Measurement-based care (MBC) gives healthcare providers the essential data they need to inform treatment decisions and improve patient outcomes. Standardized cognitive assessment tools are especially important for brain care, and can improve workflow for neurologists, mental health providers, primary care doctors, and other healthcare professionals.
In this article, we will explore practical steps for MBC implementation in a clinical setting, as well as which assessment tools are best for tracking patient progress.
Measurement-based care is a systematic approach to treatment that uses standardized tools to regularly assess patient symptoms and progress. These assessments occur before, during, and after treatment to guide clinical decision making.
Along with tracking specific symptoms, measurement-based care can help track other elements of treatment progress, including:
Measurement-based care practices are patient-centered, and strive for enhanced patient engagement. Clinical data collected via objective assessment tools can lend credence to suggested treatment options for uncertain patients, and create a therapeutic alliance between patients and providers.
One study found that approximately 30% of participants with dementia were not aware of the extent of their cognitive decline. Implementing a regular cognitive screen can help patients and their caregivers identify signs of deterioration and contribute to a personalized treatment plan.
Four core components of measurement-based care include:
Measurement-based care and evidence-based practice are closely tied together, but are slightly different. Measurement-based care focuses on gathering patient data to track progress and improve clinical outcomes. Evidence-based practice is a care model that prioritizes using the best available resources for clinical decision-making, including scientific research and clinical expertise.
Both of these practices are data-driven and patient centered, and use patient reported outcomes as essential data.
In his book Prevention of Treatment Failure, Dr. Michael J. Lambert survey findings indicate that although 85% of therapists believed their patients had improved, actual improvement rates were only around 40 to 60%. While clinical diagnosis often relies on a combination of subjective measure and data, utilizing credible objective assessment tools in cognitive and mental health services helps gather essential client data that can be used to supplement subjective assessment and diagnosis.
Here are examples of measurement-based care for cognitive and mental health treatment:
Cognitive testing can be used to track patient progress or level of impairment in age-related cognitive decline, neurodegenerative and developmental disorders, ADHD, brain injury and mental health conditions. These tests can be used to assess specific components of cognitive ability including memory, executive function, language, and more.
The Montreal Cognitive Assessment (MoCA) is a cognitive assessment tool that screens for dementia and mild cognitive impairment (MCI). It’s a commonly used tool for gathering data on a patient’s cognitive condition.
Its strengths include that it only takes 10 minutes to complete, and has high sensitivity—when it comes to severe cognitive impairment. However, it’s limited in its ability to detect earlier signs of mild cognitive impairment, and is often done on paper, leading to laborious manual record keeping.
More robust cognitive tests, such as those offered in Creyos Health, can equip healthcare providers to detect earlier indicators of cognitive conditions, get a baseline of cognitive health, test routinely, and demonstrate longitudinal and meaningful change in brain health.
Read more: Beyond the MoCA Test: How to Improve Early Dementia Detection
Measurement-based care is also useful for tracking symptoms of mental health disorders such as depression, anxiety, stress and mood disorders, and others. Comprehensive testing can take comorbidities into consideration, and document patient-reported outcome measurements.
Examples include:
Along with assessing mental health symptomatology, another example of measurement-based care is a patient satisfaction quiz related to mental health care. A 2024 report from Canadian Alliance on Mental Illness and Mental Health (CAMIMH) found that the majority of surveyed Canadians gave publicly-funded mental health services an average grade of “F” in experiences including:
As work continues to be done in the mental health sector, mental health providers can build trust with patients by collecting and implementing feedback in their own clinical processes.
Like any health care model, measurement-based care has unique strengths and limitations for patients and healthcare providers.
Measurement-based care strategies increases the quality of clinical care by:
Despite the benefits of measurement-based care, less than 20% of providers are currently integrating MBC into their clinical practice.
Some limitations and barriers may include:
Measurement-based care can help track patient symptoms at baseline and over the trajectory of the treatment process. Cognitive, mental, and behavioral health assessments save patients and providers guesswork, and create more time for the relationship-building that most patients want.
85% of primary care providers wish they had more time to get to know their patients, but 83% say the demands of their job often prevent this opportunity. The right assessment tools provide clinicians with data as a jumping off point for creating personalized treatment that feels attainable for patients.
For patients, measurement-based care:
For providers, measurement-based care helps:
When talking about Creyos cognitive assessment tools, Gabrielle Thompson, FNP-C and Founder of GT Healthcare, stated: “What Creyos helps with most is helping me confirm what I think is going on and find out if there’s a possibility of something else causing the same symptoms. I can narrow down a diagnosis using measurements like scoring.”
While the benefits of measurement-based care are clear, changing clinical practice is often challenging for healthcare workers. Along with this, many primary care providers are still uncertain about the effectiveness of cognitive screening tools—specifically pen-and-paper tests such as the Mini-Mental Status Exam MMSE, Clock Drawing, Delayed Word Recall.
Computerized cognitive assessments with more robust testing and reporting capabilities, like Creyos Health, are designed to address the issues physicians have had with traditional tools.
In addition, preparation and education for staff members can help to ease the transition without adding more administrative labor.
One 2018 review of MBC implementation (JAMA, Lewis, Boyd, Puspitasari, et al.) in behavioral health services suggested the following ten steps for providers:
Read more: How to Bill Using CPT Code 96132 for Neuropsychological Testing
The success of measurement-based care comes down to the quality of its assessment tools, as well as how easy they are to implement. These tools should be research-backed, standardized, and user-friendly.
Validated through research in over 400 peer-reviewed studies, the Creyos platform offers a suite of brain health assessment tools with features including:
With tools that can be used in-clinic or at home, Creyos makes testing cognitive function easy for patients and providers.
When it comes to cognitive, behavioral, and mental health, standardized assessment tools are a powerful resource for providers and patients alike. Patients who understand the reasoning behind their treatment plan are more likely to be compliant, and measurement-based care provides them with informative data.
This care model also encourages patients to express their thoughts and feelings, which leads to a more personalized treatment plan. Mental and cognitive health treatment does not have a one-size-fits all model, and the data providers gather helps address individual patient needs and capacity.