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Hey, everyone. Welcome back to The Testing Psychologist podcast. I’m here with you for another clinical episode. Today, I am talking with Test [00:01:00] Developer, Dr. Andrey Vyshedskiy and Customer Solutions Director, Kevin Wolfe. They are the lead folks at Boston Cognitive.
You may have heard of the Boston Cognitive Assessment. It is a brief cognitive measure for adults to determine whether there’s evidence of cognitive decline and reason for a more thorough battery. So if you’re in a practice working with adults, this can be cool tool. I tried it myself. It’s pretty elegant administration.
We get into a lot of details around Boston Cognitive. We talk about the development, norm and standardization, clinical use cases, billing, anything that you might want to know about trying this measure. Of course, the hope is that it may fit into your practice.
Let me tell you a little bit about the guests and then we’ll get to the conversation. Dr. Andrey Vyshedskiy got a PhD in Neuroscience from Boston University. He’s conducted [00:02:00] research in neuroscience, cardiopulmonary acoustics, optical vibrometry, and developmental psychology.
He’s co-founded several successful companies, received numerous awards from the NSF, the NIH, and the DOD, and directed the development of several FDA-approved medical devices. He has authored over 100 scientific publications, book chapters, and conference presentations. His work has appeared in the New England Journal of Medicine, Thorax, Chest, the Journal of Neuroscience, and other leading scientific journals.
His partner here, Kevin Wolfe, is the Director of Customer Solutions at Boston Cognitive. As you will hear on the episode, there’s a discount code for our users. It’s TESTPSYCH50. That’ll also be in the show notes, but you can email Kevin to learn how to get started with Boston Cognitive and make sure to get that code applied.
Like I said, this is an interesting discussion. I know very little about the area of test [00:03:00] development, so being able to have a conversation with folks who have done that is always intriguing to me. I think you’ll be interested to hear the use cases for this measure and how it might fit into particularly a practice that specializes in adult neuropsychology.
At this point in time, this should release in late December. So there may still be some spots or availability for The Testing Psychologist mastermind groups, which start in mid-January, late January, 2025. These are group coaching experiences for folks any level of practice development. You can get more information and sign up for a pre-group call at thetestingpsychologist.com/consulting.
In the meantime, I will present to you my conversation with Dr. Andrey Vyshedskiy and Kevin Wolfe.
[00:04:00] Andrey, Kevin, welcome to the podcast. First of all, when I have multiple guests, I always like to have folks just say a little bit about yourselves so that people can orient to your voice. They’ve already heard the full introduction so they have a good idea, theoretically, of who you are, but let’s, like I said, give them a chance to orient to your voice. So Kevin, if you want to go first.Kelvin: Hi, this is Kevin Wolfe. I’m the Sales Manager at Boston Cognitive. I came across their technology about a year ago and we are launching it to the commercial market with great success. I look forward to [00:05:00] more psychologists becoming aware that it’s there.
Dr. Sharp: Fantastic. Andrey.
Dr. Andrey: Hi, this is Andrey Vyshedskiy. My background is neuroscience. We developed this cognitive. assessment about 5 years ago. We spent a lot of time on it and we’re proud that it is finally finds interaction
with a lot of clinicians and researchers.
Dr. Sharp: Awesome. Yes. I’m glad to have you guys here on the podcast to talk about Boston Cognitive. It’s a really interesting measure. I think it occupies a unique space in the field that a lot of people are trying to occupy. So I’m really interested in a more in depth discussion here about the measure.
I’ll start with the question that I always start with for folks, which is, why this? Out of all the things you could do with your time and energy in this field, why are you putting all of your [00:06:00] time and energy into this particular pursuit? Maybe Andrey, you can start.
Dr. Andrey: Absolutely. The history of the development of this assessment is very interesting. We’ve been conducting observational clinical trial of a novel intervention for Alzheimer’s and we needed a tool to measure cognition online virtually, and there was really nothing available. We had to create our own tool.
We spent probably three or four years thinking carefully and developing this measure, Boston Cognitive Assessment, and then we used it inside our observational clinical trial, which was successful. [00:07:00] We wanted an assessment that’s about 10-minute-long, that goes through multiple domains and that people feel comfortable with, people feel fun almost playing with it. So that’s what we’ve done.
Dr. Sharp: Yes. Kevin, how about you?
Kelvin: My story is a bit more personal. My father passed away last July from heart failure. He had moderate to severe dementia. He had been declining for years. I begged my mother to not let him drive anymore. I would not ride in the car with him. His primary care physician never tested him once, his cardiologist never said anything, and my mother to this day maintains dad did not have dementia because it wasn’t on his test.
We have 10,000 Americans a day turning 65. The need for [00:08:00] an efficient, accurate, reputable assessment is needed more than ever. And so my mission is to try and get primary care physicians to further to neuropsychology, to neurology, get those patients tested, and get them the appropriate interventions.
Dr. Sharp: I think that personal component, I would imagine a lot of people can identify with that just as our parents or grandparents or siblings now at this point are aging into that cohort. It’s just growing larger and larger, the number of folks who might need something like this.
Let’s go back to the beginning. I would love to have some insight into the development process. I have a sense of [00:09:00] how you came up with the idea, but how you even got started on developing something like this. We can dive into some details as we go along.
Dr. Andrey: That is very interesting. We started with many possible cognitive tasks that we can try. They were about maybe 20 or more. I still have a file with all of them saved. Slowly but surely, some of them are unusable in a virtual administration environment.
The context is very important. This is a self-driven, self-motivated test, so we have to be very clear on the directions. We have to be almost entertaining [00:10:00] to a participant. So we got rid of everything that didn’t fit. And what we’re left with are eight domains that are very relevant, almost orthogonal, and provide different aspects of cognition. On the other hand, the test is not long. It’s 10 minutes, so it’s manageable.
We aimed for 10 minutes, particularly for the purposes of being able to assess memory. At the beginning of the test, we provide five names of animals. We make sure that a participant remembers those animals, but that is the short-term memory. [00:11:00] That is the memory that is only dependent on the neocortex and independent of the hippocampus, but what we really want to test, we want to test the hippocampal function.
And so at the end of the assessment, in about 10 minutes, we come back and ask the same five animals, and the magic happens. Most people can easily remember all five animals. When people cannot remember one or two or three animals, that’s a good sign that something happens to the hippocampus.
And that is reflected in the score. And the score can be measured longitudinally over time. And that creates an opportunity to try novel treatments and look at the effect of [00:12:00] different lifestyle changes.
So being able to do this test every week or even every day creates an excellent context, excellent feedback tool for you to try to improve your life, improve your diet, improves your social connections, and maybe cognitive involvement and so on, and see how your global cognition changes over time.
Dr. Sharp: I like that we’re dipping into the structure of the measure of the test. Let’s provide a little bit more context for folks just so they know exactly what we’re talking about. You’ve mentioned that it’s self-administered and it’s relatively short. I should have asked on the very beginning, but give me the big picture overview, what is the Boston [00:13:00] Cognitive and what can clinicians expect when they look at it?
Dr. Andrey: The test starts, as I mentioned, with short-term memory test with these five animal names. And then it continues to a language measure that measures language comprehension ability in participants.
I should say that every item in the test is gradually increasing in difficulty. For the language test, there will be 5 steps of difficulty. And then after the language test, there is a mental rotation, so that measures the ability of the lateral prefrontal cortex to control the posterior cortex, and that comes in [00:14:00] 5 steps.
I also should say that every item is preceded by the training item. So participants are trained on the simplest possible variation of that item. So participants are trained and then there are five levels. So that’s the third domain. The fourth domain is attention. We are asking participants to repeat numbers forward and backward in multiple steps of difficulty.
Another domain is arithmetic domain. We’re going through multiple levels of difficulty in mental arithmetic. And finally, there is orientation domain. We check if the participant [00:15:00] remembers the year, the month, and the day of the week. The final is the launch of memory where we ask the participant to recall the five animals that were presented in the first item.
Dr. Sharp: How do you arrive at these specific domains and tasks?
Dr. Andrey: We started with about 30 different tasks and then we expelled everything that is hard to measure online. Basically, whatever left is whatever can be used online, technologically. So these are the eight best.
Dr. Sharp: The thing that caught my eye is the self-administration. [00:16:00] Maybe one of you could talk a bit about that, just the delivery method and the idea that it’s delivered on a phone or tablet or computer maybe, I’m guessing a little bit here. You can speak to that.
Kelvin: Certainly. That’s actually part of what really interested me in their technology when I found them is that there’s zero computer skills required. A lot of people think it’s actually AI, it’s not, it’s just really well written because right from the get go on the sound check, the software makes sure that you can hear the instructions clearly.
It gives you have a random number. If you could get the number, obviously you could hear what’s going on. And then essentially you simply listen to the verbal instructions which are very clear, and then you choose the most appropriate answer, one right after another.
It’s something that my 81-year-old mother can do even though [00:17:00] she struggles with texting these days. When she took it, she didn’t have any problems following the instructions and cleaning the assessment.
She was absolutely thrilled to find out even though she’s a little compromised, she is above normal for her age. So that’s something I hope we’ll get a chance to elaborate on. It’s not just a raw score because that cannot tell the whole story. Would you agree, Andrey?
Dr. Andrey: Yes, absolutely. What we do, we have a model that compares the raw score to your peers of the same age, same gender, and comes up with a percentile. Percentile is much more informative; the raw score is much less informative. So who cares if you’re 25 or 24 out of 30, if you are better than 99% of your peers, [00:18:00] who are considered cognitively normal, then you are in a good shape.
Dr. Sharp: Sure. Maybe we could detour for just a bit into that aspect of the development; the standardization sample or how you came up with the norms. What did that component of development look like for test measure?
Dr. Andrey: We always start with a lot of participants. You get students to test all the participants they can find. And this is the paper that we published in BMC Neurology. In that paper, we compared BoCA to MoCA. [00:19:00] We looked at the influence of age and education in BoCA and we didn’t find any or very little. So BoCA is not influenced by age or education much.
And then we created norms out of that data. We used that norms to generate a model to calculate percentile. When you finish the test, you get a report with all your domains and the total score placed on the bell curve. So you are visually seeing where you are on the bell curve compared to your peers of the same age and same gender.
Dr. Sharp: I love that. So is it coming up with a standard score in addition to the percentile or is it a [00:20:00] different metric?
Dr. Andrey: Raw score, standard score, and the percentile.
Dr. Sharp: Got you. That was one thing that jumped out to me because I got the sample of the test. I still don’t know how I compared my peers because I apparently didn’t complete it appropriately, but I will do that. I was struck by how easy it was to complete.
And like you said, Kevin, it’s a really elegant design just from a software standpoint as someone, I’m a co-owner in a software business now and understand how hard it can be to make this look really good and function really well. And it does both of those things. I pass along some congratulations to the development team and everybody involved in that, because it looks great and it’s easy to administer and understand, which is fantastic.
Dr. Andrey: Thanks, Jeremy. It was not easy.
Dr. Sharp: Software is not easy. [00:21:00] That’s a statement. Yes. So tell me, how do you decide, because that generates a whole, gosh, host of issues or hurdles to get over when you decide to administer something in-house or have someone be able to self-administer a measure on their phone without a clinician involved? So tell me about the decision-making process there and how you solve some of those problems of making sure people could understand the test like software or hardware issues. I’m curious about that whole process.
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Dr. Andrey: You make all the buttons big. That’s the most important thing; make buttons bigger. There is redundancy between verbal instruction as well as written instruction as well as very intuitive interface and participants being able to confirm their choice. So participants on most tasks have to click twice to confirm their choice before the results are submitted.
[00:24:00] The training level is very important because, for every item, we have a training level where participant can take this level as many times as participant needs until that training is passed. We do not use the results of training to calculate total score. So these are small things that have to be right, but as always, all these small things together make a difference.Dr. Sharp: Yeah, they absolutely do. Tell me about the use case a little bit. How is this coming into play in the real world? How are clinicians using it? We’ll talk about billing, of course.
Dr. Andrey: I’ll introduce Kevin just a second. What happened historically is that the test was created first and then we [00:25:00] created an environment around this cognitive test, the portal. I’m sure Kevin is eager to tell us about the portal.
Kelvin: Yeah, so going from research that it was originally designed forward to something that functions really well in a clinical environment, that was part of my role. I’ve been in medical sales for about 25 years. I’ve been behind the front desk of many clinics and I know what type of search functions they’re going to want.
I know they’re going to want to be able to do a bulk upload of their patients, making things really easy to implement in a practice. Even that part of it takes very little instruction. My training sessions are 10, 15 minutes long and you’re up and running with both. So they’re very simple to implement in your practice.
When it comes to psychologists, when you ask them, how is it being [00:26:00] used? The value seems to be in getting the patient to take an accurate test prior to coming in that will give you an understanding of what’s really going on with that patient right now. Does this look like one of the worried well who had complaints to their primary care physician? And then now do you really want to block out four hours of your day or what are you going to do with this patient?
We have some really good quotes on our website from psychologists on how they’re using it, and it’s really determining where that patient is at and what further tests do we want to set up before the patient walks through the door to save time and make the most efficient use of your appointment.
Dr. Sharp: That’s another interesting component here. I wanted to clarify with y’all, when I hear, okay, they take this before they come into the office, I [00:27:00] wonder, so do you see this as like a screener or a full-fledged measure? How does this fit in the neuropsychologist arsenal of tests, so to speak?
Kelvin: I would say, yes, it’s a bit of a screener for the worried well but also it’s scientifically valid and it’s going to provide you useful information on eight cognitive domains. As I mentioned earlier, for some primary care physicians who aren’t qualified to do full neuropsychological testing, it gets enough information that when they refer that patient, they have a valid reason other than patient complaint to send that patient over to you.
They have that numerical score that your primary care physician wants. They’re used to seeing the blood pressure readings to know to prescribe the medication, et cetera. They need that very easy out-of-the-box solution [00:28:00] to have clinically appropriate referrals to neurology and neuropsychology.
Dr. Andrey: I should also mention that all the items, all the tasks in the test are created dynamically. And so they do not repeat from one administration to another. So unlike MoCA, for example, BoCA can be taken every day and there is no learning effect. This is another thing that we published.
So it can be used as a screener first before patients arrive at the door, but then it can be used again in the office to confirm the global assessment or it is very useful to be used in any clinical trial that is trying new treatment because you can do this test every week and see [00:29:00] changes of the score over the time course. Also in intervention.
Dr. Sharp: Does the software have anything built in to do statistical comparison between results from week to week or month to month or anything like that? How does a clinician know if functioning has changed significantly?
Dr. Andrey: Every report has a graph of the total score and every domain over time, day by day. And that can be used to figure out what is going on with the with this score.
Dr. Sharp: I see. Yes. So maybe it’s up to us to look at it and say, okay, this has changed by a standard deviation over six months or something like [00:30:00] that.
Kelvin: Right. A longitudinal graph is what we provide, so no actual statistics, but you can see the comparison obviously down, up, flat.
Dr. Sharp: Right. Yes. This raises all kinds of questions about billing as well. I’m sure clinicians out there are thinking, okay, how do I get reimbursed for this time? So maybe we could speak to that for a bit. How does this fall in the whole billing world?
Kelvin: It falls under 96132 for the provider and that has the minimum number of minutes spent reviewing the results, speaking to the patients, a case of primary care doctors making referrals out to neuropsychology or neurology, making those [00:31:00] conversations with family would be appropriate and done for depending on whether it’s administered by a technician or a clinician, the 96138 would be appropriate.
Dr. Sharp: Okay.
Kelvin: No CPT codes.
Dr. Sharp: I got you.
Kelvin: The main difference is; we’re only going to have one unit. It’s not four to six hours. It’s not going to be more than a unit.
Dr. Sharp: Of course. You mentioned the feedback with the family. Are you finding that most clinicians are doing feedback or discussion of results after each instance of taking the test? Maybe that’s a bigger question. I’ll step back even one layer further and talk about clinician involvement throughout this process. So how is the clinician introducing the test and then [00:32:00] guiding through the test, answering questions about the test, and then discussing results after the test?
Kelvin: I guess I’d like to clarify, are you referring to primary care physicians or psychologists?
Dr. Sharp: That’s a good question. I don’t know a ton about how primary care, maybe we talk about the primary care aspect first and then if it’s different for neuropsychologists, we could talk about that as well.
Kelvin: So in the realm of primary care, they don’t have a lot of training in this area, yet they’re the ones that are touching all these patients. So what we have is a free four-question subjective screen that they can screen every patient as they come through the clinic.
Medicare guidelines do require primary care physicians to do an annual cognitive screening. But then if the patient has out of the four questions, three of them in the positive direction, does [00:33:00] that still mean that they’re experiencing cognitive impairment?
What’s interesting is we took a look at initial data and the patients who are scoring as impaired on the raw score with BoCA had an average of 1.6 of the subjective questions in the positive direction, while patients who still scored in the normal range on BoCA had an average of 2.4 questions in the positive on the subjective screen.
So that’s what’s interesting. That’s the challenge that the primary care is facing, is this a worried well, or is this somebody who really needs a referral? So we’re trying to provide that triage. You’ve got the free screen. If there’s questions in the affirmative, do the objective validation with BoCA. Let’s give them a clear-cut point, yes for sure, no, you’re fine for now, we can revisit this in a year or two if you still have concerns.
So that’s how it’s being used in the [00:34:00] world of primary care. If you go to the website, you’ll also see that we have a cognitive care plan software which is an additional step primary care doctors can do where they are doing things like questions about a drive and evaluation, safety at home, number of falls, things that would fall into that primary care world. And so it’s a screen measure that manages the approach for primary care.
What I’m hearing from the psychologist is they like to prescreen the patients before they come in to help prepare for the initial visit. That’s the primary role of BoCA for psychology.
Dr. Andrey: I should also mention the logistics of test administration. So in some offices, they use a dedicated iPad. They go in their portal or they go into the patient, click the button start test on this [00:35:00] device and boom, the BoCA starts on this iPad. They give iPad to the patient and patient can complete whole BoCA assessment right there.
In other practices, they are preferring to use patient’s device and so our portal has a button, send patient an SMS with BoCA link. And so when a clinician or the technician is clicking that button, the patient receives an SMS with the link to the test. They click on the SMS. The test opens on the patient’s iPhone or Android inside their own browser and they can use their own phone to complete the test.
We have measured the [00:36:00] performance on the smartphone versus larger screen like an iPad, a laptop, and there is no difference.
Dr. Sharp: That’s great.
Dr. Andrey: So people can do it on their own smartphones and the results are the same.
Dr. Sharp: I think that’s one of the benefits. It’s easy to administer. It’s really easy. I get there is the requirement that someone can operate a smartphone or a tablet, but it seems we’re getting to the point where that’s a pretty low bar to clear.
I’m thinking of my own parents who are in their early 70s and are very smartphone literate at this point. I think we’re getting to that point where the older generation is, growing up with smartphones over the last 15 years or so, they’ve had some time to practice. So that cohort of folks who don’t know how to operate a smartphone is getting [00:37:00] smaller and smaller over time. Great.
There are so many advantages of this. Where have y’all seen the most success? If there are any types of practices that you found are really benefiting from it. And then on the flip side, we could talk about practices where it may not be a great fit as well, but let’s start with the ones that seem to really be benefiting.
Kelvin: The feedback I’m getting from providers in the field is that it’s a huge time saving device. Most providers already have a backlog of six months or more. The ability to triage patients, I’ve got to get this patient in and it looks like they’re going to need a little bit more time versus this patient looks more like the worried well.
As far as where it’s not being used, I think they just haven’t heard about this yet. [00:38:00] I haven’t had anyone say I tried this in my practice and it just isn’t a fit. It’s one of those things that there seems to be a level of excitement around BoCA that it makes us very optimistic for where we’re going in the next two years, just based on the, like I said, we’ve launched just recently in the last six months and we’re getting initial feedback and it’s highly positive, is the word I’m going to use.
Dr. Sharp: Right. Let me ask a question I should have asked way back, but what is the age range for the BoCA?
Kelvin: Andrey?
Dr. Andrey: Yes. We have norms for BoCA starting from 19 years of age, but the test is applicable [00:39:00] to individuals starting from about 7 years of age. I don’t know if there is any reason for a 7-year-old to take it. It would be something like an IQ test, but there is definitely a possibility of taking this test even with children and there is no upper limit, of course.
Dr. Sharp: Okay. Can you clarify just a little bit when you say there are norms down to 19 but it is possible for a 7-year-old to take it? I would ask, what’s the value of having a 7 to 18-year-old take it? Are there norms for them or it’s just a qualitative data point?
Dr. Andrey: I don’t [00:40:00] know. I really never thought about it and nobody asked about it; measuring this in children. All our participants who are adults. I have no idea, but if somebody comes in and interested in monitoring children, that is a possibility as well. I never thought about it.
Dr. Sharp: I don’t know that I have a use case for it in kids either. I was just curious about the normative data. If somebody tried to do it, would it be useful in that way?
It’s got me thinking when you talked about the worried well, Kevin, we got a lot of referrals for “neuropsychological evaluations” for adults from probably 25, 30 years old who were concerned about memory loss or cognitive decline, things like that. And we spent a fair amount of [00:41:00] time.
I think there are a lot of practices out there you probably would know that we are trying to screen these individuals out and figure out do we need to bring them in for a full neuropsychological evaluation? The likelihood that this is actual cognitive decline is very low in a 30-year-old. So what is this about? How do we still help them? Are you seeing some of those?
Kelvin: I wish I was recording that. That’s perfect sales pitch. That’s exactly it.
Dr. Sharp: We are recording this.
Kelvin: But that’s exactly it. If there is something going on, you’ll know it. From the 8 domains, you’ll have an idea of what areas are being most affected and if they still have 30 out of 30, I don’t know.
But what do you do from there clinically? Do you have a conversation with the patient? Do you bring them in for a briefer evaluation and not block out your whole day? Everybody wants to spend their [00:42:00] time wisely and everybody has a massive backlog of patients. So that’s what I’m hoping we can help address first though for psychology and neuropsychology.
Dr. Sharp: Of course. That makes me think about the validity of the results. I know it’s hard to build everything into a short measure like this, but is there any gauge of validity or effort in the measure?
Dr. Andrey: Yeah, we’re working on that. It will come in a year or two. We are in certain methods to measure embedded validity, patient’s effort basically, not yet there, but it will be there.
Dr. Sharp: That’s great to hear. I’m guessing that’s a question a lot of people are wondering about or something like this.
So let me go back. I know I’m bouncing around, but just filling in some gaps here as far as the use case and workflow for this. Theoretically, I’m thinking about our own [00:43:00] practice where we’re booked six months out for evaluations. You said something earlier, Kevin, about uploading patients. So could we theoretically comb through our list and isolate the patients 30 to 50 years old who are booked for a neuropsychological evaluation and send a bulk invitation to take this test before they come in?
Kelvin: That’s a good question. Yes, to the bulk upload of patients. We do not have a bulk delivery system. You click on the name, click on the assessment, click the method of sending. We have three choices. They can take it in front of you in clinic. They can take it via text, SMS, or we could send an email if for some reason you don’t have a cell phone number.
That’s yours to associate. Click on the patient, click on the task, click on the method of delivery, and you’re off and running. And to [00:44:00] that point, would it be an excellent tool for triage? Without question. Absolutely. It’ll help prioritize the patients who really need to get NWC.
Dr. Sharp: That’s a good way to think of it. We started to dip into future directions. Maybe that’s a good note to start to close on. I’m curious, what do y’all have in the pipeline that you can actually talk about? What are you excited about in the next year or two as far as development for the measure?
Dr. Andrey: In terms of the test itself, several things are coming in, budget validity that we just mentioned. New even softer implementation, more pleasant, more gamey, more things that are gamified if you want, that is coming as well. We will continue to improve the [00:45:00] portal, and improve the ability of doctors to manage large number of patients like bulk send, for example, and other features, Kevin.
Kelvin: I’m sorry. I was distracted. I was thinking about a few things I have to mention before we wrap up. One of the things that makes Boston unique is, I think we’re in the pricing, you can start using Boston by going to the website, entering a handful of information about your practice.
And for $99, you have access to four Boston Cognitive Assessments. You can start using immediately. Again, very little training. We have training videos and written directions right there in your welcome email, so getting up and running, it’s [00:46:00] very easy to try it. $99 total risk. If you never use it again, no harm, no foul.
It’s even better than that, for members of your group, there is a 50% discount code. Will that be posted in the notes, Dr. Jeremy?
Dr. Sharp: Sure. Yeah. I’ll always put that in the show notes so people can access it really easily.
Kelvin: And so now we’re down to $49.50. We call it a bundle, just buy a bundle or two to try it out, get started. If it’s working out for you, we do even steeper discounts on a monthly or annual subscription. And that’s further discounted for your group versus the rest of the world.
So we can work with a provider who’s only going to do one or two a month, and we can work for a provider that’s part of a large group who’s going to do 100 of 400 a month. The pricing will be appropriate at every level. So even if you’re a smaller provider, a lot [00:47:00] of software packages you got to buy in, you got to buy in big. We’re the exact opposite when you start for $99 or in your case, $49.50, and it gets even cheaper from there.
Dr. Sharp: Tell me about the pricing a little bit more. Is it a per-usage model or is it a subscription? How does this work?
Kelvin: We sell it in bundles of four. We wanted to give people more than one instance of use so they could see it across multiple patients and try and figure out where does this best fit in their practice and they can buy as many bundles as they will.
So once they sign up, they have to use up to four. You can continue to keep administering BoCA as many as you want throughout the month. At the end of the month, we just run the numbers, if you purchased one BoCA but then you used three more, another 12 assessments, we just bill you for the additional assessments at the end of the month.
You don’t have to do anything extra to keep using it. Make it as simple as possible. [00:48:00] But we also think that most people like to avoid the per-use charge. So we try to come with an even lower price to say, hey, look, if you’d like a flat monthly payment with just use it as you need it, we’ll give you a steeper discount
And if you’re willing to pay upfront for the year, it gets cheaper. So make it really simple to use BoCA often and wherever you feel is clinically appropriate without any additional cost.
Dr. Sharp: That’s fantastic. So then just give me a ballpark of what those monthly and annual subscriptions are.
Kelvin: That is a great question. If somebody is only going to be using it once or twice a month, the hobby, Starbucks money. That’s it. So if it’s 400 and 500 times a month, then obviously it is billable and reimbursable under insurance.
In many cases, we have [00:49:00] psychologists that are doing runoff evaluations for court cases they’re doing, so it’s part of a larger evaluation for many different reasons. It was essentially just value-driven and we will work with anybody to get a price that makes business sense as well as political sense.
Dr. Sharp: That sounds good. It tells me it’s somewhat negotiable. Is that …?
Kelvin: Oh, it’s super flexible. I honestly want to get it out there, get it used. It’s flexible. That’s a great word.
Dr. Sharp: That sounds good. Thanks. As we start to wrap up, what have I missed? I don’t know if there are any other future directions to highlight or components to highlight in the current software before we wrap up.
Dr. Andrey: I can, [00:50:00] go ahead, Kevin.
Kelvin: I don’t know if we got into the fact that it is auto-scored. It’s immediately available. It’s one of those things that patient takes it in the lobby. It’s right there. You’ve got the raw score, the standardized score, the bell curve. At a glance, you know where you’re going next.
So even if you’re doing it as that patient comes in for that first visit, or if you’re doing it from home ahead of time, I think we provide a lot of clinical value with saving you a lot of time. It’s a huge time-saving device, one of the main values.
Dr. Andrey: And the patients feel that they’re taken care of. That somebody does monitor them, technician, and that’s important.
Dr. Sharp: I could see that being an added benefit, sort of an ancillary benefit of just knowing [00:51:00] that they get to take this measure regularly and get a regular check-in from their clinician. There’s a client care aspect there that may feel really good, which brings up another question for me, which is, can you schedule regular sessions or regular administrations of the measure?
Kelvin: Not at this time. As a reimbursable assessment, it is something that has to be ordered by a provider and for a specific reason. If you have a standing order that you want the front desk for here’s the batch of patients that I want tested monthly, great, go for it.
Dr. Sharp: I see. That makes sense. I appreciate you guys coming on. I know there’s so much that we could get into as far as development and experience with the measure, but [00:52:00] from what you’ve said so far and with my personal experience as well, admittedly limited, but it stands out as really easy to take, pretty easy to administer and if it’s reimbursable, that’s fantastic as well. That’s always a key factor for most of us.
So thanks for the time. Thanks for discussing all of this and for sharing the discount code with our audience. I hope that folks will try it out and see if it works in their practice.
Kelvin: I think they’ll be hooked if they try it. So that’s why we want to go really low barrier of entry $49.50. Yes, they’ll know it. I don’t even have to sell it once they try it.
Dr. Sharp: That sounds great. Yes. Thank you guys again. I really appreciate it.
Dr. Andrey: I appreciate the time. Thank you.
Kelvin: Thank you, Jeremy.
Dr. Sharp: All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some [00:53:00] information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes, so make sure to check those out.
If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes, Spotify, or wherever you listen to your podcast.
And if you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have mastermind groups at every stage of practice development; beginner, intermediate, and advanced. We have homework, we have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.
[00:54:00] The information contained in this podcast and on The Testing Psychologist website are intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis or treatment.Please note that no doctor-patient relationship is formed here and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical [00:55:00] provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.