Overview: About Screen

Screen Inc. is a leader in CNS Assessments/Testing.

We developed one of the top-rated neuropsychological tests in the U.S.—the Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI).

 

The Screen Story

Like other technology companies before it, Screen Inc. has a fascinating history: how it started, what problems it had to overcome, and how it came to develop one of the best computer-directed neuropsychological tests for the early detection of Mild Cognitive Impairment (MCI).

Our story is still unfolding and we make new adjustments every day. But one thing has never changed: we are still focused on the early detection of memory problems and doctor follow-up for the elderly. We stay closely connected to our physician/customers and with cutting-edge Alzheimer’s researchers, insuring that Screen’s tests will continue to evolve and help physicians. Most importantly, our hope is that Screen’s tests will make a difference in the health and happiness of patients, families and friends.

This conviction, hope and determination allow us to continue to push through barriers and create products and services that never existed before.

 

The Screen Inc. Story

In 1995, Dr. Emory Hill, a psychologist who was to become the founder of Screen Inc., was coping with his father's death due to Alzheimer's disease. After the passing of James C. Hill, Emory was looking back at the frequent visits with his father, James Hill, during his disease. He wished he had known earlier that his dad had this disease—when his dad was still healthy enough to really talk about things.

Emory asked some physician friends why they didn't routinely screen for Alzheimer’s—so families could be alerted, early treatment offered and patients kept safe as the disease progressed. He asked a number of primary care physicians, "Couldn’t you give them memory tests when they come in for their normal checkups, and refer them to specialists if the tests indicate that they are having problems?"

He heard replies that fell into several categories: “We’re not convinced that there is a test out there that can detect MCI. Some of us use the MMSE, but by the time it picks up cognition problems, it just confirms what the family already knows—the patient has Alzheimer’s"; “We don’t have the staff time to routinely screen for decline”; and “It is too expensive to screen, for what we can charge”.

Driven by a desire to create a completely new battery of tests capable of detecting MCI in its earliest stages, Dr. Emory Hill founded Screen, Inc. As we continue to advance the company’s mission, we dedicate our work to the memory of James C. Hill and to the patients, and their families, whose lives have become entangled with Alzheimer’s. We know that this work is worthy of our best efforts.

 

Early Test Development

In the beginning, Emory Hill and his team carefully evaluated all available research—looking for clues about how one should go about detecting MCI and the earliest stages of AD. Research in MCI and AD was showing that tests could better predict MCI or AD if patients were examined over several cognitive dimensions: memory and a variety of executive function abilities. Moreover, by combining tests of these separate cognitive dimensions into a single test battery, the statistical ability to predict MCI was greatly enhanced.

The Screen team refined the most usable individual tests to measure each of the three cognitive domains. The team undertook both usability and validity research to ensure that high standards for accuracy, patient satisfaction and test completion were obtained. Screen Inc. analyzed its separate tests for the most predictive form of each cognitive dimension. After exploratory and confirmatory factor analyses, a set of the three predictive cognitive areas were then combined into one test battery—creating the ability to test for each domain separately, or, by combining them into a more generalized finding, to predict an overall probability of MCI.

 

Need For Computer Tests

Screen developed a computer-directed testing process with audio and video files, so the computer could “talk” to the patient and show them pictures, words and designs—the same way, every time. By using only creative multi-media touch screen interactions, Screen Inc. created a huge savings in the staff time necessary for test administration. There is no need to have a staff member present throughout testing. Repeated training of staff members in test administration became unnecessary and other sources of error in testing were eliminated as well. The usability studies indicated that elderly patients are distracted by the reactions of live testers to their mistakes. Patients don’t care about having a computer witness their mistakes. They feel free to talk to themselves and even criticize the tests when no live person is present. The computer administers the tests in exactly the same manner each time and, without a keyboard or mouse, computer experience doesn’t affect the results.

Now, any changes in test results over time can be trusted to represent cognitive changes rather than changes that depend upon whether or not the person giving the test seemed judgmental to the patient, spoke clearly, or administered and scored the test in the same correct manner each time.

Screen named this new, cutting-edge test battery the “Computer-Administered Neuropsychological Screen for Mild Cognitive Impairments”—the CANS-MCI for short.

 

Statistical Validation Of Screen’s Tests

Screen evaluated whether its individual tests and the combined test battery were statistically useful for the detection of MCI. Regarding its individual tests, it turned out that Screen made the right choices, as research in the field of MCI showed that the individual testing areas chosen by Screen were strong, independent predictors of MCI.

Screen wanted to find out, though, if, taken all together, its test battery could predict MCI and which domains seemed to be the best statistical detectors of MCI. With grants from the NIH (Phase 2, SBIR), Screen undertook a very extensive study that tested over 400 people in Western Washington over a three-year period. From this detailed study, Screen’s test battery was found to be statistically valid (Journal of Neuropsychiatry and Clinical Neurosciences, February 2005).

Next, Screen evaluated its test battery against independent full neuropsychological batteries of tests (the “gold standard” costing $1,500 per patient report) to see if the Screen tests could accurately detect the people who, when independently given a full neuropsychological exam, were classified as having MCI. Although Screen’s test battery cost only a fraction of the amount for the gold standard, it detected nearly the identical people diagnosed by the gold standard.

You can imagine the excitement these studies brought to the Screen team: years of hard work were paying off—and Screen was one step closer to putting a test in doctors’ hands that could reliably and economically detect early cognitive declines.

 

Internet Application

As part of Screen’s test design, the next step was to think about how Screen could put its Testing Units in clinics—so patients could be tested in the convenience of their doctor’s offices.

Screen found that by connecting its testing units to the internet, no matter where the clinics were located in the U.S., the test data could be sent to Screen’s home office in Seattle for analysis, a Test Report prepared, and sent back to the physician—all within an hour.

At this stage of its development, Screen had met several of its goals: develop a test that required minimal input by staff (greet the person taking the test, make sure the computer is on, input patient ID number, leave the patient to take the test in privacy while the computer took over), and develop a way that physicians could have a detailed, but easy to understand, Physician Report within an hour.

Over the years, as Screen continued to refine its tests and technologies, the process got better and faster.

 

Awards

Over the many years of continued developmental work, Screen’s test battery went on to be recognized by clinicians, practitioners, competitors, and independent neuropsychological testing experts for its unique contributions to early screening for MCI (AD).

Throughout the last two years, every major journal that has covered computer-directed neuropsychological testing has referenced Screen’s CANS-MCI test battery. Last year, in a study that systematically reviewed the top 11 computer-based tests that are used to detect cognitive decline in aging populations in the USA, independent researchers gave Screen's CANS-MCI test battery the top overall score.

 

Commercialization

Screen has already accomplished a lot as a company. Its tests help doctors sort out those patients who have memory problems that are consistent with normal aging, and those whose who have problems that are predictive of MCI.

Screen’s test offers reassurances for some and provides early-warnings for others.

Screen will continue to do all that it can do to help physicians detect AD and MCI as early as possible.

 

Senior Management

Screen has seasoned executives with deep experience in technology and science companies—and consideralble expertize in computer-directed neuropsychological tests.

 

Emory Hill, Ph.d.

Emory Hill, Founder of Screen Inc., has served as President since its founding in 1999. Over the last ten years, Emory has guided the Screen team to a leadership position in CNS Assessments/Testing—with a specialty in computer-directed neuropsychological testing for the purposes of detecting MCI (Alzheimer’s).

Early in the company’s development, Emory applied for and received grants from the NIA and VA to develop new, cutting-edge neuropsychological tests capable of detecting MCI (AD in its earliest stages). He is an expert in computer-directed neuropsychological testing for the early detection of MCI and a speaker at scientific conferences, workshops, presentations and Alzheimer’s forums.

As an advocate of early screening for memory problems, Emory has worked closely with senior centers, social workers, community health centers, geriatric providers, caregivers, medical practitioners and neurologists over the years.

Dr. Hill has a PhD in Clinical Psychology, State University of New York at Buffalo. Later he served as an Informatics Fellow (post-PhD) in patient testing, where he studied interface design, multimedia programming, user resistance, evaluation of adaptations to new medical record systems, and the implementation of automated medical records. A trained psychologist, Emory was in private practice for nearly 20 years. Before that, he served as an Assistant Professor at SUNY, Brockport, NY.

 

Frank Costa

Mr. Costa possesses over thirty years experience as high level executive in dynamic technology companies, ranging in size from privately held start-ups to publicly held multinational organizations.He has demonstrated an impressive track record of success as CEO of publicly traded companies, as well as VP of Marketing, Group Vice President and General Manager of numerous successful organizations.

Throughout his career Mr. Costa founded companies, obtained financing from variety of sources both private and public, managed both small as well as multinational operations for growth and profitability, and expanded the businesses through successful mergers and acquisitions.

Most recently, Mr. Costa was CEO of Perlego Systems, Inc. a privately funded startup in the Mobility space. Prior to that he was the CEO of Active Voice Corporation, a publicly held company, for five years, during that period he was able to successfully double Active Voice’ revenues and to triple its stock price. In 2001 he negotiated and concluded an agreement to sell Active voice to Cisco Corporation for $300 million (4X the revenues).

Prior to Active Voice Mr. Costa served as president and CEO for privately held companies such as ProTools Inc, and Concept One Design Inc, Group Vice President at Mentor Graphics, VP of Marketing at Orcad, and Director of European Marketing at Intel Corporation. He was also one of three founders of Synergy DataWorks, an EDA company that was subsequently acquired by Mentor Graphics.

Mr. Costa holds an MBA in International Business from the University of Chicago 1977 and BS in Electrical Engineering from Massachusetts Institute of Technology (MIT) 1975

 

Michael Anthony

Mr. Anthony has had over 15 plus years of success working with corporations both large and small, private and public. His forte is taking existing or new entities and helping develop them into strong and financially successful profit centers. From a financial standpoint, Mr. Anthony’s success reflects in helping these organizations grow as much or more than 300% through effective marketing, training, product development and team sales training. This translated to over $50 million in new revenue. He has a passion for companies that improve or amend the quality of people’s lives.

Most recently, Mr. Anthony has had great success in the Medical, Communications and Technology sector with well-measured profitability. He has had success in developing both national and international sales and marketing organizations. Through shear effort, team work, leadership and limited budgets, he has been able to grow previous companies to multi-million dollar organizations from day one and dollar one. Mr. Anthony excels in taking underperforming sales teams and companies to success through training, restructuring and developing talent.

Mr. Anthony holds a BA in Secondary Education with emphasis on History and English, minor in Business from Northwest University of Kirkland, WA and continues to gain credits towards an MA.

 

Brian Fogel

Brian Fogel has served as Director of Technology at Screen Inc. since 1999. Brian is responsible for application design, development, and deployment; as well as media design and production. Brian also serves as Principal of Art in Fact, a digital media and web development company located in Seattle.

 

Jo Laboff, Msw

Jo Laboff began her work with Screen Inc. in 2002. As an integral part of the company’s early research and validation studies under grants from the NIA, she managed over a thousand participant testings with the CANS-MCI and now oversees all aspects of Screen’s physician reports. Ms. Laboff has extensive background in providing assessment, consultation and education to individuals and families touched by Alzheimer’s disease and other forms of dementia and cognitive impairments. In addition to service with older adult populations, she has assisted individuals and families of all ages dealing with mental health and behavioral issues.

Ms. Laboff earned a Master of Clinical Social Work and a Bachelor of Science in Psychology, with distinction, both from the University of Washington in Seattle, and holds a Certificate in Geriatric Mental Health.

 

Jim Scanlan, Ph.d,

Dr. Scanlan received a B.A. from the University of Chicago and a Ph.D from the University of Wisconsin -Madison in Psychobiology.  After completing post-doctoral work at the University of Colorado Medical School, he joined the University of Washington Medical School¹s Department of Psychiatry in 1995 as a Senior Research Scientist.  Since then he has authored and co-authored over 50 peer reviewed scientific articles, has been an assistant editor for Behavioral Medicine, and a longtime reviewer for Psychosomatic Medicine, the American Journal of Geriatric Psychiatry,and many other journals. His papers have twice been cited in Evidence-Based Medicine as having particular value to physicians, and he was a co-author of a comprehensive article on the use of brief cognitive screens which was based on a survey sent to all the members of the International Psychogeriatric Association.

In collaboration with Dr. Soo Borson, Dr. Scanlan developed the Mini-Cog, a brief dementia screen used with thousands of older adults worldwide.  He has participated in a number of advanced statistical / data analysis workshops, including four sessions of the Friday Harbor Group.  His research interests include dementia detection, doctor recognition of cognitive impairment, test simplification, cognitive impairment clock scoring systems, and the relationship between cognitive impairment and co-morbid physical illness.

 

Science Advisory Board

In order to continue to build upon its scientific and medical foundation, Screen Inc. has drawn together a very distinguished Scientific Advisory Board. The Science Board will help guide Screen in new grant applications and in the identification and adoption of the latest scientific, medical and statistical findings into its test battery.

 

Distinguished Members

Screen Inc. is very fortunate to have such a prominent Scientific Advisory Board. Each Advisor has extensive experience in areas that are important to the advancement of the Screen test battery. Through their expertise in neuropsychological test design, dementia, clinical neurology, informatics, epidemiology and psychiatry—Screen will continue to advance its test battery for the early detection of cognitive disorders—especially for those disorders that are highly predictive of MCI (Alzheimer’s).

Screen’s Scientific Advisory Board is chaired by Dr. Frederick Schmitt and includes distinguished members, Dr. Soo Borson, Dr. Kenric Hammond, Dr. William Leahy, Dr. Ann Vander Stoep and Dr. Mehendra Upadhyaya.

 

Frederick A. Schmitt, Ph.d.

He received his Ph.D. in Life-Span Developmental Psychology from The University of Akron in Ohio and completed postdoctoral fellowships at the Duke University Medical Center in Neuropsychology and Geriatric Evaluation & Treatment.

Throughout his distinguished career, Dr. Schmitt has developed and evaluated statistical methodologies for the early detection of Alzheimer’s disease—and for the statistical assessment of various treatment interventions.

A prolific researcher with over 150 publications, Fred’s research interests are in the areas of dementia, Alzheimer's disease, neurocognition testing, clinical trial assessments and biostatistics.

As a clinical scientist, Fred’s primary focus is on the evolution of dementia—especially for aging, HIV, and epilepsy populations. He was the first to demonstrate the impact of HIV on neurocognition, and the response of CNS functions to antiretrovirals (AZT, NEJM, 1988). Fred recently worked with Eisai, Pfizer, Wyeth and others on the design of testing protocols for clinical trials that evaluated new drug therapies for cases of dementia and MCI.

Over his career, Fred has served many organizations that are furthering research in dementia. For example, over the last ten years, he served on the National Institute on Aging: Special Emphasis Panel on Clinical Trials. Before that, he served as the Chair of the Alzheimer’s Disease Cooperative Study (NIA)/Severe Impairment Committee—working on the development of neurocognitive assessments for advanced dementia. And, he was advisor to the AIDS Clinical Trials Group, and to the NIMH Office of AIDS Research.

At the University of Kentucky, Fred also serves as a co-director of the Memory Disorders Clinic and as co-director of the Biostatistics and Data Management Core at the Alzheimer's Disease Research Center /UK Medical Center.

 

Soo Borson, Md

Soo Borson is a Professor of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine and is the Director of the University of Washington Medical Center’s Memory Disorders Clinic.

Dr. Borson is a graduate of Stanford University’s School of Medicine. She completed her residency at the University of Washington’s Psychiatric and Geropsychiatric Programs and is board certified from the American Board of Psychiatry and Neurology (subspecialties in Geriatric Psychiatry and General Psychiatry). Soo is a Fellow of the Hedwig van Ameringen Executive Leadership Program in Academic Medicine.

Soo’s clinical interests focus on diagnosis and treatment of dementias. Her research activities bridge clinical neuroscience and health services—focusing principally on improving early diagnosis and comprehensive care for cognitive disorders of late life.

A prolific publisher (hundreds of articles) and lecturer on depression and dementia (grand rounds, symposia and continuing education)—and a core investigator in the Alzheimer’s Disease Research Center—Soo has provided leadership and service to many organizations throughout her career, including serving as past Chair of the NIMH Mental Disorders of Aging/Initial Review Group, past President of the American Association for Geriatric Psychiatry, and past President of the Geriatric Mental Health Foundation. She currently serves as senior editorial advisor to the American Journal of Geriatric Psychiatry and is Associate Editor (Neuropsychiatry) of the Journal of the American Geriatrics Society.

 

Kenric Hammond, Md

Ken Hammond serves as Director of the Postdoctoral Fellowship in Medical Informatics, and Staff Psychiatrist at the VA Puget Sound Health Care System, American Lake Division in Tacoma, Washington. He holds Joint Clinical Associate Professor positions in the Division of Biomedical Informatics (Department of Medical Education) and in the Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine.

Dr. Hammond received his MD from the University of California at San Diego, School of Medicine, La Jolla, CA. His post-graduate training (psychiatry) was taken at UCSD’s School of Medicine, University Hospital, San Diego County, CA. and at Mt. Sinai Hospital, University of Toronto, Canada. He is board certified from the American Board of Psychiatry and Neurology with a subspecialty in Psychiatry and took a postdoctoral fellowship in Medical Informatics. His A.B., cum laude, was in Biochemical Sciences, Harvard College, Cambridge, Massachusetts.

Ken’s clinical interests include using data, systems and computer applications to improve the effectiveness of medical organizations and to enhance patient care.

For the last 20 years, in addition to serving in many regional capacities at the VA, Ken has served the VA nationally. He was Chairman, VA DHCP Mental Health Expert Panel, where was responsible for the design and oversight of the development of DVA Mental Health computer applications, and was Chairman, VA DHCP Treatment Planner Task Force.

Ken has served as PI, co-investigator and consultant to many VA-funded projects, and has authored nearly 60 articles and abstracts.

 

William R. Leahy, Md

Over the last thirty years, Bill has been a physician partner with Neurological Medicine, P.A., a six person neurology practice in Maryland. His practice deals with the care of adults and children with neurologic illnesses. Many of the medical conditions that Bill treats are epilepsy, stroke, headaches, and attention deficit in children. In addition to his practice responsibilities, Bill serves as Adjunct Associate Professor at Johns Hopkins Department of Neurology.

Dr. Leahy received his MD Northwestern University, with further training at Children's Memorial Hospital, Chicago. Later, he served as a research assistant in neurochemistry at the National Institutes of Health and did his residency in neurology at Johns Hopkins.

Dr. Leahy is board certified in Pediatrics and Neurology with specialty in Child Neurology, is a Fellow in the American Academy of Neurology, and has served as an examiner for the board examination process. His undergraduate work was at Princeton.

Bill has authored over 30 scientific and clinical articles and book chapters in neurology, and has served on community health and educational committees. He is Chairman of the Division of Neurology at Prince George's Hospital Center, and has served as Chairman of the Division of Quality Assurance at Doctors' Community Hospital.

Bill is the author of a textbook, Providing Home Care, now in 3rd edition, a text used in over 400 programs in the country. His newest book, Caregiving at Home, was written for baby-boomers caring for parents and loved-ones at home.

 

Ann Vander Stoep, Ph.d

Ann Vander Stoep serves as Associate Professor of Psychiatry & Behavioral Sciences (primary department) and as an Associate Professor of Epidemiology at the University of Washington’s Schools of Medicine and Public Health. A psychiatric epidemiologist, Ann teaches Psychiatric Epidemiology and Biostatics at the graduate level at the University of Washington.

Dr. Vander Stoep received her PhD in Epidemiology from the School of Public Health and Community Medicine, University of Washington. Her BA is in Human Biology, Stanford University.

Dr. Vander Stoep conducts community-based studies to identify antecedents and outcomes of psychiatric disorders, and she had undertaken research that tests various interventions and health service models that were designed to improve the mental health status of individuals and populations. She also serves as Co-Director of the Developmental Pathways Research Program at the Child Health Institute and is a member of the Community Oriented Public Health Practice.

Her research uses epidemiological methods that address questions about the phenomenology, etiology, and outcomes of child and adolescent psychiatric disorders—and includes such issues as the developmental epidemiology of adolescent depression, the transition to adulthood for adolescents with mental illness, the development of depression and conduct problems for adolescents, the mental health status of children in the juvenile justice system, and the evaluation of school and community-based mental health interventions.

Ann has written journal articles about attention-deficit/hyperactivity disorders in children and adolescents, eating disorders, emotional health of middle schoolers and the role that adolescent psychiatric disorders play in failure to complete secondary education.

 

Mehendra Upadhyaya, Md

Mehendra Upadhyaya is Staff Physician at the North Texas VA Health Care System, Outpatient Mental Health Clinic. He also holds an appointment as Assistant Professor, Department of Psychiatry, U.T. Southwestern Medical Center, University of Texas.

Dr. Upadhyaya received his MD from the Gujarat University, Ahmedabad, India, and took his residency training in Psychiatry, Department of Psychiatry at Southwestern Medical Center, University of Texas at Dallas. His post-graduate training was in Geriatric Psychiatry at GRECC, VA Medical Center and at the University of Washington, Seattle, WA. He is board certified from the American Board of Psychiatry and Neurology with a subspecialty in Adult General Psychiatry and Geriatric Psychiatry.

Mehendra’s research interests include psychiatric manifestations of neurological disorders in the elderly, the pharmacology of novel anti-psychotic drugs, depression in the medically ill (elderly), ECT, and health service issues in geriatric psychiatry.

Over the last twenty years, Mehendra has served adult patients and the elderly in private, academic, homeless, mentally ill and long term care communities in health care systems in India, Scotland, Ireland and the USA. He has co-managed the geriatric psychiatry clinic and the long-term care services of the Department of Psychiatry at the University of Washington, Seattle, WA, and has directed the geriatric psychiatry services of a large not-for-profit health care system in West Texas. Mehendra has written numerous articles on psychiatric and neurophyschiatric disorders.

 

Screen In The World

Screen Inc was initially financed with $880,000 in grant support from the VA and the National Institute on Aging. That support was used to develop the tests, study ways to optimize their usability in doctors’ offices serving elderly patients, and then study the validity and reliability of the final tests. The result is a top-rated test battery already available to physicians in several countries and several languages so they can essentially “outsource” the memory testing of their patients. Screen’s tests are currently available in American English, country-specific English versions for Canada and England, American Spanish, Spanish for Argentina, and Portuguese for Brazil.

In response to greater numbers of requests for memory testing by patients, and encouraged by the allowance of physician fees for CNS Assessments/Tests, memory testing is rapidly increasing in geriatric healthcare across America. Screen has expanded to meet this increase in demand.