ACO Coalition Discusses Digital Cognitive Assessment Tool

During the most recent web-based seminar of The American Journal of Managed Care’s ACO & Emerging Healthcare Delivery Coalition, experts discussed a digital test that can help primary care physicians assess patients’ cognitive abilities and detect impairment sooner.

The Coalition will be gathering for a live meeting October 20 to 21 in Philadelphia, Pennsylvania. For more information, visit the Coalition meeting page.

Harry Jacob, MD, the chief executive medical officer of Primary PartnerCare, and Edward Ginns, MD, PhD, medical director of neurology at Quest Diagnostics, presented the findings of a study on the use of a new cognitive testing application. CogniSense, which was developed by Quest Diagnostics, allows the Memory Orientation Screening Test (MOST) to be administered on a tablet or other mobile device.

Jacob and Ginns began the session by explaining that early detection of dementia, including Alzheimer’s disease, is key to improving patient outcomes and decreasing costs. However, cognitive impairment can often go unrecognized by primary care physicians, presenting diagnostic challenges. Jacob and Ginns highlighted several case studies from the pilot testing, which introduced the app to 7 physicians within the Primary PartnerCare ACO.

Physicians who used the app reported that they were able to earlier identify more patients with memory impairment while minimizing referrals to specialists. It also helped them provide objective data to concerned patients and their families. “CogniSense allowed me to advocate for my patient, and enter into a collaborative investigation and evaluation with his neurologist, maintaining continuity of care,” said one of the doctors quoted in a case study.

Patients, physicians, and office staff praised the app’s ease of use.

“The senior citizen population actually were impressed that we were using iPads in the office,” Jacob said in response to an audience question about potential difficulties with the technology. He added that patients and staff said they experienced more trouble with the old paper forms.

The app, which immediately sends the patient’s answers to Quest for analysis, is part of a growing number of health information technology innovations being used in the healthcare industry. Results from CogniSense can be stored in Quest’s electronic health record system, allowing clinicians to track and monitor patients’ cognitive function over time.

Jacob and Ginns explained that digital tools like CogniSense can help accountable care organizations lower spending by keeping patients in more cost-effective pathways and reducing repetitive or wrong testing.

“Moving diagnosis and treatment into the primary care arena is a less costly pathway than in the specialty arena,” said Jacob.

Ginns agreed, adding that because identifying cognitive impairment can “bring these individuals to interventions and diagnosis, it does impact positively on cost and actually, importantly, quality of life.”