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Signify Health’s chief medical officer, Heidi Schwarzwald, MD, MPH, provides strategic leadership for Signify Health’s nationwide clinician network by championing clinical excellence in In-Home Health Evaluations (IHEs); shapes Signify Health’s clinical vision, overseeing quality and safety initiatives; and supports new product development. 

Recently, Dr. Schwarzwald authored a white paper on the innovative ways Signify Health is helping providers and health plans detect dementia earlier, supporting intervention and care planning. 

In, “Why the Home is an Ideal Setting for Dementia Detection and Care Planning,” Dr. Schwarzwald asserts that the home is often a more effective and revealing setting for identifying cognitive impairment. In the paper, she details recent developments in earlier detection and substantiates her findings with data collected from Signify Health’s national network of more than 11,000 licensed clinicians (composed of physicians, physician assistants and nurse practitioners). 

The paper is significant and timely with dementia being identified as a rising public health challenge. Currently, an estimated 6.7 million Americans aged 65 and older are affected. Alzheimer’s disease, the most common form of dementia, accounts for 60% to 80% of all cases¹.

Following the publication of her paper, we sat down with Dr. Schwarzwald to learn more.

We’ve long thought of the doctor’s office as the center of health care. What does it mean to rethink the home setting as one of the most important places for detecting cognitive decline? 

I think about a member I saw recently in his home. He is a retired lawyer and would go to his doctors appointments and pass cognitive testing pretty easily. With his level of education and focus on “getting a good score,” he did well. 

But in his home and with his spouse, I could start to see the subtle signs of decline. His conversation would drift a bit between past and present. He was forgetting dates, and while he packed his medication pill box weekly and managed to take them as prescribed, his wife was reminding him and ensuring he complied more then I think either of them were aware. These early changes may be missed in an office setting, but can be more readily seen in the home.

For Evgeniya (Ev) Berger, ARNP, DNP, every in-home visit begins with the same intention: Meet the health plan member where they are.

Diabetes does not discriminate with age. Though adults aged 45–64 receive the majority of new diabetes diagnoses in the U.S., the country has also seen increases in disease prevalence among those 18-44. Most people who develop diabetes as adults develop type 2 diabetes. Even more concerning is that nearly 90% of those who have prediabetes, and thus have an increased risk of developing the disease, aren’t aware they have it. 

As a nurse practitioner with more than 20 years of clinical experience, including many years seeing people in their homes, Jaszmin Gray has learned that each visit is an opportunity to see a more well-rounded picture of a person’s health.

When nurse practitioner (NP) Emily Tedrow enters a home, she notices the particulars that help tell a more complete story. It might be the way a health plan member organizes medications, talks about a daily routine or something in the home environment they need support with. And while Emily has been with Signify Health for nearly nine years, each visit continues to be an opportunity to better understand and support the person in front of her.