Cognitive Screening in Audiology Practice

Interview with Cognivue’s CEO, Tom O’Neill regarding Cognivue Thrive – a computerized, 5-minute, self-administered, cognitive screening tool based on FDA-cleared technology utilizing adaptive psychophysics and backed by 17 patents.

 

AudiologyOnline: Your experience is with larger well-established healthcare organizations with large market presence. What interested you in joining Cognivue as CEO?

Tom O’Neill: As a former executive of larger organizations,  I always look for that one opportunity were the conditions are right for me to leverage my experience, a great team with a great differentiated technology to drive sustainable market growth - I recognized Cognivue as that opportunity. Our product is unique and timely, particularly in the hearing health segment. The research was there and there is little doubt now that hearing impairment has a big impact on cognitive performance. Our product is solving a problem for the Audiologist and we want to be part of helping solve that problem. We just needed to start connecting with the hearing health community to gain awareness and adoption. It may seem simple enough, but there is certainly a lot of heavy lifting and strategic effort to get your voice heard as a new technology in any segment of healthcare. I would also say the appeal of becoming a partner in the cognitive health eco-system and helping drive patient awareness on the importance of cognitive screening has a tremendous appeal to me.  

AudiologyOnline: For those not familiar, tell us, what is Cognivue?

Tom O’Neill: Cognivue offers innovative technology for cognitive screening that can be easily implemented in a number of healthcare settings, including audiology. The company was founded out of an NIH research initiative that sought to develop a cognitive assessment tool that removes the associated bias and variability of traditional paper and pencil testing methods such as MoCA and SLUMS.1 Offering a computerized, 5-minute screening modality that is self-administered by the patient, Cognivue technology removes the bias and also addresses some of the challenges that have limited the implementation of cognitive screening in audiology practice – a natural setting given the ear to brain association.  Those boundaries include a lack of training/comfort with administering, scoring and interpreting written tests – or simply having the time to do so as part of a busy practice.2

AudiologyOnline: What is the relationship between cognition and audiology?

Tom O’Neill: The Lancet recently reaffirmed that hearing loss is the number one modifiable mid-life risk-factor for cognitive decline.3 Not only that, but emerging research also appears to demonstrate that hearing intervention may actually slow or potentially even reverse cognitive decline4 - this is an ongoing but very promising area of research. And so, by offering cognitive screening in the audiology setting, it provides a direct pathway between identifying a cognitive concern and implementing an appropriate mitigation plan. Further, providing this value-added service facilitates more comprehensive patient-centered care as part of the broader healthcare ecosystem. 

AudiologyOnline: Can you tell us more about Cognivue Thrive?

Tom O’Neill: For the audiology practice, we offer Cognitive Thrive, an innovative new tool based on our FDA cleared technology, protected by 17 patents.  It is a computerized, 5-minute assessment tool that is self-administered by the patient using a laptop-like device.  Cognivue Thrive incorporates three differentiated elements including the CogniCover which removes ambient light and focuses the patient, the CogniWheel, which uses a patented technology that measures each patients motor skills and then adapts the rest of the test to their motor skills and finally the CogniSystem which is our patented algorithm that measures and adapts to each patients performance.  The system evaluates 3 cognitive domains: memory, visuospatial, and executive function as well as reaction time and speed processing. Cognivue Thrive objectively, quantitatively and reliably identifies areas of concern that could be indicative of a cognitive impairment that may be addressed through hearing intervention for patients with established hearing loss. Results are immediately generated in a user-friendly Red/Yellow/Green format, along with other resources to facilitate continuity of care as needed. 

Cognivue fits effortlessly into the patient flow for various appointment types and has contributed new revenue-generating opportunities for our current professional partners. 

AudiologyOnline: MoCA, SLUMS, and other cognitive screening tools have been around for some time. What does Cognivue do better than traditional screening methods?

Tom O’Neill: Cognitive screening is often done using paper and pencil tests. These assessments can be time-consuming, fraught with human error, bias and variability not to mention costly as they require staff to administer and score the assessment. A more recent trend has been the digitalization of these paper and pencil tests to make them more accessible – but they still require the test administrator to be adequately trained on the various aspects of administering, scoring and interpreting the test and the time required to do so. As well the same issues may still exist with human error, variability and bias.  Recent data suggests that the training required and time necessary to complete these tests are the primary reasons that audiologists haven’t embraced cognitive testing.2

Now we have Cognivue, which applies 15 years of research and an FDA-cleared technology to eliminate the associated testing bias. Meanwhile, the computerized, self-administered testing format addresses the practical pain points of training and time. It’s an ideal solution for an audiology practice looking to expand and differentiate services without completely disrupting the patient flow dynamics. 

AudiologyOnline: What feedback have your received from audiologists using Cognivue?

Tom O’Neill: The response from our audiology partners has been overwhelmingly positive. Anecdotally we have heard from audiologists from numerous practice settings who early on recognized the value of adding cognitive screening to their overall patient assessment, but were either intimidated or turned off by the tools most commonly available – namely paper and pencil tests, or clunky tablet versions of the same tests.  Now having implemented Cognivue into their practice, they are discovering new ways to incorporate the information to enhance clinical practice and patient outcomes, while reaping the benefits from a business perspective as well. 

AudiologyOnline: What sort of resources does Cognivue offer to audiologists interested in implementing this technology into their practice? 

Tom O’Neill: Well, first, I have to mention that we did our homework upfront. We collaborated with the Audiologist community and formed a best in class panelist group that helped us understand their challenges and practice dynamics. As a result of that collaboration, we identified a number of needs and resources that the Audiologist required to be truly successful in adopting cognitive screening in their office. We now have many resources to address those needs including certification training programs for staff and the AuD, patient education material, MD referral resources, practice marketing content and much more. From my perspective, however, the most important resource is the continued spirit of collaboration. We don’t walk away once an audiologist adopts our product, we continue to learn and support our customers and continue to partner with them to promote cognitive health with their patients. It how we approach true customer-centric relationships.  

AudiologyOnline: How do you see the cognitive health industry evolving over the next several years, and what role will Cognivue play in that transition?

Tom O’Neill: Patient-centered care that addresses the individual patient condition is the future of healthcare. By increasing access to cognitive assessment tools, patients and their providers will have more comprehensive information to better inform clinical decisions and strategies that promote wellness and longevity. With Cognivue’s inherent benefits over traditional testing methods, we believe we can increase awareness, accessibility and adoption of cognitive health assessment to drive enhanced patient care across the care continuum. 

To learn more about Cognivue Thrive for your Audiology practice, please explore our AudiologyOnline partner page, or use this contact form to connect with Cognivue directly about monthly subscription pricing and current specials. 

References

1. Ranson, J. M., Kuźma, E., Hamilton, W., Muniz-Terrera, G., Langa, K. M., & Llewellyn, D. J. (2018). Predictors of dementia misclassification when using brief cognitive assessments. Neurology: Clinical Practice, 9(2), 109-117. 
2. Black, S. & Souza, P., (2020). Cognitive-Screening Practices Among Audiologists. Audiology Today, (September/October).
3. Livingston G, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. Vol 396, Issue 10248, P413-446. August 2020.
4. Maharani A, Dawes P, Nazroo J, Tampubolon G, Pendleton N; SENSE-Cog WP1 group. Longitudinal Relationship Between Hearing Aid Use and Cognitive Function in Older Americans. J Am Geriatr Soc. 2018 Jul;66(6):1130-1136. doi: 10.1111/jgs.15363. Epub 2018 Apr 10. Erratum in: J Am Geriatr Soc. 2018 Dec;66(12):2435. PMID: 29637544.