators.
Lopez, who is fluent in Spanish, says international patients often are concerned about the language barrier, but notes that interpreters are available in Spanish, Mandarin and Arabic; video and phone interpreting services are available in many other languages.
Coordinating the logistics is critical to a successful outcome for international patients. But Lopez notes there is more to it than that.
“Coming from overseas is a big journey to take on, and I believe being compassionate, empathetic and hearing them out is important,” Lopez says. “Often, it’s the first time they’ve reached out to somebody that can help them, and just letting them know that we understand is critical.”
Lopez recounts taking a phone call from Lorena Garcia, a woman from a small town in Mexico who was seeking treatment at UCLA Health for her 10-year-old son, Fernando, who was having developmental challenges.
Fernando had been seen by a number of doctors in Mexico who prescribed treatments that weren’t working, Lopez recalls.
“She wanted someone to understand what she was dealing with and just wanted to have support and make sure that's something that we can offer at UCLA Health,” Lopez says.
That was in 2021, when pandemic restrictions were impacting the behavioral clinics, resulting in longer wait times to see a physician. Lopez continued to communicate with Garcia, providing updates as she received them from the clinic.
After nearly a year on the waiting list, Garcia and her son traveled 1,700 miles to meet with Patricia Renno, PhD, a clinical psychologist with the Child and Adult Neurodevelopmental (CAN) Clinic at UCLA Health. After years of struggling, Fernando finally received an accurate diagnosis: autism spectrum disorder with attention deficit hyperactivity disorder.
Soon after, he began his treatment.
Door-to-door assistance
Lopez assists international patients on the front end of their journey to UCLA Health, whereas her colleague, George Nino, coordinates care from the time a patient arrives in L.A. to the time they depart.
Nino is fluent in Arabic. Most of his patients come from the Persian Gulf states of Saudi Arabia, Kuwait, Qatar and the United Arab Emirates.
“A lot of these patients come sponsored, which means that their governments pay for their treatment,” Nino explains. “The governments not only pay for the treatment and the medication but they give them a stipend to rent an apartment and to pay for their food and transportation. So these governments pay a substantial amount of money for their patients, but they are complicated cases for which they have no treatment in their country. We handle a lot of the complex cases here because we’re very successful.”
As a patient access coordinator, Nino schedules and accompanies his patients to all their appointments. He interprets for them, arranges transportation and is their advocate throughout their time in Los Angeles.
“We’re with them all the time, making sure that they have their medications available,” he says. He helps patients set up the myUCLAhealth app on their phone to access their appointments and instructs them on how to log in for telehealth visits.
Proximity to the UCLA Health campus is crucial, so Nino helps his patients and their families find an apartment within a short distance of the hospital.
When patients go in for surgery, Nino gets them admitted to the hospital and waits with the family while the patient is in the operating room. Many patients bring entire families with them to the U.S., he notes, including their parents, siblings and children.
“Oftentimes, the family is here for a long period of time, so we assist in finding resources for tutoring for the children and English-language classes for the patient,” Nino says.
Rewarding work
Lopez finally met the Garcias – Fernando and his mother – earlier this year when they traveled from Mexico to UCLA Health for a follow-up visit.
“Lorena gave me a hug, and Fernando gave me a hug. She told me thank you so much for everything that you've done for us from the beginning to now, and for future services,” Lopez recounts. “It makes me feel great to be there for someone and help them out during their time of need.”
Nino says he experiences similar feelings when he sees a patient and their family through their journey at UCLA Health.
“You feel like you've been there, that you’ve helped. It gives you self-satisfaction that I have accomplished something, that I contributed just a little bit to this human being's life.”
Jennifer Karmarkar is the author of this article.
