Page 56 - Healthy Brain Initiative, State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map

UTAH

Improving Early Detection during Medicare Annual Wellness Visits

Utah is one of the most rural and fastest growing knowledge of validated cognitive assessment tools.
states in America. Currently, about 11% of the state’s As a step in this process, UDOH sent the study report
three million residents is aged 65 or older, and the to all Utah primary care physicians, along with a list of
state has about 30,000 people with Alzheimer’s resources for people with cognitive impairment and a
dementia, which is expected to rise 40% to 42,000 recommendation from UDOH’s executive director for
by 2025. Diagnoses of dementia in later stages may routine cognitive assessment during the AWV using
lead to higher levels of disability while receiving care, the Mini-Cog as the primary assessment tool, followed
delays in accessing timely primary care, lack of care by the Montreal Cognitive Assessment tool (MoCA).
coordination, and duplication of services. The project deepened UDOH’s understanding of

To improve early detection of cognitive impairment, a some challenges that physicians face in assessing
focus of Utah’s State Plan for Alzheimer’s and Related cognition during the AWV, one of which is uncertainty
Dementias, the Utah Department of Health (UDOH) about which validated tool to use. Receiving clear
contracted with HealthInsight, a quality improvement recommendations from UDOH’s executive director
organization. HealthInsight interviewed providers may begin increasing physician use of the tools during
about their experiences and processes conducting AWVs or other occasions in which a physician has
cognitive assessments during the Medicare Annual concerns about potential cognitive impairment. Use of
Wellness Visit (AWV). While some providers reported validated early detection tools helps physicians assess
performing routine cognitive assessments during the cognitive functioning and detect potential concerns
AWV, others reported screening only under certain early, the first step in increasing early diagnoses.
conditions, such as patient requests, patient has With some legislative support, UDOH plans to
specific risk factors for cognitive decline, etc. Providers continue collaborating with HealthInsight to develop:
also expressed a need for better tools to detect early-
stage memory loss. The resulting report, Cognitive » Cognitive assessment training for primary
Assessments during Medicare Annual Wellness care physicians and their office staff that will
Visits, was a collaborative product from HealthInsight; include use of recommended tools and workflow
UDOH; the Center for Alzheimer’s Care, Imaging and improvement techniques to instill a reliable,
Research at the University of Utah; and Intermountain repeatable process in clinics.
Medical Center. » Cognitive health and wellness toolkit to help health
Actions in the Healthy Brain Initiative Road Map professionals navigate the cognitive assessment
•
include improving healthcare providers’ ability to process, including assessment, diagnosis,
recognize the early warning signs of dementia and referrals, and community resources.
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