In this episode, we delve into the cutting-edge advancements in cognitive assessments. Our host, Christopher Habig, welcomes Tom O’Neill, the CEO of Cognivue, to Healthcare Americana. Together, they explore the pressing questions of how we can improve healthcare practices and whether we should embrace new innovations just because they are available.
The pair addresses the growing concern that our bodies are often outliving our minds, leading to a rise in cognitive impairments, including mild cognitive impairment and Alzheimer’s disease. Tom sheds light on the transformation of cognitive assessments, which traditionally relied on outdated paper-and-pencil tests. Cognivue, on the other hand, offers a game-like approach to cognitive evaluation.
The podcast episode highlights the importance of cognitive assessments not only as a diagnostic tool but also as a means to educate patients about modifiable risk factors, such as lifestyle, exercise, and diet, which can significantly impact brain health. Tom emphasizes the need for a collaborative approach in addressing cognitive health, combining innovative medications and lifestyle changes to combat conditions like dementia and Alzheimer’s.
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[INTRODUCTION]
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[EPISODE]
[0:00:38] Christopher Habig: Welcome to Healthcare Americana coming to you from the FreedomDoc Studios. I am your host, Christopher Habig, CEO, and co-founder of Freedom Healthworks. This is a podcast for the 99% of people who get care in America. We talk to innovative clinicians, policymakers, patients, caregivers, executives, and advocates who are fed up with the status quo and have a desire to change it. We take you behind the scenes with people across America that are putting patients first and restoring trust in American healthcare.
One of the perks of being able to run this show is that we get to talk to people on really the cutting edge, the bleeding edge in certain healthcare fields, if you will, of the new stuff coming out there. How do we improve upon what is established? Is there a way to improve upon what is established? I think that’s always the first question. Going back to one of a great Jeff Goldblum quote, Jurassic Park, “Just because we can, does that mean we should?” There’s a lot of times where it says yes, “We should do this. We should continue to innovate. We should continue to do what’s best for the patient.” And in one of those areas, that’s a hot topic, is cognitive assessments.
How do we get accurate assessments? How do we get accurate testing? How do we get accurate results, using new technology to try to get people the access to all the different health and treatment that they possibly need when it comes to, really, their brains? The great stuff up top. Please welcome to our show, Tom O’Neill, the CEO of Cognivue. Tom, welcome to Healthcare Americana.
[0:02:16] Tom O’Neill: Thanks, Chris. I appreciate it. Happy to be here.
[0:02:18] Christopher Habig: We were talking about, in the introduction there, the gray stuff between people’s ears. Where’s the innovation? Because so many tests and this is what – you’ve said this to so many people before, is so many things, three, four, or five decades old, it is ripe for innovation. Yet, how do we make sure that innovation is going in the right places? And that we’re actually enhancing access to these types of tools to make people’s lives better?
[0:02:49] Tom O’Neill: Yes. So, first off, great question. Thanks for the time and thanks for the introduction. I think, healthcare has progressed so far long that our bodies are out living our brains. I think that’s pretty clear, based on how many people are dealing with everything from mild cognitive impairment, up into, including things like dementia, including Alzheimer’s. I think what’s changed pretty dramatically in the last six months is now the first fully approved medication from the FDA for mild cognitive impairment, including early Alzheimer’s is a drug by a pharmaceutical company called Eisai. The drug is called the Leqembi. They just approved it, but then CMS did something which is really exciting, is that they also said they would cover the cost of it.
Now, this is where it becomes a challenge is the drug is $26,500 a year. It’s not inexpensive. It’s very expensive. It also has some pretty significant side effects. So, what CMS also required was what they’re calling a registry. The simple way explain that is it’s a prior authorization process to get access to the drug and then to be put on the drug. So, there’s a lot going on now, which is making everybody from policy makers, like you said, policymakers, commercial payers, health systems, providers, everybody started to relook at how are they going to handle the onslaught of patients that are going to come looking for access to this medication.
So, you mentioned that everything that’s out there is 30, 40-year-old paper and pencil tests, and I guarantee, most of your listeners, if they’re actually just consumers or patients, understand this because they’ve either gone through it themselves or they’ve been the caregiver, helping their mom, dad, aunt, uncle, grandma, grandpa get through it, and there’s a better way. There’s just a better way.
[0:04:40] Christopher Habig: Walk us through really the history of cognitive assessment. What it was before, and then really, where Cognivue is taking it?
[0:04:50] Tom O’Neill: Yes, so it was just that. It was a paper and pencil test. You’ve heard terms MoCA, MMSE, many mental status exam. The Mini-Cog, which is two or three questions, and they’re really more just question and answer type of assessments. Now, you can ask any adult, if they want to go through a question and answer assessment and I can promise you, their first answer is going to be no. And if they’ve gone through the MoCA, or the MMSE, I can also guarantee it, they felt belittled, they felt stupid, they felt like all these things, right? Because they’re actually – it’s a human, it’s a doctor, a nurse, somebody who’s trained administers it, and it’s a question and answer type of assessment, and they’re not only having the patients answering the questions, but then that clinician is also scoring them.
The difference for us is, ours are no question and answers. Ours are a series of 10 exercises in 10 minutes, and it’s adapting to the individual’s abilities throughout the entire exercise. All 10 exercises. So, we have an intro video, so everybody gets the same introduction to the technology. It doesn’t take staff time. It’s self-administered. The patient takes it themselves and it’s self-scored. And it’s a little bit of that gamification. So, when we do market research, and we ask the patients, what do they like about it versus a MoCA or MMSE? They like it because it doesn’t feel threatening, scary. It’s not question and answer. We’re not doing an IQ test. All the things you hear from the patients, so they actually liked the fact that it feels more like a game, than it does like a question and answer, paper and pencil test.
[0:06:39] Christopher Habig: Kind of following what modern test taking has become, and for those of you who are able to log into or pull up our YouTube channel, the Freedom Healthworks YouTube channel, I believe there is a, one of your devices sitting behind you on the desk.
[0:06:56] Tom O’Neill: Yes, it is.
[0:06:56] Christopher Habig: That super simple little unit, get in there, take this exam. So, I want to talk efficacy of it. What are you seeing as far as easy usability? I mean, there’s got to be some kind of numbers out of here where people are like, “Wow, this was a lot more. This is a much more pleasant experience than sitting down with a paper and pencil or just getting peppered with questions.”
[0:07:17] Tom O’Neill: Yes, 100%. Thank you for the question. But the only interaction that the patient has with the entire test is this wheel, this little joystick in the middle. That’s the only interaction they have with all 10 exercises. So, you hover the circle, or you hover it over a specific answer, and it measures that, right? We’ve gone through the FDA. We’re the first FDA cleared computerized test for cognition. That happened back in 2015. Since then, what we’ve been doing is adding more clinical validation, so doing studies with thousands and thousands of patients. But we’ve also done things like market research to understand what the patient likes about it. That’s why we’ve added things like the intro video, things like making sure that the patient understands what the test is, and what the test isn’t.
In addition to that, making sure that we’re educating the clinicians, so whether it’s – we have two versions. We have one that is more of a screening. We sell that into audiologist, pharmacist, optometrist. And then we have the clarity version, which is in the MD’s office, whether its primary care, internal medicine, family practice, all the way up to neurology and neuropsych. So, we’re making sure that they understand the data that comes out of it, and how that helps them help their patients.
[0:08:38] Christopher Habig: I like the education really both sides of it. So, when I asked a previous question, a couple of questions ago, I’m like, “All right, so what are we doing these days, versus where are you guys going right now?” In my mind, I’m connecting the dots, and this is a way that’s much more user friendly, easier for the physician to get in there, and assess somebody. What happens after somebody does complete the task. I think you said it takes about 10 minutes or so, give or take.
[0:09:07] Tom O’Neill: Yes, 10 minutes and it self-scores. So, it gives a report, and breaks that report out by an overall score for the patient. Then also, by domain, so it helps that doctor understand what might be going on with that patient. So, if they’re going to treat the patient, listen, it could be anything from the modifiable risk factors of diet, exercise, lifestyle, mindfulness hearing, it can be those. It could be medication driven. It could be though, it could be something more significant, tied to things like mild cognitive impairment leading to dementia and Alzheimer’s. So, it helps that doctor. We don’t diagnose any – we’re not a diagnostic tool. We’re an assessment. So, the doctor is the one that diagnoses.
[0:09:51] Christopher Habig: So yes, and then you equip the physician with the understanding that if the results say this, here’s the things to look out for. It feels like a much more collaborative approach than what we had before, with more of an analog type of solution.
[0:10:06] Tom O’Neill: Yes. I think, analog is a great description. Because even the ones that the cognitive testing, the D we call them DCAs, the digital cognitive assessment tools that are out there that are like app based, they’re still that type of tool, but they’re on an iPad, they’re on an app, or in a phone. They still got those same limitations and same challenges. With ours, the first two sub tests don’t have anything to do with your score. The first measures your motor skills, and then adapts the rest of the sub test to your motor skills. Because if you’re –
I’ll give you an example, Chris. If you’re a student athlete, your motor skills are going to be very different than a 35-year-old with MS, versus my parents who are 79, and may have arthritis or some other motor challenges, and it measures your motor skills, and then adapts the rest of the sub test to your motor ability. Same with visual acuity. The second test is visual acuity, and it adapts the rest of the sub test to your visual acuity.
Now, we’re measuring every 1/12 of a second. There’s 130,000 data points that come out of ours after 10 minutes. If you think about that, if my mom who’s 79 has to look at it to try to make sure the glare is out of her way, and she takes two or three seconds to get to an answer, that can change her score. So, we tried to really focus that patient and measure them in a way that’s meaningful. So, to your point, what’s different, our test, retest reliability is significantly better than those, the MoCA and the MMSE that are out there. The gold standards, if you will, is what the doctors will call it. But certainly, we have that clinical data to support what we do.
[0:11:50] Christopher Habig: And you pull the shot of that data on your website at cognivue.com, and I always liked that. It’s always interesting in this world where people make, say, “Hey, we got this new thing out. We’re doing this. We’re doing that.” And then there’s difference between what you guys are doing and the saying, “Hey, here’s the numbers. Here’s the proof behind it here. We’re actually helping people out.”
Again, connect the dots for me. So, we take the Cognivue test, and we say, “Hey, look, there’s some potential risks here.” Bring us home there with what you mentioned earlier about new medications coming online, where they’re having success, actually helping people with dementia, Alzheimer’s, stuff that is just crippling and debilitating for really entire families, not just that individual.
[0:12:35] Tom O’Neill: So, a couple things to think about here is, there is a drug, a new drug that just got approved, this Leqembi. It’s Eisai’s drug. Eli Lilly, right in your backyard is going to – we expect that one will be approved in December, and it’s an improvement over the current Eisai drug, and there are 13 other drugs in phase three trials that are expected to hit the market in the next four years. So, there’s a lot happening.
Now, if you think about it, though, it doesn’t always have to be medication driven improvement. And I think that’s really the educational piece of this. I’ll tell you a quick, funny story. So, when I first took over here five and a half years ago, I called my parents. They live in Cleveland. I said, “I took over as the CEO of Cognivue. I’m going to bring the device by the house. I want you guys to take it.” My dad’s like, “Not a chance am I taking that.” My mom’s like, “Absolutely. I’ll take it.” I asked my dad, I said, “Why not?” He goes, “I already know I have early Alzheimer’s.” I said, “How do you know that?” He says, “Because I forget why I walked in the room and I forget where I left my keys.” And I said, “Dad, if that was the litmus test, then we all got it.” I said, “The fact that you actually recognize that you don’t remember why you don’t and that you don’t, that may be an indication.” I said, “Dad, would it be surprising for you to understand things like I know you have sleep apnea. I lived with you for 25 years before I moved out. I know, you have sleep apnea, untreated. You’ve been smoking for 64 years.” All these different things that I went through with him, he goes, “No, I didn’t know those are all key components to MCI, mild cognitive impairment.”
So, my point being is, your question is a great one, that there are great new medications coming. But there are what they call the modifiable risk factors that if you empower a patient, that they can handle, they can take care of. So, whenever I’ve talked to doctors, and I’ve been in healthcare for 30 years, they always say, “Hey, I already counsel my patients to eat right and exercise.” I’m like, “Yes, but this is an inflection point.” This is something they can look at and go, “I got an issue that I got to do something about.” I didn’t start taking my Lipitor and watching my cholesterol until I saw what my numbers were.
Here, you have a number tied to your cognitive function. It’s going to drive you to do something about it, and that’s what we’re trying to do is not only empower doctors, but empower their patients to control what they can control.
[0:15:02] Christopher Habig: So, point is that there’s no actual magic pill that’s going to do everything. It’s a combination of factors. I’m like, “This is so true because I’m sitting here shaking my head.” I think your Lipitor example was really spot on, right? A lot of people prefer to live kind of with the ostrich buried in their head – ostriches and their head buried in the sand. Let me get that out. And don’t want to look at it until someone smacks them between the eyes and say, “Look at this. This is bad. This is not good. And this will kill you unless you make a difference.” Or, “This will impact your life and those around you until you make a change.” Maybe we’re all just optimist, that we don’t want to think anything’s wrong or ever will happen. The story with your dad kind of reminds me of that. Most guys have that superhuman kind of mindset with them, and nothing ever bad is ever going to happen until one day it does.
[0:15:50] Tom O’Neill: You know what’s interesting is my dad ended up taking it, and he did fine on it. But I think that ties to that component of educating patients. The other piece is we did before COVID, when the world was different, we were doing employer health fairs. So, we did omit everything from Samsung and Silicon Valley to waste management all over the country, to Cleveland Clinic for their employees to car dealerships, groups of car dealerships. And have you ever been to a play health fair? It’s like they set it up in the lobby, or they set it up in the cafeteria, and it’s a bunch of tables and different suppliers and vendors and stuff. Usually, they’re like, two, three hours. I’m not exaggerating, Chris. We would have four machines, we would have to stay an hour and a half to two hours longer at every single one of those. We had a waiting list of people that wanted to come and take our Cognivue Thrive, which is our five minutes screening. When we’d ask them why, they’re like, “Listen, we use our brains every day. We want to understand.”
There’s a thing we call the worry well, so you and I were young enough, we may not have it, but we’ve seen and we’ve been a caregiver to, or we’ve seen grandma, grandpa, aunt, uncle, somebody deal with. Because I don’t know that you could talk to many people anymore who haven’t been touched by dementia, up to including Alzheimer’s, were they – we call them the worried well, because they’re like, “I’ve seen grandma have it. Does that mean I got this?” So, all generations. It doesn’t matter which generation. The thing they’re most worried about, not cancer and not heart disease. It’s dementia and Alzheimer’s.
[0:17:24] Christopher Habig: To the point earlier, our bodies are by and large outliving our minds for the first time and we don’t know why. I think that’s where a lot of it comes from too, is if I’m a smoker, okay, I’m pretty much understanding that lung cancer could be in the future. But from somebody who’s living this, living a healthy lifestyle, brain disease is scary, and we don’t know what causes it or where it really comes from.
[0:17:53] Tom O’Neill: Yes. Can I give you a really simple way of thinking about dementia is? I heard a doctor, actually Dr. Trenton, one of our advisors, say this. He says, and you mentioned this earlier, “There’s no magic pill. There just isn’t.” The reason there isn’t is because it’s really three factors that causes dementia. It’s inflammation, circulation, and toxins. Inflammation, circulation, and toxins. So, there’s not going to be one pill that’s going to take them all. It’s either going to be eventually some type of cocktail of multiple medications, but it is why those modifiable risk factors and the things that patients can do for themselves, really does matter when it comes to cognitive function, cognitive health.
[0:18:34] Christopher Habig: Tom, we’re going to take a quick break. We’re going to hear from our sponsor, FreedomDoc, and then come back for the second part of our episode.
[BREAK]
[0:18:43] Christopher Habig: Physician burnout is a killer. It is driving our best and brightest out of medicine. The only solution to burnout is to be your own boss. The easiest way to be your own boss is to join the FreedomDoc physician network. FreedomDoc is a unified consumer brand. It will fully finance your practice so that you can enjoy a healthier lifestyle, take better care of patients, and spend more time with your family. You focus on patients, FreedomDoc focuses on your business. So, if you’re ready to be your own boss, visit our website, freedomdoc.care to learn more, and schedule a consultation with one of our experts. FreedomDoc accessible concierge health care.
[INTERVIEW CONTINUES]
[0:19:17] Christopher Habig: Once again, we are back with Tom O’Neill, the CEO of Cognivue. In the first part of our episode, Tom, we were talking about health assessments, really, mental health assessment tools and where they were, where they are now. You’re running Cognivue now, and really on the cutting edge again, to use that term, and I don’t mean to be puny in a healthcare podcast, by saying, the bleeding edge and cutting edge of it. But we talked about Alzheimer’s dementia. That’s like the worst of the worst from cognitive assessments, and you brought up so many other different items, things for people to keep an eye on or be aware of, that is a full-blown dementia, full-blown Alzheimer’s. So, kind of taking a step back and taking a peek under the hood. Did you grew up as a little kid being like, “You know what? One day I am going to lead a rule-breaking, groundbreaking, innovative cognitive assessment company one day.” Was that your childhood dream?
[0:20:15] Tom O’Neill: It wasn’t. I’m not sure I even had college in my dreams when I was in high school. I was more of the class clown. I ended up finding my path in college. But I chose healthcare because it started with Johnson & Johnson, and spent a number of years at J&J. And I’ve been in healthcare, like I said, for 30 years, which just means I’m old, right? But for me, it is about making a difference, and having an impact in life more than just having an income and having a career or a job.
What made a difference for me here was same thing. I saw my grandma go through dementia, which is on that really heavy end of the spectrum of cognitive issues. But I also saw my Aunt Sal. My Aunt Sal, just a quick story, it’s very different because it tied to hearing. The easy way to explain this is we hear with our ears, but we process those sounds with our brain. Hearing is the most modifiable risk factor for mild cognitive impairment and dementia. It’s fact based, it’s study based. It is the most modifiable risk factor. It also takes people on average, seven years to go get their ears checked and maybe get hearing aids.
It is one of those things, whether it’s ego driven, or I just don’t want to spend the money or whatever it might be. I saw my Aunt Sal go from this amazing, dynamic businesswoman, person at family parties, birthday parties. She’d be jumping around, all the rooms. She’d be talking to everybody, having a great time. Also, I saw her start to try to read your lips, try to interpret what you’re saying, to maybe a couple of years later, laughing at the wrong time, because she was trying to just keep up, but wasn’t hearing things right. To ultimately seeing her sit in a room, on the couch, and we lost her to dementia, right?
So, it was one of those things where I think it really could have made a difference, had we gotten her to go get her ears checked. Because when your brain has to work overtime to try to process sounds, it starts to have an impact on your cognitive function. So, for me, it was very personal with me, seeing what happened with my grandma, and then also with Aunt Sal. And I think with Aunt Sal, it definitely was something that could have been impacted or changed based on getting her to an audiologist, or hearing information specialist to get her some hearing aids. That’s what drives it for me.
[0:22:48] Christopher Habig: I find that fascinating. I had no idea that hearing was – I mean, isn’t that more like risk factor? Or is that the number one telltale that –
[0:22:57] Tom O’Neill: It’s the number one. It’s the number one risk factor, excuse me, the number one modifiable risk factor to cognitive function or cognitive impairment.
[0:23:07] Christopher Habig: Interesting. Interesting. I’m going to go ahead and turn the volume down on my earphones right now, as we’re talking, just as you say that. But I’m like, not to not to make light of it. But it does blow my mind, because I’m sitting here thinking, it’s genetics, it’s unhealthy lifestyles. Hearing. So, it’s sensory.
[0:23:25] Tom O’Neill: So, think about it. It works for both ways. For hearing and vision. So, we see with our eyes, but we interpret those images with our brain. We hear with our ears, but we process those sounds with our brain. The retina is nothing more than brain tissue, right? So, think about those things and what are important, so your doctor should be thinking about things that are the obvious, right? What are the drug interaction that the medication that patient might be on? Do they have a hearing issue? Do they have a vision issue that they just haven’t resolved, they’re taking care of?
In fact, our biggest segment, our fastest growing segment is hearing care professionals right now, because it allows them to have a bigger broader health care conversation with that patient, versus just your hearing. We have an issue with your hearing, it’s also impacting, or could be impacting your cognitive function.
[0:24:19] Christopher Habig: You mentioned earlier how very few people is in America, in the world, have not seen the effects of dementia, or any type of dementia on loved ones, maybe themselves. So, I like your thinking that this isn’t just a medical issue. This is a society issue. Give us a little bit insight on what you mean when you say that cognitive diseases are a society issue.
[0:24:43] Tom O’Neill: It has to mean this is a $1 trillion impact in the world. So, there are, we call it the graying of America. I resemble that if I had hair. But the graying of America. People are getting older, the population is getting older, and because of those things like diet, exercise, lifestyle, inflammation, circulation and toxins, we know that this is becoming a bigger and bigger issue. It’s not just an issue for the patients. The challenge is the health system, the health care system is not taking care of these patients. We know in a very traditional sense that primary care within a system is that screening people’s cognitive function, like they should. These are good friends. I have a lot of friends who are in that space, the primary care, family practice, internal medicine docs. When I ask them, why don’t they do it on a regular basis? It’s really three things.
It’s first off, they’re seeing 30 to 40 patients a day, and they don’t have the time to do it. The second thing is, if they do, do it, the payers, the commercial payers, don’t necessarily pay primary care, internal medicine docs to do it. They don’t have any brothers’ codes out there for the specialists, the neurologists, neuropsychs. By the way, it takes four to six months, on average, to see a neurologist in America, right? So, you got to get to see your primary care doc.
But if the payers aren’t going to help make sure that’s covered, that’s a real challenge. A third is, up until like I just mentioned earlier in the show, there was no prescription they could write. There’s still not necessarily a prescription because that drug that I mentioned, it has to be infused. So, they have to go to an infusion center twice a month, for an hour each time, to get the infusion, and then they’re going to have to be watched very closely because of the side effect profiles.
Those are the three things keeping primary care and traditional health systems from really integrating what I think you should be the fifth vital sign, which is cognitive testing, cognitive function, into the health system as it is, and I don’t care if it’s policymakers, payers, the health system itself, or the providers. They’re all challenged. So, we were in a lot of discussions now, with this recent drug approval, because health systems realized when Eisai and when Lilly gets approved, and when they turn on to direct to consumer advertising, which is not necessarily going to be just advertising for the drug, but it’s going to be educating consumers on mild cognitive impairment, and they’re all going to come asking about it.
Right now, the health system is not set up for it. So, when I say it’s as much as society issue with this, because guess who’s taking care of these patients? It’s caregivers, it’s family members, it’s people that don’t have access to neurologist or to those medications. So, to me, it’s as big or bigger society issue, because the impact on the caregiver isn’t just the time it takes to take care of their loved one. It’s the impact of them at work. It’s the impact of them in their financial means. It’s a society issue.
[0:27:52] Christopher Habig: I want to dive into, what you said about, this should be a normal part of routine visits to your physician. I fully understand, really, the handcuffs and limitations that are placed on primary care, just from a time standpoint. So, I totally agree with you. I’m kind of sitting here thinking like, “Wow, Tom, I wonder if there was a different economic model out there for primary care that allows doctors to” – you’re laughing. So, looking at the concierge and the direct primary care world, do you see a big opportunity for physicians and those type of practices to use something like your product in Cognivue, to be able to really put these cognitive assessments and really, brain health at the forefront of what we kind of collectively deem as preventive medicine?
[0:28:43] Tom O’Neill: Yes, I do. I absolutely think they can be a key component of this, because they’re the frontlines. By the way, when I talk about the other primary care doctors that are maybe within a system, and they’re employed, they’re not bad doctors. They all want to do the right thing for their patients. But it’s just the machine. It’s the system, that keeps them from being able to do all the things, I think, they want to do for their patients. So, I do think that that concierge doc is a great model for both doctors to certainly practice great medicine, probably the way they want to practice medicine, but also for patients to have access to kind of the best newest technologies that are out there.
We also, we’re just very strong supporters of the independent docs, but also independent pharmacists. So, we have a number of independent pharmacies. We don’t sell to the big three or four pharmacies, but we do sell to independent pharmacies, CPSN, and others that are really clinically service focused to make sure that they’re bringing value to their patients as well. But ultimately, yes, I think concierge docs are a great first step, and the organization you are doing the commercial for, very specifically, they make sure you have access to a neurologist, or a neuropsych, or a psychiatrist, a psychologist. If you need that, as a follow up. If they can’t intervene, whatever they can intervene with, they intervene with. If they can’t handle it, it’s something outside their scope, then they can recommend you to a specialist that can handle it.
[0:30:18] Christopher Habig: So much of healthcare is identifying, assessing, and then educating. That goes along with just the lack of time that most physicians in insurance dominated world are just able to do. I know it’s picking on doctors. But you know what, there was a choice out there. There are options out there, if they’re tired of the hamster wheel, as we’ve already said earlier with the FreedomDoc commercial. There you go. So, thanks for calling that back out.
Tom, as we come to a close here, I got two more questions for you. One, give us a brief glimpse of what the economic model is behind Cognivue. Is this more of a device sale? Or what are we talking about for anybody who might be interested in exploring more?
[0:30:58] Tom O’Neill: Yes. So, it’s two models. One, which is the primary model we sell under, it’s a subscription model. For a low monthly subscription, whether you use it on one patient or 100 patients, it’s the same price. Okay, there’s no upfront capital, there’s no per click fee. It’s just the monthly subscription. Then, there is a capital with service. So, if you want to own the device, you can purchase it, and then have a low monthly service fee for everything from the software updates, to the upgrades, to the new devices and other things. It’s really those two models. But the subscription model is the one that primarily gets the – that’s what we get signed up for.
[0:31:37] Christopher Habig: You said earlier, mostly with pharmacies, clinics, more of a direct to clinician type of approach.
[0:31:45] Tom O’Neill: So, for sure. Certainly, we’re having a lot of conversations now with health systems, because they know that this patient population is going to be coming to their door. But we’ve really set ourselves up and developed our business where a lot of other cognitive testing technologies have built their business on pharma development. We’ve built it on providers and practices. So, we have been working with the MDs, with the audiologists, with the pharmacists for years, to really understand the patient flow. How do you charge the patient? What do you charge a patient? How do you have a conversation about brain health with a patient? How do you educate a patient? Those are things we’ve spent our time become an experts in.
[0:32:27] Christopher Habig: Last question for you, Tom. I’m going to make you the billboard czar of the entire United States. You got the ability to control every single billboard that is out there. Cars are flying by at, let’s say 75 miles an hour. What are you going to put on your billboards across the nation?
[0:32:44] Tom O’Neill: I’d say, “Go get your brain tested” or “Just brain health. Brainhealth.com. Go ask your doctor about your brain health.” Chris, it’s a much bigger issue. And I would say, the majority of your listeners, whether they’re the doctors, or they’re their patients or consumers absolutely understand this. They’re just looking for a place they can go to get it looked at.
[0:33:09] Christopher Habig: Tom O’Neill, CEO of Cognivue. Tom, thanks for joining us here on Healthcare Americana. This has been a pleasure speaking with you.
[0:33:16] Tom O’Neill: Yes, appreciate it. Thanks, Chris.
[0:33:18] Christopher Habig: That’s going to do it for this episode. If you haven’t yet, be sure to subscribe to the show on your favorite podcast platform. Check us out online at healthcareamericana.com to catch previous episodes. Subscribe to our mailing list and visit our online store. Once again, I am your host Christopher Habig, thanks for listening.
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[0:34:40] Christopher Habig: Hi, again, everyone. This is Chris. In Healthcare Americana, we’re always on the lookout for great stories to tell in the healthcare industry. We’d like to hear yours. Check out healthcareamericana.com, and send us your ideas for episodes or if you’d like to be a guest. Thanks again for listening. Hope you enjoy it.
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