New horizons in frailty identification via electronic frailty indices: early implementation lessons from experiences in England and the United States.

Frailty represents an integrative prognostic marker of risk that associates with a myriad of age-related adverse outcomes in older adults. As a concept, frailty can help to target scarce resources and identify subgroups of vulnerable older adults that may benefit from interventions or changes in med...

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Publicado en:Age & Ageing Vol. 53; no. 2; pp. 1 - 11
Autores principales: Orkaby, Ariela R, Callahan, Kathryn E, Driver, Jane A, Hudson, Kristian, Clegg, Andrew J, Pajewski, Nicholas M
Formato: Artículo
Publicado: Oxford University Press / USA Feb2024
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2024
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      pub: Oxford University Press / USA
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        atl: New horizons in frailty identification via electronic frailty indices: early implementation lessons from experiences in England and the United States.
      aug:
        au:
          Orkaby, Ariela R
          Callahan, Kathryn E
          Driver, Jane A
          Hudson, Kristian
          Clegg, Andrew J
          Pajewski, Nicholas M
        affil:
          New England Geriatric Research , Education, and Clinical Center (GRECC), VA Boston Healthcare System , Boston, MA , USA
          Division of Aging , Department of Medicine, Brigham & Women's Hospital, Harvard Medical School , Boston, MA , USA
          Section on Geriatrics and Gerontologic Medicine , Department of Internal Medicine, Wake Forest University School of Medicine , Winston-Salem, NC , USA
          The Improvement Academy, Bradford Institute for Health Research , Bradford , UK
          Academic Unit for Ageing & Stroke Research, University of Leeds, Bradford Teaching Hospitals NHS Foundation Trust , Bradford , UK
          Department of Biostatistics and Data Science , Division of Public Health Sciences, Wake Forest University School of Medicine , Winston-Salem, NC , USA
      su:
        England
        United States
        Medical screening
        Public health
        Human services programs
        Elder care
        Frail elderly
        Conceptual structures
        Electronic health records
      sug:
        subj:
          Medical screening
          Public health
          Human services programs
          Elder care
          England
          United States
          Continuing Care Retirement Communities
          All Other Miscellaneous Ambulatory Health Care Services
          Health and Welfare Funds
          Frail elderly
          Conceptual structures
          Electronic health records
      keyword:
        deficit accumulation
        electronic health record
        electronic medical records
        frailty
        implementation science
        national health service (uk)
        older adult
        older people
        population health management
        deficit accumulation
        electronic health record
        electronic medical records
        frailty
        implementation science
        national health service (uk)
        older adult
        older people
        population health management
      ab: Frailty represents an integrative prognostic marker of risk that associates with a myriad of age-related adverse outcomes in older adults. As a concept, frailty can help to target scarce resources and identify subgroups of vulnerable older adults that may benefit from interventions or changes in medical management, such as pursing less aggressive glycaemic targets for frail older adults with diabetes. In practice, however, there are several operational challenges to implementing frailty screening outside the confines of geriatric medicine. Electronic frailty indices (eFIs) based on the theory of deficit accumulation, derived from routine data housed in the electronic health record, have emerged as a rapid, feasible and valid approach to screen for frailty at scale. The goal of this paper is to describe the early experience of three diverse groups in developing, implementing and adopting eFIs (The English National Health Service, US Department of Veterans Affairs and Atrium Health—Wake Forest Baptist). These groups span different countries and organisational complexity, using eFIs for both research and clinical care, and represent different levels of progress with clinical implementation. Using an implementation science framework, we describe common elements of successful implementation in these settings and set an agenda for future research and expansion of eFI-informed initiatives.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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