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Brain Health Navigator (BHN)

DAC-SP co-created and implemented a Brain Health Navigator model with 6 sites in the U.S. to help provide timely care for patients with cognitive decline in primary and specialty care settings.

BHN model toolkit

The Brain Health Navigator (BHN) toolkit provides downloadable resources for you to use in your local healthcare system. These tools are prototypes and are intended to be used in conjunction with one another. These tools vary in utility depending on where you are in the BHN journey and can be used iteratively throughout the implementation process. Since all healthcare systems are unique, these resources can be adapted to various clinical approaches and serve as a starting point for developing your own BHN program.

Toolkit Objectives

  • Promote the adoption, dissemination, and sustainment of brain health navigator model in US healthcare settings.
  • Contain the resources necessary to design, implement, and sustain a brain health navigator model in primary and/or specialty care settings in US healthcare systems.
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This PDF provides an overview of The Brain Health Navigator (BHN) toolkit, and its provided resources for to use in your local healthcare system.

Toolkit Overview

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The resources in this section include a Jobs To Be Done (JTBD) Checklist, along with a Workflow Overview Template, and Workflow Examples.

Creating Workflows

3 Resources

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The resources in this section include Business Model Archetypes, along with a Billing Code Resource Guide, Executive Summary of Billing Code Categories, and a Code Selection Flowchart.

Billing & Business Case

4 Resources

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The resources in this section include a Lexicon and Training Resources.

Training & Education

2 Resources

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BHN model toolkit

Creating Workflows

Website

Jobs To Be Done (JTBD) Checklist

Overview of the specific tasks and clinical interactions at various stages of diagnostic assessment and care that could be included in your workflow and may inform your business model archetype.

Open Web Tool

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PPT

Workflow Overview Template

Modifiable template for healthcare systems to use as a starting point for mapping out local clinical workflows.

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PDF

Workflow Examples

Six workflow case studies from each of the BHN program sites to be used as a starting point for creating your own workflow to be created with local clinical decision.

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Billing & Business Case

PDF

Business Model Archetypes

Four system archetypes of how the BHN role might be implemented in your local healthcare system including examples of strategies for billing and revenue generation.

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PDF

Billing Code Resource Guide

Reference guide with possible billing codes relevant to early detection and care coordination, including a helpful Q&A.

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PDF

Executive Summary of Billing Code Categories

Supplement 1 from the Billing Code Resource Guide. Summary table comparing five different billing code categories.

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Code Selection Flowchart

Supplement 2 from the Billing Code Resource Guide. A billing decision tree for healthcare services that helps determine the appropriate billing codes in your local healthcare system.

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Training & Education

PDF

Lexicon

Contemporary nomenclature, terminology, and education for topics relevant to a BHN model.

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PDF

Training Resources

Summary of key terms and references to be leveraged for developing training resources for BHNs or other care providers.

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“It's possible but it's all about the workflow!”

Program Overview

Program Objectives

To improve the pre-diagnosis journey by developing a brain health navigator program, modeled after oncology and diabetes, and piloted with existing forward-leaning health systems with real-world experience.

  • Empower US health systems to rapidly identify causes of cognitive decline in the frontline setting
  • Streamline the diagnostics journey for patients and health systems to specialty care, where applicable
  • Connect patients experiencing cognitive decline to appropriate care and support
  • Develop & evaluate a BHN model that is both scalable and sustainable nationally, in a wide variety of settings

Catalyst for BHN Program

In previous DAC-SP programs, a boundary spanning role was created to facilitate the implementation of cognitive assessments and blood biomarkers into clinical workflows. This BHN program was designed to expand upon those initial learnings and develop a BHN model focused on sustainability and scalability.

PCPs need simple solutions and incentives

“What I've heard repeatedly from [PCPs] is they want an ‘easy button.’  They want something they can just click that then sends the referral and it gets dealt with somewhere else.” — Dr Donna Wilcock

Many patients are lost in the system

“The system doesn't know they have mild cognitive impairment cases. If they have dementia, the health care system misses 80% of them.” — Dr. Malez Boustani

Families desperately need help

“If I had a BHN, I would use them to connect families to community resources, get them the emotional support and education." — Dr. Jacki Raetz

There is a need for boundary spanning role(s) to benefit patients and systems

Site Criteria & Selection

DAC-SP recruited a diverse range of practices to ensure wide applicability across the US healthcare system.

  • Program Leadership and Change Management: Team composition and stakeholders
  • Contemporary Experience: Of the diagnostic journey for new disease-modifying therapies, including blood biomarkers, positron emission tomography (PET), cerebrospinal fluid (CSF), and magnetic resonance imaging (MRI)
  • Patient Diversity: Race, ethnicity, social determinants of health
  • Implementation: Readiness and capability
  • Sustainability:  Of program beyond the grant period

Thank you to our collaborators who helped co-develop and pilot the tools and processes in real-world settings

About Dac-SP

Photo Caption: The team behind the Brain Health Navigator (BHN) program, while on a Zoom call.

The Davos Alzheimer’s Collaborative Healthcare System Preparedness Program