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How Decision Support Can Solve the Dementia Diagnosis Gap

Written by Neurotrack Team | Oct 9, 2024 7:15:16 PM

When it comes to closing the dementia diagnosis gap, screening for cognitive impairment at scale is really just half the battle. When Neurotrack spotted other friction in diagnostic workflows, our product and clinical teams took on a new challenge and added a decision support component to our offering.

The new Dementia DataHub reports that 61% of people with dementia in the US may be undiagnosed. Experts agree that we will never close the gap without PCPs diagnosing dementia, and as the massive Baby Boomer cohort ages, this urgency grows. According to the Alzheimer’s Association 2024 Facts and Figures Report, dementia occurs in 10% of people 65 and over. Mild cognitive impairment (MCI) affects another 22%. And 10,000 adults turn 65 daily in the US — making seniors 20% of the total population by 2050.

Low score, then what?

We’ve seen excitement around our product in a variety of clinical settings, increased consensus on the advantages of digital screening in general, but we’ve also noticed that the workflows of even the most ambitious medical groups can stall following a flagged result. Of course, this finding prompted concern and reflection. What interferes with a timely diagnosis?

More confidence and clarity needed

Our tool gives providers a streamlined way to do cognitive screening at scale, and it eliminates the subjective scoring that can create doctor-patient tension. Our platform offers a brief objective measure to detect impairment in any population, and it automatically assesses additional domains where concern is warranted. But the next steps are not always well established, particularly when it's a new experience for many PCPs.

This is well supported by the Alzheimer’s Association’s 2020 findings that nearly 40% of PCPs surveyed are uncomfortable making a dementia diagnosis, and nearly a quarter say they’ve had no residency training in dementia diagnosis and care. We also know PCPs are under tremendous pressure to see more patients in less time.

Nudging becomes know-how

Our product and clinical teams identified that providers (especially PCPs) benefit from prompting with in-the-moment reminders of best practices and clinical guidelines. Depending on the situation, these steps could include:

  • Gather and review other information
  • Rule out reversible causes
  • Compare findings against preferred diagnostic criteria
  • Make a diagnosis
  • Create a care plan 
  • Provide ongoing support
So we took three actions to address this need.
  1. We color-coded and reconfigured our provider-facing reporting to emphasize the level of concern and encourage teams to take action where appropriate
  2. We produced educational materials for teams on how our cognitive screening fits within a larger clinical effort to catch and diagnose MCI and dementia early.
  3. We compiled a short list of essential dementia decision support prompts to use as a standalone checklist within our reporting or integrate into any EHR.
The information we curated (from the DSM-5, CMS, Alzheimer's Association, American Academy of Neurology, and more) can help any team develop an efficient diagnostic workflow at last. And our checklists will build confidence and empower providers to triage, evaluate, and diagnose or refer patients without delay.

Neurotrack's decision support features are there to assist those who are getting up-to-speed in diagnosing neurocognitive disorders — and serve as an unobtrusive reminder for teams who have these steps down pat. Now that we've made the improvements, we see our customers are more effective in making diagnoses and chipping away at those gaps.

The help you've hoped for

One of the lone neurologists on a Southern California-based team recently joined a training session for the PCPs in his group. Seeing Neurotrack's standardized screening technology coupled with embedded decision support features gave him tremendous relief. With Neurotrack’s tools on board, he saw the PCPs would soon be empowered to diagnose and manage these patients more efficiently with less of his involvement, and one of the biggest bottlenecks in their organization could disappear. HIs praise was effusive: “This is everything I hoped for!”

Want a closer look? Please contact us to arrange a demo today.