Public Health.

Area of Science:

• Neurology
• Geriatrics
• Public Health

Background:

• Primary care providers (PCPs) identify only about 50% of expected mild cognitive impairment (MCI) or dementia cases.
• Existing methods for cognitive decline evaluation lack systematic, culturally appropriate approaches, especially in diverse populations.
• PCPs report knowledge gaps and resource deficits in diagnosing and managing cognitive impairment.

Purpose of the Study:

• To pilot the Brain Health Navigator (BHN) model, testing boundary-spanning roles to simplify the diagnostic and treatment journey for cognitive impairment.
• To address limitations in current primary care practices for identifying and managing Alzheimer's disease (AD) and related dementias.

Main Methods:

• The BHN model engages PCPs and residents, acting as a central node for pre-diagnosis referral and post-visit care.
• Utilizes MyChart for screening, digital cognitive assessments, and integrated electronic health record tools (Epic smart sets) for orders and documentation.
• Incorporates an AI-driven tool to enhance questionnaire completion and patient understanding, alongside a social worker for functional data and family support.

Main Results:

• The BHN model, with support from a social worker, offloads administrative and coordination tasks from PCPs.
• This allows PCPs to concentrate on clinical interpretation and examination, improving patient-centered care.
• The integrated workflow aims to enhance overall diagnostic accuracy for cognitive impairment.

Conclusions:

• The BHN model demonstrates effective use of boundary-spanning roles and integrated workflows for timely and accurate AD diagnoses.
• This approach shows promise for scaling to other health systems to improve cognitive diagnostic processes and patient experiences.
• Supports enhanced care for cognitive impairment within both primary and specialty care settings.