The primary care brain health navigator: A perspective on implementation

Area of Science:

• Neurology
• Primary Care Medicine
• Healthcare Systems Analysis

Background:

• Gaps in primary care (PC) settings hinder the early detection of cognitive impairment.
• Existing systems-based issues limit the effectiveness of primary care providers in dementia screening.
• A standardized approach is needed to evaluate cognitive decline within the primary care setting.

Purpose of the Study:

• To explore the role and function of a primary care brain health navigator (BHN) in improving early detection of cognitive impairment.
• To determine how a BHN can be integrated into the patient-centered medical home team.
• To identify requirements for the sustainable implementation of a BHN in primary care.

Main Methods:

• Conceptual framework development for the BHN role within primary care.
• Analysis of systems-based barriers and solutions for cognitive impairment detection.
• Review of requirements for effective integration and support of BHNs.

Main Results:

• A BHN can mitigate primary care provider time limitations and standardize cognitive impairment evaluations.
• Integration of the BHN within the PC medical home team is crucial for success.
• Advanced payment models and policy evaluation are necessary for BHN sustainability.

Conclusions:

• The primary care brain health navigator is essential for enabling early detection of Alzheimer's disease and related dementias.
• Intentional development, implementation, and support within the PC setting are critical for BHN effectiveness.
• BHNs enhance the capacity and capability of primary care teams for dementia screening and management.