Seven months after ditching paper screening for Creyos, Claremedica is catching over 90% of new dementia cases at the earliest stage.
Cognitive decline is often the one vital sign primary care does not routinely check. Claremedica, a value-based senior primary care organisation serving more than 34,000 Medicare Advantage patients across 35-plus sites in Florida, is trying to change that. Seven months after replacing its paper-based Mini-Mental State Exam (MMSE) with a digital cognitive assessment from Creyos, the organization says it is now identifying more than 90% of new dementia cases at the early or mild stage, the point at which proactive care planning is still possible [1].
The scale of the gap the switch is closing is notable: nationally, more than 60% of cognitive impairment goes unidentified in primary care, even as the number of Americans living with Alzheimer’s is projected to nearly double, from around 7 million today to a projected 13 million by 2050.
Most clinics still rely on brief pass/fail screeners such as the Mini-Cog, MoCA or MMSE, tools that can flag moderate-to-severe decline but are prone to missing it earlier, with results that can vary depending on who administers them and how.
Perhaps the most telling detail in Claremedica’s data is not the patients who were never screened, but the ones who were. Claremedica had used the MMSE organization-wide for more than two years before switching to Creyos, and nearly 80% of patients newly identified with dementia after the switch had already been screened using the older test, in some cases more than once, without their decline registering.
Company-wide, Claremedica’s dementia identification rate more than doubled after adopting Creyos, a shift the organisation attributes almost entirely to catching earlier-stage impairment that traditional screeners are known to miss, rather than to any change in diagnostic practice or physician behaviour.
“In primary care, we’re trained to look at vital signs: temperature, blood pressure, heart rate,” said Dr Nehal Gheewala, chief medical officer at Claremedica. “But not cognition, which changes just as subtly over time. So we asked ourselves: what would happen if we could?”
Where the MMSE returns a single pass/fail score, Creyos produces a domain-level cognitive profile spanning memory, attention, reasoning and executive function, administered on a tablet by a medical assistant without physician supervision required, with results returned as structured data alongside recommended next steps.
Average screening time fell from roughly 12 minutes with the MMSE to six minutes with Creyos, Claremedica says, freeing up close to 90 minutes a day in a typical physician’s schedule.
The platform’s support for 13 languages, including Haitian Creole, addressed a specific gap in Claremedica’s patient population, and its integration with more than 90 electronic health record systems, including Epic and athenahealth, allowed the rollout to slot into existing clinical workflows rather than requiring a separate system.
Adoption reached more than 95% among Claremedica physicians on day one, the organization’s highest first-day uptake across ten clinical technology rollouts to date in its broader disease-detection programme. That came after Claremedica paused operations organisation-wide so staff, from clinical leaders to administrative teams, could hear directly from Creyos co-founder and chief scientific officer Professor Adrian Owen before a single patient was screened.
“I don’t ask clinicians to trust me, I ask them to look at the evidence and decide for themselves,” said Owen. “So that’s what we did before Claremedica screened a single patient: I walked their physicians through three decades of research, the peer-reviewed studies, how the tasks were validated, how they were built. Clinicians are, rightly, sceptical of new tools until they’ve seen the science behind them. Once they had, the confidence wasn’t something we had to build, it was already there.”
Gheewala described the pre-launch session as “an important, although maybe risky, move to really convey how seriously we were taking this and our desire to be a leader when it comes to cognitive care,” adding that a year on, “we’re happy to say that decision was right.”
Creyos, formerly known as Cambridge Brain Sciences, was founded by Owen and describes itself as building on three decades of research and one of the world’s largest cognitive datasets; the platform is FDA Class II-registered and has been used in more than 400 peer-reviewed studies to date.
Claremedica is now tracking how earlier identification correlates with downstream outcomes, including falls, avoidable hospitalisations and total cost of care, over the next 12 to 24 months, the data that will ultimately determine whether digital cognitive screening becomes standard practice across value-based primary care rather than remaining a differentiator for early adopters like Claremedica.
For a Medicare Advantage-focused provider whose economics depend on managing chronic disease proactively rather than reactively, catching dementia years earlier is not just a clinical win; it is a direct test of whether digital screening can move the needle on the cost curve that value-based care models are built around.
