Access to Care for Alzheimer's Disease

Hello everyone and welcome to Access for Care to Alzheimer's Disease, an event that we are hosting with the Alzheimer's Association. I am Steven Collens, the CEO of MATTER. We are a healthcare technology incubator and innovation hub. Built on a belief that collaboration between entrepreneurs and industry leaders is the best way to develop healthcare solutions. Our mission is to accelerate the pace of change of healthcare, and we do three things in service of this mission. First, we incubate startups. We launched in 2015, and since then we've worked with more than 850 companies that range from very early to growth stage startups, and we have a suite of services to help them. At every stage of development, our member companies have raised more than $5 billion to fuel their growth. Second, we work with large organizations like health systems and life sciences companies and payers to help them strengthen their innovation capacity. We help them find value in emerging technology solutions, unlock the full potential of their internal innovators, and create a more human-centered healthcare experience through system level collaborations. And third matter is a nexus for those who are passionate about healthcare innovation. We bring people together to be inspired and learn and connect with each other. And we put together forums like the one we're here for today. This is our second year working with the Alzheimer's Association to advance innovation to improve the lives of those living with Alzheimer's disease or related dementias. Last year, the pitch competition focused on early detection in primary care settings. And this year the focus is on solutions that increase access to quality person-centered care for people living with Alzheimer's disease in underserved communities, inequities in access to care for people with Alzheimer's disease, STEM from socioeconomic disparities, limiting resources and healthcare options for those in those communities. These disparities manifest in delayed diagnosis, inadequate support services, and a lack of tailored interventions perpetuating a cycle of unequal treatment and outcomes for individuals affected by Alzheimer's. Today we've brought together leaders who are working in this space to discuss these barriers, to care how to improve access, how our healthcare system can and should collaborate and opportunities for innovation. Dr. Jay Bott leads the Deloitte Center for Health Solutions and the Deloitte Health Equity Institute, and he is a practicing internist and geriatrician. Ashley Alexander is CEO of the Kelsey Research Foundation. Ashley also co-chairs the Alzheimer's Association Innovation Roundtable. Katie Evans is the Chief Mission Engagement Officer of the Alzheimer's Association, and our moderator today is Laura McIntyre, senior Director of Health Systems at the Alzheimer's Association. She works with health systems and health plans to increase early detection and enhance quality of care for those at risk of Alzheimer's disease and related dementias. If you have questions for any of the panelists, please drop them into the chat and Laura will weave them into the conversation as we go. And following the panel discussion, my colleague Casey Sheridan will provide a brief overview of the second annual Alzheimer's Association pitch competition. Thank you all for joining us today. I'm looking forward to the conversation. And with that, Laura, I will turn it over to you to get started. Thank you, Steven. So I'm so grateful to be here today and talk about really how we can improve access to care and to introduce you to this amazing panelist. So we'll start with Dr. Bhatt. Tell us a little bit about your role and how you're currently working with people living with Alzheimer's disease and related dementias. Thank you, Laura, and just real gratitude to the Alzheimer's Association of your leadership and for collaborating with matter. I've just been fortunate to work with matter over the years and tremendous value that creates for the innovation ecosystem. So I'm a primary care physician, internist, geriatrician at a community health center on the south side of Chicago. So I directly care for those with dementia or cognitive impairment and delirium and with work with their caregivers. So that experience is humbling and it's just an honor to care for patients with their families and caregivers. I also lead our Deloitte Health Equity Institute, which advances health equity as an outcome. We do that through research, through social impact with community investments, as well as building the capacity and capabilities of people in our firm and giving them experiences to engage in purpose-based client and social impact work as it relates to health equity. And so this issue has come up through new care models, thinking about biopharma and the treatments and the drug discovery process. Think about how do we advance both treatment and support for those that may be on their way to dementia or have dementia. And then our Center for Health Solutions at Deloitte does research across the industry in life sciences and healthcare. And so I also personally, my father has got mild cognitive impairment on his way to potentially dementia at a various continuum. And so family experience as well. Thank you. Thank you. Dr. Bhatt. Ashley, tell us about your role and how you're working with Alzheimer's. Absolutely. I'm Ashley Alexander, president and CEO of Kelsey Research Foundation in Houston, Texas. We are the research affiliate of a large multi-specialty physician group here in Houston and oversee and implement all research for their patient population and for their physicians. And we've had the honor and privilege of partnering with the local chapter in the National Alzheimer's Association on a variety of research projects over the years. Most recently for Focus on Brain Health with the US Pointer study, we serve as part of the Houston team implementing the US Pointer study for our 455 participants here in Houston. We also, in the future, are hoping to be part of some real world clinical trials on the use of the therapeutics that have been developed. And in a similar standpoint on a personal front, both my husband and I have lost our maternal grandmothers to Alzheimer's and dementia. And so there is a personal drive to be involved and see advances in these areas. Thank you. Thank you. Ashley and Katie. Hi everyone. Katie Evans. I am the Chief Mission Engagement Officer of the Alzheimer's Association. And really just to ground everyone on who the Alzheimer's Association is, we're leading the way to end Alzheimer's and all other dementia, and that's by accelerating global research, driving risk reduction in early detection, and of course maximizing that quality of care and support. So in my current role, I have the honor and privilege of leading a team, and we're developing new products and solutions for healthcare systems for the long-term and community-based organizations, the scientific community, and then as well as people who are of course living with Alzheimer's and dementia and their care partners. So we're really trying to provide that support and those resources for these audiences so that we can both accelerate research but then transform clinical and care practice. And similar theme to the other panelists, I actually lost my father this summer to Alzheimer's, so I'm in it in the fight and ready to see what we can do more together. Well, as you can see, we have an amazing panel today to talk about barriers to care and then potential solutions. I echo everything we've heard today. I too have a father living with vascular dementia entering the middle stage. So not only do I live the work every day, I live it when I leave this job to care and provide the best care for him. And so thinking about Alzheimer's, we know that the number of the Americans living with Alzheimer's today is growing rapidly. More than 6 million Americans of all ages have Alzheimer's and is the size of the US population age 65 and older continues to grow. So will the number and proportions of Americans living with Alzheimer's and other dementia. It's projected by 2050 that the number of people living with them, assuming that we don't have breakthroughs to prevent or cure this disease will likely be around 12.7 million. And so as we think about that care and how we will care for our older adults, thinking about innovation, thinking about their current barriers and how to overcome them are really critical. And so Ashley, what are the main barriers that come to mind today that individuals who are living with Alzheimer's are facing when accessing quality care and support services? So a couple of things that I hear about from our participants in the US Pointer study, many of which have served as caregivers, it is access and availability to care teams and the coordination of those care teams. A lot of challenges, and we all know this and are aware of it, but the need for more neurologists within our care continuum, but also access to get into primary care as well. And then the coordination often for these individuals of primary care in one system and then subspecialists, neurologists, et cetera, and other systems and making sure that you are having a reconciliation of that medication of the conditions that are happening. And I also think to go expand into the support services, it's understanding what support services exist within your community and then gaining access to those support services. You don't know what you don't know, and you get into this and face a lot of challenges and become overwhelmed. And what can caregivers do and provide and what can the individuals provide or ask for and advocate for as well? Yes, I agree. Ashley, Jay, what about you? We know you're a practicing physician. What barriers are you seeing for the patients and the caregivers in accessing quality care and support? So thank you so much Laura. And just building on Ashley's comments, which I think are spot on, one of the things I wanted to say is that this is not just a moral imperative, it's an economic imperative as well. And we see more frequent hospital admissions, higher more days in nursing home facilities, nearly 55,000 yearly total cost per person and poor quality of life for both personal dementia and they're typically unpaid caregivers. So one is lack of information, education caregivers may be unaware of available resources, support groups and educational materials, but it's also the literacy levels that various people may be at. I typically take care of historically underserved and historically marginalized vulnerable and literacy levels are quite variable. So with a limited amount of time, it requires a team that coordinates around this limited access to specialized cares. Kelsey had suggests. I think this can lead to delays in diagnosis and inadequate treatment. And then the others fragmented healthcare system, lacking coordination between different clinicians, team making it difficult for caregivers to navigate through various services, coordinate the care of their loved ones, emotional and psychological stress, feelings of isolation, anxiety, depression. And so the caregivers may need mental health support, counseling, respite care, and other peer support groups. The financial burden as alluded to, can be a challenge. And then lack of this respite care and support services. So caregivers that may need time off from their responsibilities or need to work something out with their occupational responsibilities. But by addressing these barriers, I think caregivers can receive the support they need to provide the best possible care for their loved ones with Alzheimer's. Yes, I completely agree. And I think about workforce as well. And so even if we make those caregivers aware, then we need a well-trained workforce. And so I think that's an additional barrier. So thinking about workforce and in thinking about the healthcare ecosystem, Katie, what are your thoughts around how is the healthcare ecosystem currently addressing these barriers? That's a good question, Laura. I would say that better. Alzheimer's disease care really requires conversations about memory at the earliest point of concerned and having a knowledgeable and accessible care team to diagnose, monitor disease progression, and then of course treat when appropriate. And we do know what effective dementia care looks like. In fact, there are some models of care that have even been developed. They've demonstrated both effectiveness and proven out some cost savings. So right now, we're fortunate Laura and her team, they're actually working with health systems across the country to help each system build their own dementia care program. But I'd also say that more needs to be done to address these barriers, especially for the rural and underserved communities. So for us to encourage and implement more coordinated care models across the country for people living with Alzheimer's and other dementia. We did launch this summer a dementia care navigation round table. And this round table is supporting very broadly implementation of dementia care navigation, and it's an effort to convene experts where they can share best practices, build and disseminate resources. The experts are really from across the entire healthcare ecosystems. So that includes systems, clinicians, payers, researchers, and just other stakeholders who are really committed to advancing the delivery of high quality person-centered dementia care navigation. And that's something else to note is an important cornerstone for this work, really centered on guiding principles for dementia care navigation, which were developed by a group of dementia care experts and convened by the Alzheimer's Association. And these guidelines were recently published in the journal, Alzheimer's and Dementia, the Translational Research Thank you, Katie. And that's really a great update on where we are, but we have a ways to go. So I'm curious, Jay, because of your role with Deloitte and you think about the healthcare ecosystem, how do you think they are addressing barriers? What is your perspective on that? Knowing the answer may be sometimes they're not. And so I'm just curious, what are your thoughts about how the healthcare ecosystem is addressing them? Yeah, I think the ecosystem and the various players, then I recognize this as a critical issue and it's being addressed in variable ways by different stakeholders. But the reality is that all stakeholders need to come together. And we're seeing some of this play out with the guide model, which is a new model launched by CMS. We've also seen this through collaborative evidence-based collaborative care models, Dr. Mel Bai and others have driven this forward. You have a scalable dementia care coordination team that then has access, coordinate delivery and monitoring with the family caregiver, patient counseling, self-management. You have memory care mental health practitioners, you have community resources and primary care providers, but that model also needs supportive reimbursement. Often we think about the payment model and then, okay, how do we box the care into the payment model? But it's really about what is the care that people with dementia and their caregivers need with dignity and respect, and then how do we pay for that effectively and where the various approaches are going to be. So I think there's certainly technology and innovation that can help support this using those solutions as enablers to augment the work of care teams that can improve the condition and integration of care services for individuals. Alzheimer's disease, whether it's telemedicine, voice activation, predicting needs that may be necessary. We're seeing this some with around drug discovery as well as artificial intelligence. But I think that addressing health equity, supporting innovation and addressing affordability is really the pillars of the CMS Innovation Center strategy that the guide model supports. And I suspect that more will come on board, but we've seen U-C-S-F-U-C-L-A and a number of other academic centers take these collaborative dementia care models and move them into clinical programs. And so we need more of that happening. We know there's evidence about model today that works, and we should test how we can enhance those models that create AAD a support for the dyad, those suffering from the DS and the disease and those caring for 'em. And I'm excited to see what emerges. And we too are very excited about guide and implementing the models. So thinking about that, thinking about even the potential solutions, you had talked earlier Dr. B about those underserved populations. So what are some unique barriers? We know that African-Americans and Hispanics are disproportionately affected by this disease. And so what are some unique barriers? We're going to talk a little about solutions in a little bit, but what are some unique barriers that we have to consider when we're developing out innovations and solutions? So what's the barriers for underserved populations? I think one, as we think about building on just the care model, it's one in which the workforce and the caregivers can operate reliably and effectively. And often if I see a patient, it's 15 to 30 minutes the followup's, 15 new patient's, 30 minutes, imagine how we are to get what we need done in that time. So you've got to think about what is the continuum, what do you focus on there? How do you have other players on the team play a role? How does technology enable some of the support? So I think you've got to think through that model for your population. One of the things is digital literacy. So we kind of think about what's our own genius bar for patients that need support with various tools and the support for caregivers. I think the other piece around treatment, clinical trial diversity, we know that we got to continue to advance that, although black Americans are twice as likely as white Americans have Alzheimer's and Hispanics, but 1.5 times likely we see the clinical trial participants don't reflect that. I think in some of the more recent ones, we've seen the Hispanic community be represented better, but still tough for the black community. And to the point made earlier about rural communities, I think that's a really important issue as well. And so as think about care models got to account for the rural needs as well. So I think when I think about equity and inequities space, it's racial and ethnic, certainly disproportionately impacted, but it's place-based too. And it's veterans. It's people that have had experiences that may put them at higher risk for dementia, and then it's the social support and the caregivers, which is a barrier. Some of them may not have the ability to have caregiver support and if it's unpaid even harder. So I think these are ones that we've got to have the model and stakeholders solve for. Yeah, absolutely. So Ashley, when you mentioned clinical trials and even participating, I wondered to the US Pointer study, which really focused on underserved communities, what were some of the barriers that really stood out to you all as you were trying to not only recruit them but then offer some of those solutions? Absolutely. So we were lucky here in Houston for the US pointer study and the US pointer study overall to achieve over, for the study overall 30% participants of color in Houston, we achieved 45% participants of color for the US pointer, which is focused on a lifestyle intervention to reduce those at high risk. But you enroll them in the study, how do you ensure that they still participate and still make it to required appointments and meetings and transportation was a big issue for us, and especially living in a community that is a car based or with limited great strong public transportation. So we were creative with Ubers or with helping. We often took meetings or took appointments out to home. And this was one benefit of having our affiliation with our medical group is their clinics are in the communities so we could see patients at the clinics that were closest to them to reduce that transportation barrier. These were little pieces that we put in place, but I agree the rural health is something that I hope that we can be innovative on. That was my grandmother in a very rural setting. And how do you get the care to her and how do you get the diagnosis to her or the ability to diagnose to her as well? There's conversations we had at a meeting yesterday of care at home or assessing and testing people at home where they are more comfortable, but also where you have an opportunity to assess their social determinants of health that may be playing a role in both their current care and future care. And that kind of brings me to kind of the other barrier that we think about. And so Katie, what barriers come to mind? And she mentioned social determinants of health, but what are other barriers that come to mind among these diverse communities? So when you think about these. Older adults, they of course have some nuanced healthcare needs that are really often compounded by complex social issues. And so if diagnosis occurs later, it is typically what I just said in the later stages of the disease. And these individuals are more cognitively and physically impaired and therefore in need of more medical care. So as a result, the populations really are at a greater risk, poor health outcomes, they may receive inadequate care or encounter barriers to care, and they also face some staggering treatment and care expenses. So I know we're not talking about solutions, but I'm excited to get to that part. Yeah, absolutely. And it's actually a great time to pivot to that. And so we've identified and we've thought about the barriers, transportation, location, finances, language, culturally competent, all those things. But let's think about and pivot to opportunities to improve access. So Ashley, with a complex healthcare system, what have you seen actually improves access to care. With the system we're affiliated with, I've seen the leveraging technology for virtual care, both video visits and also just virtual eVisits or email-based visits that you can conduct, but that allows individuals to have access to their subspecialists and their primary care in a more convenient timeframe in their setting that is comfortable to them and allow them to reduce some of those transportation barriers. Now you reduce transportation, but you also increase technology, potential technology barriers. So what are we going to do there and how do you address that? And that is something that I think is an ongoing question for all of us today. So those are the pieces. And then also taking care to the home. The facility we're affiliated with has a care team that goes into the home of individuals that those that are high risk to help reduce those readmissions and to ensure some of the coordination occurs in particular after a discharge from a hospital. Certainly. And that's a great way to think about going to the patient, meeting them where they are. So we know that collaboration in healthcare is key. In fact, Dr. Bott has made reference to that several times, right? That the system is fragmented, but there's opportunity for collaboration. So Dr. Bott, what strategies can be implemented to improve the coordination and integration of care? You alluded to guide earlier. And so thinking about navigating multiple care systems, you mentioned guide earlier, but what does that look like in a solution for this care? How do we improve that? And what are other thoughts about getting this type of solution integrated into the healthcare ecosystem? I would say that we have evidence-based models, the collaborative care model that's been in play, that work. The question is whether there's will and desire to implement those and scale 'em. Some of them may require additional resources or investment, but you could take the existing approach of where you are in a care setting and think about what are the needs that individual may have and organize the workflows around that. So there are alerts and various tools to help early identification. And so I had a few years ago, a high school math teacher and I said, tell me about how work is. Is it you feel like you're operating at the same pace, you're doing things appropriately, or is it taking you longer or is it not? And you can do a mini mental status or the exam, but asking people about what's happening in their life elicits like, oh no, actually it's slower. I need help for using spreadsheets that once I really knew how to use. So that signals, okay, I got to get this person into an evaluation process help you in that. So I think that one is figuring out helping people work at the top of their training. And medical assistants can play a role as they do in our situation where we have limited time and capacity. Our care coordinators play a role. If you have Medicaid managed care, the care coordination can be supported there. If it's with duals and Medicare, there are other supports as well. And then I would say one of the recent studies we launched was around employers and that employers could catalyze initial 20 years of health span. So that's healthier life and longer life for everyone and disproportionately more for Alaska natives, American Indians and the black community. And part of it was using the prevention methods, the science and the approaches we already have today. So there's a difference between lifespan, which is longer life, but maybe poor quality of life and health span, which is longer and healthier life. And so we've got to address some of the drivers of health that Ashley and Katie have alluded to as part of that model. And I also think that we're seeing some technology approaches how to AI to predict how the condition will affect the brain physically over time or predict how symptoms will change over time. So then that allows you to plan more effectively for the future or genetic profiles and create models of predict who might more likely to develop later in life this condition so that along with sensors and technology to understand how a person's behavior is shifting or changing. Are they doing something that's more risky or signs that the health is deteriorating? Absolutely. Thank you. Ashley. How can healthcare professionals be better equipped and trained to provide culturally competent and person-centered care for individuals living with Alzheimer's disease? I personally believe that this is something that in Houston with the local chapter of the Alzheimer's Association, our organization has done well. And I think it is partnering with organizations within the community that understand the cultural barriers of groups. So beyond just the Alzheimer's Association, working with specific groups in your community and those members of the leadership that can explain how those communities approach different aspects of healthcare because everyone is different. But I feel that the partnership that we have with Alzheimer's Association has done a wonderful job of training the physicians through continuing education, the nursing staff, et cetera. Absolutely. And that's one of the reasons why Katie's here today because that is really the goal of the mission engagement division is to really focus on not only creating that, but really learning from the field. We will go out to the health systems, we hear from their needs around training and then really provide that so we can develop that in real time. So Katie, any other additional information that you'd like to share about how we're really supporting the training and equipping our folks out there that are delivering this care? Yeah, sure. So everybody on this call knows that Alzheimer's is a complex brain disease. So we do believe it's very likely that there's going to need to be multiple strategies that can reduce risk and address the disease in several different ways along an individual's life course and underrepresented and underserved communities we discussed or disproportionately impacted, and they're less likely to be diagnosed and less likely to be recruited to participate in research and clinical trials like we've shared. They're less likely to have access to that care and support services. And I think Javin mentioned that this has got to change and we must do better. And so the conversation we believe starts with your patients about brain health. And just as with other chronic conditions, the best way to reduce risk and detect problems early and improve safety and quality of care is really to act now. So as individuals are managing other chronic conditions, it is critical to be aware of dementia risk. And so the Alzheimer's Association, we've been partnering with payers and health plans and systems across the country really to identify strategies and solutions that can provide people living with dementia and their caregivers just access to these providers and systems that prioritize diagnosis and care. And for us, that comes in many, many forms. It could be new digital toolkits, it could be continuing education, it could be us building out recognition programs or coaching products and building out assessments to help people understand where they are and where they need to go. So really this education for providers, we're trying to heighten awareness and access to detection and diagnose and of course enhanced care coordination, the management and access, and then ultimately really reduce that economic burden of this just devastating disease, both for people living with the disease, the caregivers and healthcare systems, and I want to say in all communities and really emphasize in all communities. Absolutely. And we know, and you all have alluded to it already, that probably innovation is going to be a really critical role to help overcome this. So if we think about entrepreneurs who may be here today as they think about innovation, let's talk about how innovation is going to play a role. And so I'm wondering, Katie, do you have any more comments? Would you think about technology or innovation, how it can be leveraged in specific ways? Sure. Currently half of all primary care physicians in the United States report that they feel unprepared to treat patients with dementia. And so to respond to this challenge in particular, the association launched Project Echo, which connects leading dementia care specialists with care providers in communities with high need. And ECHO stands for extension in community health outcomes. And it's through a knowledge sharing that Project Echo is able to bring these dementia care expertise to local community. So it's based on a model created at the University of New Mexico and Project Echo is really bringing mentoring and support from teams of specialists to primary care and long-term providers in underserved communities. So we are trying to increase early and accurate diagnosis of dementia and that grows affordable high quality care and support in these underserved areas. We've got some interesting statistics too because since 20 18, 70 2% of long-term care respondents strongly agreed or agreed that Project Echo improved the quality of care. Another stat is 427 providers have completed Project Echo, and I think the one that we're all really proud of is almost half a million covered lives have been impacted. So we know that Project Echo is just one example of how innovation and technology can be leveraged to improve not only clinical education but also quality of care and then of course health outcomes. Thank you. And yes, we have seen a lot of impact from our dementia project Echo, which is focused on primary care. Dr. Bra, what about you? When you think about technology and innovation and leveraging it to improve access to care, what comes to mind for you? I think there's what already talked about around virtual and digital care. So that's sort of one around just care delivery. There's other elements to consider around practical and reliable tools to identify and monitor the person's cognitive, functional, behavioral, psychological needs and certainly the typically unpaid caregiver stress. So there's opportunities to use technology in those areas as well. How do you continuously evaluate and modify a personalized dementia care plan That is something can be done by the caregiver or with other clinical team members. Doesn't always need to be a clinician that's delivering care that's a nurse practitioner or a physician or a pa. I mean the other is implementation of psychosocial interventions aimed at preventing or reducing the diet's burden related to cognitive, functional and behavioral needs. And then I would say tools to help navigate the system and the community of resources and needs that individuals may have. And then we already see technology oriented around supporting patients with social needs. So there are a number of solutions around social needs that you can refer, navigate people through and then close the loop that they've been delivered. I would say the other is around some of the areas I alluded to earlier about the use of AI machine learning and sensors as well. And then I think voice activated tools to generate, provide information or guidance or even for a caregiver to check in on a patient with Alzheimer's or other things. And I would say that I think we've got to do more around managing the agitation and the behavioral change that Alzheimer's patients experience and how that has an impact in their life and the life of the caregiver. And then the think about the environment and how do you create an environment that's conducive to minimizing risk and harm for those patients. Alzheimer's, for example, falling may be a consideration. So I know that folks in Europe, particularly in Denmark, taught their patients how to fall to minimize injury and risk. So these are some of the areas in addition to augmenting care models, we know work to try to move the needle. And I think it can seem overwhelming. So it's just picking what's the one thing you're going to try to move in the next six months and then six months after that to try to have a longitudinal plan but in bite-size, practical chunks. Well, I appreciate all of that you said, because the other thing that you really identified when you think about innovation is yes, you address things like technology and ai, but you also thought about just thinking outside the box. Teaching someone to fall and fall well is an innovative way of thinking that can prevent harm. And so sometimes thinking out of the box. So Ashley, what about you? I know you have some experience having some new innovation in your practice. So tell us where you see innovation and technology play a role in improving access. I think that it's a great frontier and so many opportunities are ahead for improving access with technology. And also this goes a little bit to what the pitch competition was last year in improving testing capabilities within primary care or earlier detection within primary care. And I think they work hand in hand. One of the things I would say for organizations, startups that are looking to innovate in these areas and to be able to move into health systems, it's showing the ROI being able to demonstrate what it is. And to Dr. Bot's point of point, be very specific and focus on what you can do initially and focus on what the codes are that are associated with your technology or your innovation and how that will play out within a health system. And understanding general operations of a health system and how different practices work and every organization is different, but to get in the door is to have that basic understanding and to be able to clearly demonstrate the ROI and what you value your technology or your innovation brings not only to the patient, but to the providers and the organization overall I think is imperative to be able to move forward in this area. Yeah, absolutely. And that's part of why we created the Alzheimer's Association Innovation Roundtable and have our pitch competition because we know that more innovation is needed and it's an opportunity to really share that. And as Ashley said, based on the winner last year, she liked what she saw and she began to put more innovation in her system. So we have a lot of questions, so hopefully we can get through some of them. So first question is what are the top low hanging fruit opportunities that you see that should be in the ecosystem of startups but isn't? So where are those gaps in that ecosystem? And then why isn't a solution? Let's see, a little bit of a typo, but taking care of loved ones. I think that's the question. So where are the low hanging fruit opportunities for the startups and potentially even solutions for loved ones or caregivers? Dr. bha, I might call on you for that one because you've talked a little bit about that. I think I would just reference back to some of our earlier points on thinking about where there's opportunity to help coordinate services more effectively, helping drive navigation and care planning tools that can help educate more effectively caregivers and patients earlier on in the process about what to expect and how to plan for it. I think this is something that if you plan for, it's not going to be perfect and can still have challenges, but can mitigate a lot of what may happen that may lead to suffering or poor care or hospital visits or acceleration of the condition. So whether it's medication support from orienting people to familiar environments to knowing they even think about, we have medically tailored meals for people, what about medically tailored playlists for those with dementia? Helping people think about what helps them stay grounded and things that are familiar and manage for that agitation. So I think there's a lot of places to start between supporting people through treatment, catching them earlier, and supporting them to monitoring their journey to supporting care coordination and caregiver services and helping support managing and updating a care plan. Absolutely. Thank you. So we had one question here about the US pointer study, so we can send out, so I don't know, Ashley, if you have a second, you can drop a link in. If not, we can certainly send out more of, this study is actually wrapping up. It's looking at lifestyle, so that's coming soon. I believe there's information even on our website, az.org around the pointer study that you can learn more about that. I'm kind of just going through here. Yeah, go ahead Katie. I wanted to say one of the first questions I did was that I might've accidentally deleted, but I saw you, so I feel compelled to answer. But it was how can the Alzheimer's Association help startups? And I wanted to share that we do offer collaboration in pre-competitive environments through a few different round tables. Most notably is the innovation round table that Ashley is a chair of. And again, this is a round table that brings together innovators, champions, experts, thought leaders, really across that healthcare sector. And they're looking at ways to ultimately reduce risk and improve early detection, increase access to evidence-based person-centered care for those facing dementia and Alzheimer's. And then we also have something called the Alzheimer's Association Business Consortium. And the goal with this group is really to advance the disease and dementia research through innovation, and that is through small and medium-sized biotech diagnostics, medical device and contract research organizations. So the members of the small business consortium, they work in areas of common interest, again, pre-com competitively, so that they can advance the field of dementia research and the goals of their organization. So the team really provides leadership and direction to the group's area of focus, which includes collaborations and recognition, visibility and knowledge and information sharing. And I know we're going to talk a little bit later about the pitch competition, but these round tables, you can find it@az.org, are other new ways we are able to support those startups. Thank you, Katie. Actually, I did see that, and you're right then. I didn't see it. It had disappeared. So I'm glad that you remembered one question in here. Is there a way that you can provide support for families with members of dementia and Alzheimer's? Absolutely. So if you go to az.org, there is a robust list of resources through ALS connected and Alz Navigator also in your community is nearby a local chapter that have local in-person support groups and education and ongoing. Ashley alluded how closely she's been working with our Houston chapter. So we do have chapters all throughout the nation, but whether it's online, you can also call her 800 number twenty four seven helpline with dementia trained care and support persons that really support those living with the disease and their caregivers. So we certainly can help with that, but az.org is a great place to start with that. Let me read through, because we're going to kick it to Casey in just a minute this here. How would you encourage entrepreneurs to make solutions that plug into existing ecosystems of care and tech tools instead of making countless standalone solutions? Anyone have a thought or comment about that? That's a really, I can start one. I would say co-creation, co-design, who's thinking about with whoever the solution is oriented towards, and ideally both care team member as well as patient and family caregiver, caregiver impacted, that's one I would say see where there's gaps in a geography or in a system of care and see where you can plug in to help address a gap there that then could be elsewhere and grow. I would see where there's also, where we don't necessarily have research around aspects of the care model, and I do think some of the analytics, artificial intelligence, machine learning, sensor voice, there's a number of open spaces there, and I'm not a consumer electronics show this year, but it'll be interesting to see what they have brewing in terms of emerging technology that is enabling better, safer, high quality care for patients with dementia. And then there is still biotech, biopharma, MedTech those communities as well. Well, this has been an amazing discussion and I am so grateful for the panelists today. So now I would like to introduce to you Casey Sheridan. She is the partnership manager at Matter to provide a brief overview of the second annual Alzheimer's Association pitch are interested in applying. So Casey, I'll hand it to you. Awesome, thank you Laura, and thank you so much, Dr. Bhatt, Ashley, Katie, so much for your time and expertise today. That was a fantastic discussion. Like Laura said, matter is thrilled to be powering and partnering with the Alzheimer's Association on our second annual pitch competition, and I'm going to spend just a couple of minutes here providing a few details for those that are listening in that are interested in So to start off, as we mentioned earlier, the focus for this year's pitch competition, our solutions that are working to increase access to quality person-centered care for underserved people living with Alzheimer's disease or related dementias. So if you are a solution that's working towards this goal, then you absolutely qualify and we encourage you to apply to this program. So this is a high level snapshot of the timeline that we are working towards. So applications are currently open. My colleague Kay, who's on the Zoom here is about to drop the application link in the chat so you can check out more information there. Applications will close a week from Friday, so Friday, January 19th at midnight central time. From there we'll have a review and selection committee that'll be carefully reviewing all the applications and we'll announce the top five finalists who will be moving forward in the program by February 7th of this year. From there, we'll have those five finalists participate in a weeks long from February 12th to March 18th, receiving expert mentorship and exclusive resources to build their solutions and to refine their value propositions. Lastly, the program will culminate in a pitch competition that'll be in person at matters offices in downtown Chicago on Tuesday, March 19th, where the five finalists will have an opportunity to pitch their solution to a panel of industry experts as well as a live audience, both in person and virtually of key stakeholders in the room. The first place startup will be awarded a cash prize,$15,000 and a six month comp matter membership. And the second and third place startups will receive a cash prize of $5,000 each four submission criteria. These are the four kind of main boxes to check to make sure that you are all good to apply to the program. So again, we're seeking entrepreneurs who are developing solutions that are working to increase access to quality person-centered care for underserved people living with Alzheimer's disease or related dementias. This is a global call for solutions, so it does not matter where you are in the world. We're accepting solutions that are both based in the US and across the rest of the world. Our programs also open to individuals and teams from across the entire healthcare innovation ecosystem. So whether you're a university researcher, if you're a student, if you're an entrepreneur, if you're already an existing startup of any stage, you absolutely qualify to apply to this program ranging from early stage concepts all the way up through marketed solutions and full-blown businesses. The selection criteria that the Review and Selection committee will be primarily focused on when reviewing your application is detailed here on the screen. So first and foremost, the ability to clearly articulate the challenge statement addressed in the program description. So if you can convey how your solution is working, the goal that we outline in the challenge statement, clearly in your application, that will give you huge points. We'll also be looking at the quality feasibility and scale of your proposed solution or technology. We'll be looking at the differentiation of your solution within the competitive landscape. We'll be assessing the capability of you and your team to develop and execute the solution that you propose and as well as the ability of your solution to actually increase access to quality person-centered care for underserved folks living with Alzheimer's disease benefit benefits of participation. So the five startups that are accepted as finalists into the programs will be engaging with other cutting edge startups. They'll be networking with peers working within the same space and leading influencers in the space. They'll receive expert mentorship from industry leaders and subject matter experts to validate their solutions and refine their value propositions. Accepted startups will gain exposure to both the Alzheimer's Association and Matter communities. They'll have the opportunity to pitch their solution to a live audience with potential investors, partners, clients, and mentors in the audience. That'll be, again, in person in Chicago on Tuesday, March 19th, as well as the opportunity to win that cash prize that I detailed earlier. So like I mentioned, the deadline to submit is next Friday, January 19th at midnight central time. If you have any questions between now and then about your application or if you qualify to apply, please feel free to email me. Again, my name is Casey, C-I-S-E-Y at Matter Health, and I'll be happy to meet with you and answer any questions that you have. Please visit Matter Health slash Challenges to find and more background information. And we're excited to read all of your applications and get everyone back together again at the final Pitch Competition on March 19th. So that is all we have for today. I want to just say thank you again to the Alzheimer's Association for your partnership on this initiative and many others. We love working with you and thank you so much, Dr. Bhat, Ashley, Katie, and Laura for your time for today's program. And lastly, thanks to you all who have joined our call today. We hope that you learned something and please feel free to reach out with any questions. Hope you have a great rest of your day.