Thinking Ahead: Telemedicine in Cognitive Assessment [Interview]

We recently had the pleasure of talking to Dr. William Mansbach, the creator of the Brief Cognitive Assessment Tool (BCAT). The BCAT is a screening and treatment tool designed for any clinical and residential setting in which cognitive functioning and cognitive impairment is a central issue. Dr. Mansbach has been active in using telemedicine in his treatment for years and is now beginning to offer his services through video visits. We were curious to learn more about the implications of video visits for cognitive assessment, and Dr. Mansbach was kind enough to take some time to explain his experiences and the lessons he’s learned.

SimpleVisit: What first drew you to telemedicine?

Dr. Mansbach: I was first drawn to telehealth a few years ago because of the demand from a multi-state healthcare company in the New England area. They had a need for psychiatric care for remote dual eligible patients who had no other way of receiving mental health services on a consistent basis. Getting a patient into the office for mental health visits can be a challenge. This challenge only intensifies when you add barriers such as distance and travel. Since then, we continued to offer services telephonically but have been very interested to expand into offering visits over video. Layering telehealth into care is very much a trend and we see a huge opportunity as memory care appears to be lagging behind.

SimpleVisit: Where do you see the fit between telemedicine and the services BCAT offers?

Dr. Mansbach: The BCAT is focused on providing assessment and care that is a balance of brevity and validity. Our short form test runs about 15 minutes and can test multiple key cognitive areas. With that in mind: In the scope of telemedicine, we see an opportunity to offer tests on a more broader scale as provider access increases plus improve follow-up treatment options. Often the test can be administered but follow-up is lacking, making readmission common. With telemedicine over video, we can access and work with patients to provide more consistent placement and treatment based on the results of testing.

SimpleVisit: What do you foresee as the impact of telemedicine on the field of cognitive assessment?

Dr. Mansbach: Being able to act more efficiently on assessments is the number one outcome we hope to achieve with telemedicine. Getting a baseline of reportable scores that can be monitored and traced as patients are placed from setting to setting would be massively helpful as we track recovery and treatment. By having more regular touch points with patients over these video visits, we can monitor the effectiveness of our treatment. Being able to act more quickly when a patient is regressing to adjust treatment and placement accordingly, would result in a reduction of readmissions. I would hope eventually that cognitive assessment could become similar to blood pressure — a measure that is easily tested at many access points, and which is monitored very closely.

SimpleVisit: What benefits does telemedicine bring to you and your provider team?

Dr. Mansbach: Access and capability to conduct visits have been large benefits to us as providers. Being able to overcome barriers in settings have allowed our providers to see patients much more regularly than otherwise possible. Beyond that there are the cost savings associated with reduced travel and more regular visits. “Trainwreck” events are a financial burden for everyone involved, so being able to prevent those are a major cost savings as well. Lastly, it allows our providers to get families and other providers involved in visits more easily. Often in geriatric care, the family may not be able to make visits, but with telemedicine you remove the conventional barriers of getting the family and care team involved in visits.

SimpleVisit: What new opportunities does telemedicine potentially create for the BCAT?

Dr. Mansbach: First and foremost it will expand the reach of our provider base. There are currently 3,500 providers certified to administer the BCAT. Since 2011, mental health evaluations have been routine for Medicaid check ups.  We hope to expand the number of our providers that can assist with this using telehealth. Additionally, we hope to partner with more businesses wishing to offer mental healthcare that might not have the budget to operate in-house. We also see opportunities for care takers who rely on the BCAT for referrals and can use telemedicine to generate referrals and assess more efficiently.

SimpleVisit: What are the broader implications for telemedicine in mental healthcare?

Dr. Mansbach: Many of the benefits I have already discussed apply across different spectrums of mental health. A high-tide raises all boats. Improving memory care can have a profound effect on mood and vice versa.

SimpleVisit: Tell me a little bit about your SimpleVisit experience?

Dr. Mansbach: SimpleVisit has been a really good fit for BCAT because what we needed was technology based on what people actually use. Smartphones are so prominent now, and finding a company that works with them was big in our selection. Lastly we have had really positive experiences with the SimpleVisit coordinator. Having a pseudo office manager available virtually has been very helpful to patients in getting online and set up so that we don’t have to.

About Dr. Mansbach

Dr. William Mansbach is the founder and CEO of Mansbach Health Tools LLC, which supports the BCAT Approach.  He is also the CEO and President of CounterPoint Health Services, a multi-disciplinary behavioral healthcare company specializing in geriatrics.  For many years he was the COO of the largest geriatric behavioral healthcare company in the U.S. specializing in long-term care.  Prior to this, he was co-founder and Chief Executive Officer of Comprehensive Geriatric Services, a Maryland-based company providing mental health services to residents in long-term care settings.  Dr. Mansbach has a national reputation as a clinician and consultant in the aging field.  He has been a pioneer in the development of Memory Clinics, and is the creator of the BCAT® system, a series of cognitive tests and intervention strategies.  He has published and presented numerous articles and workshops on geriatric mental health and cognitive assessment, and is active in creating healthcare policy.  Dr. Mansbach sits on the Maryland Governor’s Alzheimer’s Disease Council.

About SimpleVisit

SimpleVisit is a video service which allows patients and providers to connect over the video platform of their choice. With SimpleVisit providers are able to deliver on-demand visits to patients over any device or platform they have available to them. For more information on SimpleVisit and on how we are enabling providers to host virtual visits check out www.SimpleVisit.com