Date of Publication


Project Team

Advisor: Mary Val Palumbo DNP, APRN, GNP-BC



When the Coronavirus pandemic reached the United States in March 2020, many healthcare services moved to telehealth delivery. For patients with cognitive impairment, the Mini Mental Status Examination (MMSE) moved from traditional face-to-face assessment to telehealth testing in one Vermont specialty clinic. The aim of this DNP project was to provide quality assurance of this method prior to implementation of the MMSE Version 2 that would follow a similar telehealth protocol.


To assess MMSE quality administered via telehealth, a retrospective chart review of patients (n=30) seen between April 2020 and September 2021 was completed. Linear regression calculated the slope for each patient’s MMSE score per unit time to compare the face-to-face and telehealth rates of cognitive decline for each individual. A paired t-test was used to compare MMSE slope for face-to-face and telehealth assessments.


The difference in individual rate of decline from in-person to telehealth MMSE assessment was not statistically significant (p=0.07). These results suggest individual rate of decline was consistent between telehealth and face-to-face MMSE assessment. The characteristics of individuals for whom measurement of cognitive capacity via telehealth does not match the predicted decreasing trend, informed the development of a protocol for conducting the MMSE Version 2 via telehealth which is the focus of this DNP project.


Telehealth cognitive assessment using the MMSE appropriately follows the predicted rate of individual decline when compared to face-to-face assessment: therefore, it is reasonable to develop the MMSE Version 2 protocol for telehealth administration and perform subsequent quality review.

Document Type