• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Henry Ford Health System Always Events

Henry Ford Health System Always Events






Total Views
Views on SlideShare
Embed Views



2 Embeds 158

http://alwaysevents.pickerinstitute.org 157
http://translate.googleusercontent.com 1



Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

    Henry Ford Health System Always Events Henry Ford Health System Always Events Presentation Transcript

    • Henry Ford Health SystemDementia Screening for Senior Patients
    • Picker Awards“Understanding and respectingpatients’ values, preferences,  Picker awards established in 2003and expressed needs is thefoundation of patient-centered  Independent nonprofitcare” Harvey Picker  Patient-centered care Founder 1915-2008  Improvement of patient’s experience and interaction with health care providers  Picker Surveys are the world standard for measuring performance “through the patient’s eyes”
    •  World Health Organization If the costs of AD were a  Significant threat to health of all nations world economy,  First chronic disease to be cited it would rank as Dementia as Chronic Disease the 13th largest  Genetic vulnerability & environmental exposure  Importance of risk factor modification ▪ Disease modification National Alzheimer’s Association  Pre-dementia states ▪ Mild Cognitive impairment ▪ Pre-clinical AD AD  Earliest stages are target of treatment National Alzheimer’s Project Grant Medicare Wellness Visit  Patients must be asked about cognition at an annual visit
    •  Dispel the mythology of memory loss with aging  “Normal” age related cognitive decline is not normal Make the Diagnosis  Alzheimer’s Disease?  Lewy Body Disease?  Frontal Dementia? Care vs Cure Disease modification strategies Family as patient Community Alliances
    •  Current norms  New treatments target outdated preclinical states  MCI  Biomarkers and risk  Preclinical changes factor identification Neuropsych tests  Serial testing (within change late in course subjects) more powerful  NP testing normal in to predict pathology brains with AD changes ▪ Need office easy to administer office based tool  Normal NP test does not ▪ Repeat regularly as part of health mean brain is normal maintenance  Second to last biomarker to change
    •  Lack of time for assessment Uncertainty regarding diagnostics Complexity of cognitive testing Lack of resources for management of behavioral and social issues, community resources, caregiver training Henry Ford Hospital
    •  Routine dementia screening annually, starting at age 70 Internet tools for cognitive and behavioral assessments Identify a specific dementia syndrome Provide appropriate medical and non-medical treatments Align patient and caregiver with network of community supports
    • NIH Toolbox NeuroQualPublic domain web-basedassessments Computerized 30 minutes Scoring and interpretationOversight by supportpersonnelIdentifies MCI, AD, non-AD Behavior assessment Caregiver distress
    • Accessed through CarePlusGuides diagnostic history, physical exam, tests, and treatmentIdentifies red flags for referralDirect link on CarePlus for Neurology referral if needed
    • Education Grosfeld BehaviorCollaborative management Community referrals All are referred Direct link on careplus Located at HFH
    • June 1-Sept 30 Oct 1-Nov 30 Dec 1-Feb 28 Mar 1-May 31 Development Training Pilot EvaluationRefine web based tools Physician  Every patient >/= 70 Computerized screenInterpretive component Support personnel screened in 2 clinics for patients >/=70Designate space in Social workers Database collection Screening labseach clinic for testing Meet with advisory Meet with advisory MRI (or CT) brainPurchase computers group group Specific diagnosisIT issues Cholinesterase inhibitorPatient advisory group for AD or DLBIdentify 2 primary care Documentation ofclinics for pilot social work outreachDevelop physician call/conferencetraining CDs Meet with advisoryHire social worker groupDesignate space forsocial workerOutcomes measuresdesignated
    •  Physician  Social Work  History  Stage dependent learning series  Medications ▪ Anticholinergic burden  Care management reduction  Day respite ▪ Sedative reduction  Area Agency on Aging  Targeted neuro exam referral  Objective Tests  Support group  Treatment  Behavior management ▪ Medical  Sleep guidelines ▪ Nonmedical  Meals on wheels  Reduce Vascular Risk  Referral for Financial  Driving Medical Assistant Planning Computerized cognitive test Computerized behavioral assessment Caregiver distress/burden
    •  Patient satisfaction Diagnoses Use of dementia medications Physician satisfaction
    •  Any health care  Training modules on CDs organization or practitioner to be shared with other with EMR can utilize this institutions new process  Organization must refine/adapt NIH toolbox with interpretative component  There is a guideline/template for primary care physicians  There is a social work template Alzheimer’s association chapters exist in all 50 states  All chapters can adopt the reimbursement model for their social workers
    •  Matching funds  Physicians are more  Siemens likely to adopt age  Microsoft specific screening when  Pfizer/Eisai testing is No cost to maintain  Standardized templates in Careplus  Interpreted once created/modified  Performed by a technician No proprietary costs to  Reimbursement utilize NIH toolbox commensurate with Alzheimer’s social complexity of visit workers can bill for services
    •  How the topic is framed/presented Where will testing take place Space for social worker Who will oversee testing Templates Patient/caregiver advisory council Outcomes Other