Interview with Dr.Mansbach of BCAT
I 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. I was 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.
Jake: 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 these 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 travel. Since then we have continued to offer services telephonically but are 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.
Jake: 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 not only offer tests on a more broader scale as provider access increases, but also improve follow up treatment. Often the test can be administered but follow up lacks, so readmission becomes common. With telemedicine over video not only can we access but we can work with patients to provide more consistent placement and treatment based on the results of testing.
Jake: 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 how effective treatment is. Being able to act more quickly when a patient is regressing, and 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.
Jake: 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.
Jake: What new opportunities does telemedicine potentially create for the BCAT?
Dr. Mansbach: First and foremost it will expand the reach our provider base has. There are currently 3,500 providers certified to administer the BCAT. Since January 2011 it has been part of the routine medicaid check up to do mental health evaluation, we hope to expand the number of providers we can assist with this using telehealth. On a larger scale we hope to partner with more businesses looking to offer mental health care who may not be able to afford it 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.
Jake: 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.
Jake: 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 that is 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 that almost virtual office manager has been very helpful to help patients get online and set up so that we don’t have to.
