Identifying Frail Patients by Using Electronic Health Records in Primary Care: Current Status and Future Directions

Abstract

With the rapidly aging population, frailty, characterized by an increased risk of adverse outcomes, has become a major public health problem globally. Several frailty guidelines or consensuses recommend screening for frailty, especially in primary care settings. However, most of the frailty assessment tools are based on questionnaires or physical examinations, adding to the clinical workload, which is the major obstacle to converting frailty research into clinical practice. Medical data naturally generated by routine clinical work containing frailty indicators are stored in electronic health records (EHRs) (also called electronic health record (EHR) data), which provide resources and possibilities for frailty assessment. We reviewed several frailty assessment tools based on primary care EHRs and summarized the features and novel usage of these tools, as well as challenges and trends. Further research is needed to develop and validate frailty assessment tools based on EHRs in primary care in other parts of the world.

Higher Hospital Frailty Risk Score Is Associated With Increased Risk of Stroke: Observational and Genetic Analyses

“…Using frailty assessment tools based on EHRs may bridge the gap between frailty research and clinical frailty assessment. 47–49…”

“…Using frailty assessment tools based on EHRs may bridge the gap between frailty research and clinical frailty assessment. [47][48][49] Similarly, a formal quantification of frailty in patients with stroke could be helpful in the design, execution and analysis of clinical trials evaluating novel treatments for stroke, complementing the notion of chronological age with information about the clinical status of patients.…”

Frailty Assessment in the Older Adult Surgical Patient—Crucial Questions for the Future

“…Although several validated frailty assessment tools exist, screening has not been routinely implemented. Potential reasons include the large variety of frailty assessment options, each with different constraints or goals depending on the setting, and the increased workload required to complete the questionnaires or physical tests . Use of the electronic health record (EHR) has been proposed for frailty assessment on an individualized and system-based level .…”

“…Potential reasons include the large variety of frailty assessment options, each with different constraints or goals depending on the setting, and the increased workload required to complete the questionnaires or physical tests . Use of the electronic health record (EHR) has been proposed for frailty assessment on an individualized and system-based level . Hall and colleagues present a timely and relevant study adding to the limited body of literature regarding the feasibility and implications of a system-based EHR best practice advisory (BPA).…”

“…2 Use of the electronic health record (EHR) has been proposed for frailty assessment on an individualized and system-based level. 2 Hall and colleagues present a timely and relevant study 3 adding to the limited body of literature regarding the feasibility and implications of a system-based EHR best practice advisory (BPA). The BPA generates a Risk Analysis Index (RAI) score to diagnose frailty and potentially reduce late-term mortality following elective surgery.…”