PossinK, NIH, R01 Supplement P0568851 4/4/2023

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PROJECT SUMMARY/ABSTRACT Dementia causes substantial burdens for patients and caregivers, which were exacerbated by the COVID-19 pandemic. The current state of dementia care is inadequate to meet the needs of this growing, vulnerable population. Scalable, effective, and person-centered dementia care models that are aligned with value-based healthcare reforms are needed now. The Care Ecosystem is an accessible, remotely delivered team-based dementia care model, designed to add value for patients, providers and payers in complex organizational and reimbursement structures. Care is delivered via the phone and web by unlicensed Care Team Navigators, who are trained and supervised by a team of dementia specialists with nursing, social work, and pharmacy expertise. Care Protocols guide proactive, quality care that is documented in the electronic health record. The evidence base to date suggests that the Care Ecosystem improves outcomes important to people with dementia, caregivers, and payers when delivered in a controlled research environment, including reduced emergency department visits, reduced polypharmacy, higher quality of life for patients and lower caregiver depression. With our parent project, we are conducting a rapid pragmatic trial in 6 health systems serving geographically and culturally diverse populations. With this supplement, we will address unanticipated challenges in real time to ensure that we complete the project as proposed, meeting enrollment targets and staying on our timeline. In Aim 1, we will bolster recruitment of Latino/Hispanic, Black/African American, and rural participants. In Aim 2 we will expand our clinical teams so they can manage high needs patients, carry larger caseloads, and deliver the medication care protocol with equity to all patients. In Aim 3, we will cover unanticipated expenses in accessing and managing electronic health record data. This work will pave the way for expanding access to high quality dementia care in the future, mitigating the negative impact of dementia on patients and their families across the nation.