Indiana University School of Medicine/Indiana University Health

The U.S. Indiana Flagship site was located at Indiana University (IU) Health in partnership with the IU School of Medicine. IU conducted the study in a primary care setting, including physicians and nurse practitioners. They created a new primary care-based role called the Brain Health Nurse Navigator to bridge the hand-off from primary to specialty care and help with diagnostic evaluation, post-diagnostic care, and support for patients. They used Agile Implementation methodology13 to run sprints to adapt digital cognitive assessment (DCA) workflows to each local environment and they measured the impact on clinical trial referrals.             

The IU site exists in a multi-payer healthcare model with various private insurance companies, government programs (e.g., Medicare, Medicaid), and self-pay patients. The involved primary care clinics included a large family medicine residency program, Family Medicine practices, General Internal Medicine practices, Internal Medicine-Pediatrics practices, mixed specialty primary care practices, and enhanced primary care practices designed to meet the unique needs of older adult patients.

13. Pool, E., Poole, K., Upjohn, D., Hernandez, J. (n.d.). Agile Project Management Proves Effective, Efficient for Mayo Clinic. American Association for Physician Leadership.
See Key Lessons

Site Leads

Deanna R. Willis

Deanna R. Willis

MD, MBA. Family Medicine Professor of Primary Care and Population Health Research, Professor of Family Medicine, Indiana University School of Medicine

Casey Roell

Casey Roell

MS, MBA. Vice Chair of Finance and Administration, Department Family Medicine, Indiana University School of Medicine

Nicole Fowler

Nicole Fowler

PhD. Associate Professor of Medicine, Indiana University School of Medicine and IU Center for Aging Research

Jared Brosch

Jared Brosch

MD. Associate Professor of Clinical Neurology, Indiana University School of Medicine

Dustin Hammers

Dustin Hammers

PhD, MS. Associate Professor of Neurology, Indiana University School of Medicine

Key Partners

  • National Institute on Aging Alzheimer’s Disease Research Center
  • Indiana Chapter of the Alzheimer’s Association
  • Regenstrief Institute
  • Blue Agilis

What are the key lessons learned from the site?


Engaging champions early and leveraging their support to scale the program.

The IU site engaged champions across different stakeholders in their organization early in the planning stage and had continued support throughout implementation. Having champions in neurology, geriatrics, primary care, and at the executive level, meant that they had a broad team who worked together to navigate challenges and find pathways forward. 

By starting with a committed team of champions, researchers, and providers, the IU site was able to take an incremental approach to gaining additional primary care provider buy-in and expanding the program’s reach and sustainability.

Goal 4: Determine core stakeholder team and change-management approach.


Managing change effectively with an implementation coach

The IU site used an implementation coach at the beginning of the project to ensure smooth planning and implementation of the program. The coach provided guidance, helped staff track toward goals, and managed the feedback loops between the staff and managerial teams. IU found having an implementation coach to be crucial for success, particularly navigating personnel changes that occurred during the program.

Goal 8 Assemble your project team.


Adhering to the standardized workflow

To ensure adherence to the Early Detection Program’s workflows, the IU site would regularly perform check-ins to refine their program. This review started with staff self-audits, used reports of the process metrics, and moved to peer- or supervisor-led audits to identify any inconsistencies or deviation from the recommended workflow. Note that this type of process auditing should be built into the work culture and the monitoring procedures upfront.

Goal 16: Monitor progress to catch and resolve issues.