Background and Goal: A previous study across seven primary care clinics found that many older adults who completed a digital cognitive assessment showed possible signs of cognitive impairment. In this companion study, researchers assessed how agile implementation, an approach based on iterative improvements and tailored clinic workflows, could support the integration of digital cognitive assessment screening into routine care for patients aged 65 and older.
Study Approach: Researchers conducted a pragmatic clinical quality improvement project with seven primary care clinics in Indiana. The agile implementation process involved eight key steps: identifying opportunities for improvement, selecting the screening tool through a structured stakeholder evaluation, developing an implementation evaluation plan, mapping existing workflows, testing changes through time-bound training cycles called sprints, monitoring performance through weekly check-ins and dashboards, assessing organizational impact, and formulating a standardized operating procedure.
Main Results
The intervention engaged 69 of 108 clinicians.
The screening rate increased over the course of the 12-month period.
Four clinics fully adopted the program, each reaching a screening completion rate of at least 20%. Five clinics continued using the screening tool one year after implementation.
Each clinic adapted the process to fit its specific setting while maintaining alignment with a shared core model.
Why It Matters: The findings from this study demonstrate the successful implementation of a digital cognitive assessment tool in primary care using agile implementation principles
Agile Implementation of a Digital Cognitive Assessment for Dementia in Primary Care
Diana Summanwar, MD, et al
Department of Family Medicine, Indiana University School of Medicine, Indianapolis, Indiana
