Think about your last doctor’s visit. How much time did you spend in the waiting room? Did you fill out a questionnaire by hand? You probably answered many of the same questions once you went into your exam room.

In fact, Canada ranks last among 11 OECD countries in how quickly people can get in to see their family physicians. On top of that, the 20-minute, in-and-out visit can create a disconnect in the patient-doctor relationship.

Daniel Penn hopes to change all of that.

He started the health startup Shift Health in 2011 to help bring the patient voice back into the doctor’s office. The company’s online platform, TickiT, provides user-friendly surveys to help doctors screen patients prior to their appointments.

Daniel’s efforts to better the patient-doctor experience have not gone unnoticed. He was just selected for the Forbes 30 Under 30 list in the healthcare category and will be in Israel attending the Forbes conference.

Daniel’s interest in health began early, albeit on the other side of the coin. When he was in Grade 12 he got a severe concussion playing soccer. As an active teen, he did what any 17-year-old would do: he ignored the concussion and kept on playing.

“It was at a critical point, just before my first-term exams, which would affect the universities I got into. At the time, my hospital was telling me to rest and my school was telling me I had to do my exams. The two parts of my life weren’t matching up and no one was asking how I felt,” he says.

It took him more than a year to recover from the concussion. Luckily for Daniel, both his parents were physicians.

“I had the support I needed at home,” he says. “What about all the patients who don’t have that kind of support? How do we create a health system that values the patient voice as truth?”
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That’s been Shift Health’s core mission from the start. It was around the family dinner table that Daniel’s mother, Dr. Sandy Penn, showed him the prototype for a psychosocial screener app designed for adolescents. The app was the early days of TickiT, which has since been expanded for other populations.

The TickiT platform uses graphics and icons to help patients self-report their symptoms and then organizes that patient-inputted data into a report for physicians to review. Doctors are alerted to important details with “flags” to help them shift through the information and focus on key issues during the visit.

Daniel was on board from the get-go, helping build the company as CEO. Clients have included Toronto’sHospital for Sick Children, BC Children’s Hospital, Boston Children’s Hospital and the San Francisco Department of Public Health, among other organizations.

With his attention focused on growing the company—which now has seven employees and is looking to expand—Daniel is currently riled up about Canada’s one-size-fits-all healthcare system. It’s not easy getting new technology into the Canadian health space, he says.
“In the United States, healthcare is a business. While that can be bad in some ways, it’s also good: business always innovates,” Daniel explains.

Many of the community health clinics that Shift Health works with in the US are quick to try new technology. Procurement in Canada, he says, is much harder. It’s easy to get doctors on board with an app or a new device—it’s getting to a “yes” up the approval chain that is much harder. Also, the Canadian market often looks to the US to buy its technology, but Daniel believes we should be looking to Europe for the innovations our system needs.

“We buy US systems because it’s close and it’s easy, but we need to research more about what has happened in social healthcare systems, like in France and Denmark, and the decisions they’ve made that have impacted their health systems,” he says. “When I moved to Denmark, before I could even get a SIM card for my phone, I had to take out a country card and get a family doctor.”

Preventive and proactiv​e healthcare is where the industry is headed, he contends. But it will take more leadership and audacity to do it.
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“We have a healthcare system that wants to change, but no one is willing to take a stand on how we’re going to change it,” says Daniel. “If we want to move toward a preventive health system, we need to bring the patient voice back. At Shift Health, we’re trying to build tools that can help do that in an efficient way.”

In his 2015 testimonial for the Canadian Bell Let’s Talk campaign, Howie Mandel described the workplace stigma of mental health.

“If we take care of our mental health like our dental health, we’ll be OK. We all talk about our dental health, but talk about my mental health—no, no, no. In corporate North America and Canada you can say in the middle of the day: ‘I have to leave at 3:00. I have to go and see my dentist.’ But you look at the looks in the office when you say: ‘You know what, I gotta go to a psychiatrist.’ You’ll get looks and that’s what’s wrong, and that’s why we’ve got to talk about it. There’s no stigma.”

Because of this stigma in the workplace, people who have mental health issues often find it difficult to ask their employers for help, even though professional support may be available through company benefits and employee assistance programs (EAPs). However, employers are strongly motivated to address mental health issues, which account for significant absenteeism and reduced workplace performance (presenteeism). The Mood Disorders Society of Canada estimates that mental health–related issues account for as much as 79% of long-term disability claims in Canada.

For many people, the first step after admitting to themselves that they may have a mental health issue is to search for assessment tools online. While there are many such tools, it is not easy to find a validated one that also respects confidentiality. A tool offered and promoted by one’s employer may be a preferred choice, especially if it is coupled with other services and supports.
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FeelingBetterNow (FBN) is an online tool that employs a diagnostic risk-assessment algorithm to place individuals within one of three distinct levels of risk. Low-risk users are directed to self-care tools, while medium- and high-risk users are seamlessly triaged to appropriate care providers, such as EAP counsellors, psychologists or physicians. The tool, created by Toronto-based Mensante Corporation, is offered through employers and EAPs.

​FBN was originally developed as a tool to assist family physicians in making an initial mental health diagnosis, but the company pivoted when employers and EAP providers demonstrated a strong interest in the product. Mensante now sells FBN primarily through those channels.

The company redesigned FBN so that it could be used directly by people seeking a validated and confidential initial mental health assessment. In addition to its assessment results, FBN also offers users a tailored action plan of recommendations, links to support resources (tailored to the employees of a given organization) and additional tools organized in a toolbox.

​FBN also includes a built-in database of more than 70 mental health, self-harm and suicide prevention crisis lines across all Canadian provinces, territories and localities.
Since FBN primarily serves employees, it is designed to work with organizations’ existing employee wellness, absence and disability management programs. It can also provide consolidated and de-identified data to help organizations evaluate the effectiveness of their human resource programs.

Founded by psychiatrist Sam Ozersky, Mensante is strongly oriented to current clinical practices and maintains aClinical Advisory Board. The company recently revised FBN to incorporate the latest version of the American Psychiatric Association’s classification and diagnostic tool, the Diagnostic and Statistical Manual of Mental Disorders or DSM-5. FBN now covers 95% of the mental health spectrum.

As the recent Bell Let’s Talk campaign emphasized: “Talking is the first step towards meaningful change and building greater awareness, acceptance and action.” As employers recognize that some of their employees face mental health challenges and begin to openly deploy and promote resources like FeelingBetterNow, they are helping to build that awareness and acceptance, and—most importantly—they are also providing resources to help people take action.

Digital technologies have been extremely disruptive to many sectors, and most observers predict a similar impact to healthcare. In anticipation of the resulting opportunities, venture investment in digital health technologies has grown rapidly over the last few years, but may have peaked recently.

“The existing healthcare institutions are proving resistant to change as a result of issues around economic pressures and reimbursement, regulations, efficacy and safety, privacy, entrenched behaviours and other factors” says Dr. Sumner-Smith, who advises three dozen digital health startup ventures in his role at MaRS. Dr. Sumner-Smith, who originally trained as a molecular biologist and has worked in several capacities in biotechnology, bioinformatics and enterprise software, says the resistance to change on the part of healthcare institutions will likely mean that most innovation will take place outside these institutions, in the same way that ride-sharing and music downloads developed outside the existing taxi and music industries.

One of the characteristics of newer digital approaches is that they involve managing data in volumes that are several orders of magnitude greater than previous practices. As Dr. Sumner-Smith points out, “there is no evidence that existing healthcare institutions have the capacity to accommodate such volumes. Someone using a simple consumer device that monitors several biological parameters continuously will quickly accumulate more data than is likely stored in official institutional health records.” At this time measureable biological parameters are of limited use in the practice of healthcare but it is clear that comparatively trivial parameters can have great value when analyzed in combination and at scale (i.e. Big Data). In addition, impending developments in micro-sensors are likely soon to lead to the cheap, easy and accurate measurement of a far larger number of biological parameters.
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“Decisions as to how to provide the best possible healthcare services will increasingly require an understanding of how all relevant data is generated, where it is stored and how it can best be combined and analyzed,” says Dr. Sumner-Smith. 

Epic EHR has taken quite a bit of flak in the last few months. First, a 39 page report was submitted to Congress on behalf of the US Office of the National Coordinator for Health Information Technology head Dr. Karen DeSalvo in April of this year. The report criticized the practices of EHR vendors for their control of patient information and “gag order” contract clauses, naming Epic as a main offender.

Later in October, a piece published in Mother Jones by Patrick Caldwell had few kind words to say about the country’s #2 EHR software vendor and self-proclaimed possessor of over 56 percent of the country’s patient records. “Instead of ushering in a new age of secure and easily accessible medical files, Epic has helped create a fragmented system that leaves doctors unable to trade information across practices or hospitals,” Caldwell writes.

While participating in such indictments and public thrashings of a software vendor that makes billions can be a droll activity, it is far from productive. Instead, we aim to provide some constructive criticism to Epic and other similar vendors who somehow dominate the market yet leave thousands of customers unsatisfied.

To point the market in a better, more results-oriented direction, here are five things companies like Epic can do to improve their offerings and the outcomes they bring:
 
1. Recognize the Need for Interoperability
When reading criticisms of Epic and other similar vendors “interoperability” is a word you will often hear brought up. Specifically, a lack thereof.

If a provider installs an Epic EHR system but does not want to use their proprietary billing or clinical modules, there will be heck to pay in the form of a confounding workflow and a general lack of easy methodology.

Epic will need to implement open-ended methods for clients who do not wish to use Epic software for all of their record-keeping and administrative needs rather than practically forcing each customer to go with the full suite.
 
2. Facilitate Easier Data Transfers to Other Providers with Competitor Systems
Epic’s software suite does an excellent job of communicating within installed hospital systems, some say. Different departments can quickly gain access to the files and information they need across the organization.

Transferring information to a different organization, however, is a different story. Sending and receiving updates to files or events like test results or prescriptions filled can be difficult. Worse, it can lead to errors like redundant entries, incorrect data and other mishaps that can directly detract from the quality of patient care.

“What [Epic] doesn't have — and ditto systems created by competitors Cerner and Meditech, the other bigwigs in EHR — is a framework to connect to other facilities using competing EHR systems,” Caldwell writes.

Standardization of file formats and a reliable, consistent way to export and import information could solve this problem. The issue as it stands now seems to be that companies like Epic have little incentive to operate simultaneously alongside systems installed by competitors.

In fact, Epic used to charge a per-patient fee until quite recently for such transfers. Defending the practice, Epic’s Eric Helsher stated: “We felt the fee was small and, in our opinion, fair and one of the least expensive, but it was confusing to our customers and others in understanding how it worked. There was logic to it, but it confused people, so we decided to end the fee until at least 2020 when we'll consider reevaluating.”

The tone of such statements belies the begrudging reaction Epic has when it is scolded and told to “play well with others.”
 
3. Improve the Quality of Individual Modules
When Epic was first released to the market, EHR systems were in their infancy relative to the development of other software. As such, Epic was one of the only solutions available that could offer a full suite of software modules as an end-to-end solution.

While as a whole the capabilities of the system can be satisfactory, each component when examined individually can be quite underwhelming. “What you hear is that, if you were to buy the best of breed — the best cardiology system, or the best chemotherapy system — no one would ever choose Epic,” University of Michigan researcher Julia Adler-Milstein told Caldwell.

​To solve the problem, Epic must look to its smaller but recognized competitors. SOAPware, for instance, has received top marks for its functions that improve the quality of patient care. CureMD has similarly been praised for its E&M functions as well as its seamless integration with revenue cycle management modules. Making incremental improvements to each module could result in a more satisfactory product overall.
 
4. Open the Door to Outside Improvements
Most restaurants don’t let you bring your own condiments to the table, but software is different. Companies like Apple and Google released easy-to-use stable APIs so that third-party developers could create programs that added to the functionality of their mobile devices — thus, the App Store was born.

If EHR vendors like Epic would release similar APIs, innovation and competition would lead to huge improvements in functionality. Some companies are actively exploring this route, even collaborating with one another, but they will more than likely become competitors to Epic’s existing model rather than an impetus for it to adapt.
 
5. Be Wary of Nasty Rumors
At the risk of getting into more tabloid-style content, let us suffice it to say that many of the roles Epic has filled indicate a conflict of interest. According to Caldwell, many on Capitol Hill see Epic CEO Judy Faulkner’s appointment to the White House Health IT Policy Committee in 2009 and the company’s subsequent rise to prominence as hardly a coincidence.

Even if such hinted-at allegations were not true, the fact remains that large companies should be cautious when throwing their money around lest others get to talking. Maintaining an ethical image should be priority one for any company that wants to proclaim a customer-oriented focus rather than a focus on growth by any means necessary.
 
Get More from the Little Guy
CureMD aims to improve upon the criticisms leveled towards our industry at large by emphasizing interoperability and high-quality modules systems that can be purchased a la carte. We also maintain a steady staff of technical support to ensure that none of our customers get left high and dry should an issue arise.

 Learn more about how our company tries to be different than the big guys by taking a look at our EHR and digital medical systems solutions.
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Author Bio:
Alex Tate is a health IT Consultant at CureMD who provides perceptive, engaging and informative content on industry wide topics including EHR, EMR, practice management and compliance.

Sometimes a great idea comes when you’re not expecting it. One day, Ali Esmail’s wife made a comment that stuck with him. She thought that filling a drug prescription should be as simple as depositing a cheque, which you can now do by taking a photograph of your cheque with a smartphone. Later, when Ali was diagnosed with an ear infection, he discovered that many pharmacies offer home delivery services. Combining these two insights led Ali and his colleague Vejey Gandier to develop PopRx, a mobile app and associated service to fill and deliver prescription medications. PopRx was recently featured on CBC TV’s“Next Gen Den,” a spinoff of “Dragons’ Den.”

​When Ali and Vejey demonstrated their initial smartphone app to independent pharmacies, they discovered a much larger market opportunity. While all Canadian pharmacies are under considerable economic pressure, the smaller independent businesses are at risk of being left behind as they lack the resources required to follow the path of broader retail offerings being pioneered by large retail pharmacy chains. Independent pharmacies are looking for different ways to survive and compete.

A few decades ago, most pharmacies were small independent stores. In fact, Canadian regulations require that drugstores be owned by pharmacists. However, emerging pharmacy chains like Shoppers Drug Mart, which is now the largest Canadian pharmacy chain, developed a business model that enables pharmacists to operate independent dispensaries as licensed associate-owners inside a retail drugstore chain. In this fashion, pharmacists can benefit from a single consumer brand with the support of a large corporation. Pharmacy chains continue to grow market share at the expense of independent pharmacies.

In a further bid to increase revenues, pharmacy chains like Shoppers have moved to larger store formats. They’ve added cosmetics, food and other retail categories to their offerings, bringing them into competition with supermarkets. Interestingly, Shoppers was acquired by Loblaw, the largest food retailer in Canada, in 2013. Meanwhile, expanded supermarkets are in turn under competitive threat from hypermarkets that offer an even wider range of products, like the world’s largest retailer, Walmart. While pharmacy sales are only a small fraction of its business, Walmart is the third-largest pharmacy chain in the United States after Walgreens and CVS.

So what are small independent pharmacists to do? They cannot compete by offering a wider selection of retail merchandise in a large store. Fortunately, convenience remains very important to consumers. A recent survey found that 57% of Americans choose a pharmacy based on its location and live within an average of two kilometres from their chosen pharmacy.

Personalized home delivery is often a distinguishing feature of independent pharmacies. However, small pharmacies often lack the resources required to provide online technologies that assist customers in managing all of the processes related to obtaining a prescription online, including the initial prescription filling, prescription renewal, medication tracking, customer verification, payment and effective delivery scheduling. This is the need that PopRx recognized and positioned itself to address.
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PopRx aims to be the quickest and easiest way to organize and order medications with same-day delivery at no extra cost. The app enables users to initiate the filling of a new prescription by taking a picture of the script. The company quickly realized that an app that managed only new prescriptions would be hard to market. They also realized that consumers have issues with every stage of medication management, not just the initial fill. That’s why PopRx also offers users a way to automatically generate a list of their medications by taking a picture of each bottle and to track their prescription renewals and order them through the app. As for payment, insurance companies are billed directly and any supplementary payments can be made immediately through Apple Pay or Stripe via the app. Users can also book delivery at a time that fits their schedules.

PopRx offers its technology and service to independent pharmacies based on exclusive rights to serve a defined geographic region. Through PopRx, these pharmacies are able to offer the latest customer service technologies to their customers, meeting demands for the increasingly comprehensive and personalized services expected of them in a cost-effective way. This allows the independents to compete for business by offering a business proposition focused purely on convenient sales and services, and it allows the app’s users to be matched to the specific pharmacies that can meet their needs. It’s a win-win situation.
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The initial PopRx pilot took place in Winnipeg and was later expanded to the Vancouver and Victoria areas. Most recently it was rolled out in the Greater Toronto Area and surrounding regions.

​Ali and Vejey are clearly excited by the great feedback and early traction they have achieved. You can learn more about the PopRx proposition in this recent BetaKit interview.

Melinda Richter, head of Janssen Labs, describes the organization she leads as “addicted to progressing science to the patient.” On May 7, she will be one of the many exciting speakers at MaRS HealthKick presenting to an audience of innovative health entrepreneurs, investors, and corporate and government partners.

Speaker highlight: Melinda RichterMelinda’s passion for empowering patients was first ignited by a near-death experience. While visiting Beijing, Melinda, then a young executive with a fast-track career path at a global telecommunications company, was bitten by a bug. She rapidly developed a severe, acute illness that could not be diagnosed and from which her doctors felt she would not survive.

Fortunately, after the intervention of a specialist and several months of therapy, she recovered, and her experience kindled a passion to do something that would make a difference. As Melinda puts it, she wanted to “make the healthcare industry as advanced and sexy as the tech industry.”

Watch Melinda’s TED talk to hear her tell her story.

As Melinda said in a recent interview: “Everybody that you meet has a story about why they are in this space and it is either because they have had a family member who has been sick, or they have been sick, or they have some personal passion—it is certainly why I got into the industry.”

Indeed, a similar experience drove e-Patient Dave to become an advocate for the empowerment of patients, as I described in a recent blog post.

With no scientific or medical background, Melinda decided to focus on finding ways to reduce the barriers to the development and commercialization of new therapeutics, medical devices and diagnostics. She founded Prescience International, an award-winning firm dedicated to accelerating research by creating the necessary supporting infrastructure, educational programs and financing. Prescience enabled life sciences (and cleantech) entrepreneurs to focus on progressing their ideas toward commercialization to ultimately reach and benefit patients.

In 2013, Melinda announced that Prescience was partnering with pharmaceutical giant Johnson and Johnson (J&J) to expand J&J’s external research and development engine, “adding capital-efficient infrastructure, high-impact services, technical and funding programs, and strong networks to provide unparalleled access and engagement with entrepreneurial communities around the globe.”

Melinda knows about the many barriers that health entrepreneurs—like those presenting at HealthKick this year—face in their work, but she is also aware of the many ways that those barriers can be lowered and surmounted, driving benefits to patients.

It should not be surprising that you are your own best advocate, especially when it comes to your health. Yet many people place the management of their health fully in the hands of their doctors and the healthcare system, especially in times of crisis.

This reality became clear to Dave deBronkart when he was diagnosed with Stage 4 renal cancer and was told his prognosis was very poor.

With the support of his physician, Dave took matters into his own hands. By networking with other patients he discovered a treatment that in a minority of cases was very effective, albeit with severe side effects. Fortunately for Dave, he responded well to the treatment and his cancer has been in remission for eight years.

Dave’s experience makes a very compelling story for why patients should be empowered and engaged in their own health; you can watch his TED talk to hear him tell it.

Fortunately for others, through his experience Dave became aware of the e-patient movement and became an active participant. (The “e” in e-patient stands for empowered, engaged, equipped, enabled and educated about evidence.)

e-Patient Dave advocates strongly that the relationship between patients and healthcare providers is changing rapidly, driven by the explosion and ready availability of information thanks to technology and other forms of innovation. While patients can now play key roles as partners in the health decision-making and treatment process, there is often resistance to this changing paradigm by members of the medical community.

Dave was recently invited to be a visiting professor of internal medicine at the Mayo Clinic, where he presented his concept of “the new science of patient engagement” at Grand Rounds. Dave welcomes this and other evidence that leading medical thinkers are beginning to endorse true patient engagement.

Dave is a great advocate for the rights of patients everywhere and for the essential role that technology innovation plays in enabling and driving paradigm changes. I was very pleased to invite him to appear as a speaker and panellist at MaRS HealthKick 2015.

To learn more about MaRS HealthKick 2015, visit the website or join the conversation on May 7 on Twitter using the hashtag #HealthKick2015.

• Organized by MaRS Health, nearly 40 startups will present their business at the annual pitch competition.
• This year, the event will also explore a key theme that is quickly becoming the underlying movement driving the future of healthcare—patient empowerment.

• With new technologies and services, individuals are now empowered to make his or her own choices about their health. MaRS HealthKick 2015 will feature speakers who will address this growing trend in healthcare innovation from hospitals and doctor diagnoses to patient self-awareness, self-diagnosis and self-advocacy.

Sensors are critical components to effective digital health applications. If you can’t measure an important biological or medical parameter, there are only a few genuinely useful things you can do with smart, mobile and Cloud technologies alone.

Useful sensors don’t necessarily have to be sophisticated to measure an important parameter. Take Sensassure’s first product for senior care – it measures moisture – the moisture in a senior’s underwear or diapers.

Urinary incontinence can be highly distressing, while also creating direct (e.g. rash and ulcers) and indirect health risks (e.g. falling). This video makes a clear case for the benefits to both users and healthcare providers, as shown in a pilot study at ExquisiCare:

Like most people, I feel and believe I look younger than I am. But I am likely deluding myself.

What if you could accurately measure your effective age, your physiological age, to compare it with your chronological age that you already know? Now you can with iHeart from VitalSines Inc.

iHeart measures aortic stiffness. The aorta is the main artery leading from the heart to the rest of the body. Ideally the aorta should be flexible, but with age it tends to harden or stiffen along with other arteries in the body. A flexible aorta will tend to dampen some of the blood pressure spikes by briefly expanding as blood is pumped from the heart; a stiff aorta won't, adversely increasing the velocity of blood flow in a way that can be measured.

iHeart uses aortic pulse wave velocity (AoPWV) analysis of blood pressure measured at a fingertip to calculate aortic stiffness. The stiffer your aorta is, the older you are physiologically, irrespective of your chronological age. This has been well documented through clinical studies. While there are daily fluctuations, the long-term trends are what matter.

The good news is that aortic flexibility can be improved by exercise, diet and behavioural changes. As a result, iHeart can help determine if any program you undertake to improve your health is actually working. In the absence of an overall measure, you could be fooling yourself, so while you may be working out in a gym and 'looking good,' stress, lack of sleep or a poor diet may be countering the overall health benefits you expect. 

The complete system is comprised of the new fingertip pressure monitor connected via Bluetooth to an iOS device for data gathering and analysis, together with a personal site in a web portal for recording and trend analysis.

VitalSines are now conducting an Indiegogo campaign to fund completion and delivery of the first 500 devices. Take a look – it could change our life!

Disclaimer: VitalSines Inc. is an advisory cient of MaRS Discovery District where I work part-time.

Martin Sumner-Smith

Does it seem like you have been forgetting things recently? Are worried that you might be developing early signs of dementia? If so, then you are not alone.

More than 50% of people over 60 are concerned about memory loss. Some age-related memory loss is inevitable, but memory loss can also be a symptom of more serious conditions, including Alzheimer’s disease.

It is a truism of marketing that fear ‘sells.’ Given the devastating effects of dementias, there is a ready market for online memory tests and training programs, which has been targeted by many companies. But do these tests and programs work? Are people pinning their hopes on unproven products that might even falsely reassure them and delay a visit to their physician?

An appropriate test must correctly identify all people who have symptoms that might be of concern and encourage them to visit their physicians, while reassuring the majority of people taking the test who have concerns, but actually have no unusual symptoms.

How do you know that a test does exactly this? There is only one way – you must perform clinical trials.

An example of one such clinically-validated test was just released by Cogniciti Inc. It has proven to be very popular. In the first week there were 37 thousand site visits, by 27 thousand unique visitors, the majority in their 50’s-70’s, which is the age-range for which the test was clinically tested. Importantly, 15 thousand people completed the full 20-minute assessment, and many returned to use the other online resources.

Cogniciti was founded in 2010 by Baycrest, a Toronto leader, “…developing and providing innovations in aging and brain health,” together with MaRS Discovery District.

While touting the scientific basis of the test, Cogniciti is quick to describe it as a ‘thermometer’ for memory health. Just as a thermometer can detect fever, encouraging someone to seek medical attention, so Cogniciti’s test is an early-warning indicator, not a diagnostic tool.

Initially the Cogniciti test was only promoted in Canada, but of course it is available to Internet users anywhere, although fluency in English is required.

When users begin the test they are offered the opportunity to be automatically reminded to take the test again after a suitable period, such as a year. Regular testing with a standardized and validated test will prove invaluable to track any worrisome declines in memory performance over years, sounding an alarm much earlier than otherwise might be the case.

Disclaimer: MaRS Discovery District, an organization with which I work, holds a minority equity position in Cogniciti.
Martin Sumner-Smith