Evaluating Implementation of an EHR-Enabled Alzheimer's Disease Care Pathway in Primary Care to Enhance Assessment and Detection Practices

Document Type

Conference Proceeding

Publication Date

6-9-2026

Publication Title

Neurology

Abstract

Objective: This initiative seeks to evaluate the implementation of an electronic health record (EHR) enabled Alzheimer’s disease (AD) care pathway and AD assessment and detection practice outcomes. Background: The 2025 Alzheimer’s Association Special Report indicated that nearly 80% of Americans want to know if they had AD before experiencing symptoms or prior to symptoms interfering with daily activities. While a brief cognitive assessment (CA) is a required component of the Medicare Annual Wellness Visit (AWV), PCP CA practices remain suboptimal, with 58% of surveyed PCPs citing time constraints as a barrier. To streamline workflows and measure AD assessment practices, Midwestern University, Corewell Health, and Tufts Medicine implemented EHR-enabled AD care pathways in primary care settings. Design/Methods: In October 2025, all sites began implementing EHR-integrated cognitive screening tests (MoCA, Mini-Cog, MMSE, or the SLUMS) with auto-score features, for patients presenting with cognitive concerns or during AWVs. Tools to enhance further cognitive evaluation include an OPA (“our practice advisory”) and a cognitive impairment SmartSet. Primary endpoints include number of eligible patients that receive a CA, number with an abnormal CA score, and number receiving further workup, including labs, imaging, and referrals. Results: Baseline data pre-implementation across three sites over 6 months indicates that 18% of eligible patients received a CA; of those, 18.6% received an abnormal screening score, and 13% had lab testing completed within the last 6 months to rule out reversible causes of cognitive impairment. Ultimately, 0.25% of eligible patients during the baseline period received a new AD diagnosis code (G30.0, G30.1, G30.8, G30.9). Conclusions: Baseline data highlights gaps in use of CA for eligible patients in primary care, and reinforces the need for continued education and standardized, EHR-integrated workflows. Future analyses will evaluate active study period data and changes relative to baseline.

Volume

106

Issue

11 Suppl 1

First Page

3936

Comments

American Academy of Neurology Annual Meeting, April 18-22, 2026, Chicago, IL

Last Page

3936

DOI

10.1212/WNL.0000000000216813

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