Ahead of the marcus evans National Healthcare CMO Summit 2023, and the National Healthcare CMO Summit 2024, Tom O'Neill discusses why brain health screening is not currently routine, and what would solve some of those issues.

1. Interview with: Tom O'Neill,
President & CEO, Cognivue, Inc.
“Every physician knows that the earlier
they catch cognitive impairments the
quicker they can intervene, but most of
the time they don’t test for impairment
unless specifically asked for by a patient
or caregiver. Brain health screening
needs to become another vital sign that
is checked at annual exams. We need to
make brain health a critical component
to a person’s overall health,” says Tom
O'Neill, President & CEO, Cognivue,
Inc.
Cognivue, Inc. is a solution provider at
the marcus evans National
Healthcare CMO Summit 2023, and
the National Healthcare CMO
Summit 2024.
What are healthcare leaders
struggling with today, as it relates
to cognitive function testing or
assessing?
The biggest challenge right now in
testing for mild cognitive impairment -
before it becomes more permanent such
as dementia or Alzheimer’s disease - is
that it is not done. There should be
consistent cognition assessment in
mass, across healthcare organizations,
in the primary care setting as well as
other clinical settings, but it isn’t being
done. It has been paper and pencil
testing for over 40 years. Health
systems aren’t set up to manage the
tremendous staff time and resources
needed to administer and score tests,
then have a conversation with the
patient. Not only that, there is no pill
they can prescribe so they have to
leverage modifiable risks factors such as
diabetes, smoking, diet etc. Doctors
need to be able to intervene with those
patients in a much bigger way. They see
patients for ten minutes, which is not
enough time to incorporate a proper
cognitive test, so they do a Mini-cog
test to check the box. Payers also make
it difficult for primary care to get
reimbursed for those tests. These are
the biggest healthcare system issues
today.
Unfortunately, if a cognitive issue is
delayed, over time it progresses from
mild to moderate, which then becomes
a neurologist’s issue, who is likely to be
booked up for six months.
What we need is a very specific,
innovative system that is focused on
making brain health screening as
common as screening of vital signs like
blood pressure, heart rate and so on.
We need to make brain health a critical
component to a person’s overall health.
The systems managing a strategic
population health model have a real
opportunity to drive this.
What technology does Cognivue use
to test cognitive function? How
does it remove human error and
variability?
With paper and pencil tests, Mini-cogs,
every doctor and nurse in the office will
administer it differently. When you
remove biases and human errors that
can come into play, you can get a good
snapshot of a patient’s cognitive
function. Our test removes as much of
those as possible. It is an FDA cleared,
computerized test using adaptive
psychophysics technology. It is self-
administered and self-scored in the
doctor’s or clinician’s office, but it just
needs someone to enter the patient’s
name, birth date and sex at birth. It
takes the patient through ten exercises,
and it brings out a simple two-page
report on six brain domains and two
performance measures. It is a nice
clean report for a doctor to review and
take appropriate action.
How would routine screening with
Cognivue improve the overall
standard of care?
The earliest you catch cognitive
impairment, the quicker you can
intervene, and possibly slow progress or
reverse it through the modifiable risk
factors. There are three systemic issues
that drive dementia: circulation,
inflammation and toxins in the brain. If
you test earlier and catch those issues,
you can have a real impact on the
patient. We hear doctors saying they
already counsel patients on eating right
and exercising, but their words often fall
on deaf ears. Now they have an
inflection point for them, a report on
their brain health. That will really help
them take their condition more
seriously.
How does this impact the efficacy of
new drugs coming into market?
There are new drugs coming into
market that can take care of plaques
and tangles, the issues that cause
dementia, but mild cognitive impairment
must be caught at an early phase for
these drugs to have an effect.
Any final comments?
There is definitely a pushback from
primary care doctors who are forced to
see many patients every day. They pick
the simplest test, whether it is effective
or not. The simple Mini-cog has been
challenged by the American Association
of Neurology for being prone to human
error, bias and variability. This requires
a very innovative, deliberate, and
strategic approach from healthcare
systems. Dementia is a big and growing
issue across the world.
Why Brain Health Screening Must
Become Part of a Patient’s Annual Exam
The earliest
you catch
cognitive
impairment,
the quicker
you can
intervene

2. About Cognivue, Inc.
Cognivue, Inc. is a world-class neuroscience company focusing on cognitive health with the world’s first FDA-cleared computerized
test of cognitive function. The Cognivue device and technology are based on years of research that uses adaptive psychophysics to
focus on information processing by testing key cognitive domains. The technology significantly improves the ability of healthcare
providers to implement a personalized assessment of cognitive function in a wide variety of care settings. The company is elevating
the gold standard of cognitive health assessment and empowering the healthcare community to monitor, identify and act early on
cognitive health concerns.
www.cognivue.com
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