Using an Electronic Comprehensive Geriatric Assessment and Health Coaching to Prevent Frailty in Primary Care: The CARES Model

Garm, Antonina; Park, Grace H; Song, Xiaowei

doi:10.21767/2471-299x.1000051

Cited by 9 publications

(14 citation statements)

References 32 publications

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“…Targeting several end-users, such as patients, care givers, and health professionals, it provides a small set of scales for the assessment of the mental, functional and frailty states. Finally, the work by Garm et al [ 53 ], although not a mobile application, is worth mentioning since it proposes a system that, even though it does not fully support all the envisaged dimensions of CGA, explicitly proposes a digital alternative to the paper scales and the application of a reduced subset of CGA built around the assessment of frailty (FI-CGA).…”

Section: Mobile Health and Geriatric Patient Assessmentmentioning

confidence: 99%

Geriatric Helper: An mHealth Application to Support Comprehensive Geriatric Assessment

Silva

Felgueiras

Oliveira

2018

Sensors

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The Comprehensive Geriatric Assessment (CGA) is a multidisciplinary diagnosis approach that considers several dimensions of fragility in older adults to develop an individualized plan to improve their overall health. Despite the evidence of its positive impact, CGA is still applied by a reduced number of professionals in geriatric care in many countries, mostly using a paper-based approach. In this context, we collaborate with clinicians to bring CGA to the attention of more healthcare professionals and to enable its easier application in clinical settings by proposing a mobile application, Geriatric Helper, to act as a pocket guide that is easy to update remotely with up-to-date information, and that acts as a tool for conducting CGA. This approach reduces the time spent on retrieving the scales documentation, the overhead of calculating the results, and works as a source of information for non-specialists. Geriatric Helper is a tool for the health professionals developed considering an iterative, User-Centred Design approach, with extensive contributions from a broad set of users including domain experts, resulting in a highly usable and accepted system. Geriatric Helper is currently being tested in Portuguese healthcare units allowing for any clinician to apply the otherwise experts-limited geriatric assessment.

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Section: Mobile Health and Geriatric Patient Assessmentmentioning

confidence: 99%

Geriatric Helper: An mHealth Application to Support Comprehensive Geriatric Assessment

Silva

Felgueiras

Oliveira

2018

Sensors

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“…Likewise, frailty assessments that are electronic but not web-based, such as the EMR data analyses of frailty within the UK and several other countries [ 23 , 38 ], and the frailty assessment within the EMRs [ 26 ], were not included. Other useful but non web-based assessments that may have been excluded can include those that are eimbedded in specific clinical programs or research investigations such as InterRAI, a well-established global initiative, in which a wide-range of embedded functional tools are developed, including frailty scales [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, an electronic frailty index calculation in the Electronic Medical Records (EMR) system has allowed for frailty measures in primary care for millions of older patients in the UK and several other European countries [ 23 , 24 ]. More recently, a computerized frailty measure named the electronic frailty index (eFI) has been constructed based on the electronic Comprehensive Geriatric Assessment (eCGA, a multidisciplinary diagnostic assessment that evaluates many domains of older adults’ health and care needs) [ 25 , 26 ]. Being available in the EMR system and as standalone software that runs on personal computers [ 25 ], the eFI-CGA is time-efficient and cost-effective.…”

Section: Introductionmentioning

confidence: 99%

Web-based software applications for frailty assessment in older adults: a scoping review of current status with insights into future development

et al. 2021

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Background A crucial aspect of continued senior care is the early detection and management of frailty. Developing reliable and secure electronic frailty assessment tools can benefit virtual appointments, a need especially relevant in the context of the COVID-19 pandemic. An emerging effort has targeted web-based software applications to improve accessibility and usage. The objectives of this scoping review are to identify and evaluate web-based frailty assessment tools currently available and to identify challenges and opportunities for future development. Methods We conducted a review with literature (e.g., using MEDLINE databases) and Google searches (last updated on October 10, 2021). Each of the identified web applications were assessed based on eight featured categories and assigned a rating score accordingly. Results Twelve web-based frailty assessment applications were found, chiefly provided by the USA (50%) or European countries (41%) and focused on frailty grading and outcome prediction for specific patient groups (59%). Categories that scored well among the applications included the User Interface (2.8/3) and the Cost (2.7/3). Other categories had a mean score of 1.6/3 or lower. The least developed feature was Data Saving. Conclusions Web-based applications represent a viable option for remote frailty assessments and multidisciplinary integrated care of older adults. Despite the available web-based frailty assessments on the Internet, many missed certain needed features for professional use in healthcare settings. This situation calls for fully comprehensive web-based applications, taking into consideration a number of key functions linking graphical user interface and functionalities, and paying special attention to secure data management.

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“…Employing the eFI-CGA in clinical programs can benefit effective assessment of intervention results. In the Community Actions and Resources Empower Seniors (CARES) clinical intervention evaluation program (47), healthcare professionals develop individualized treatment plans and make referrals to community-based programs based on eFI-CGA results (48,49).…”

Section: Discussionmentioning

confidence: 99%

A Computerized Frailty Assessment Tool at Points-of-Care: Development of a Standalone Electronic Comprehensive Geriatric Assessment/Frailty Index (eFI-CGA)

Sepehri

Braley

Chinda

et al. 2020

Front. Public Health

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Background: Frailty is characterized by loss of biological reserves and is associated with an increased risk of adverse health outcomes. Frailty can be operationalized using a Frailty Index (FI) based on the accumulation of health deficits; items under health evaluation in the well-established Comprehensive Geriatric Assessment (CGA) have been used to generate an FI-CGA. Traditionally, constructing the FI-CGA has relied on paper-based recording and manual data processing. As this can be time-consuming and error-prone, it limits widespread uptake of this proven type of frailty assessment. Here, we report the development of an electronic tool, the eFI-CGA, for use on personal computers by frontline healthcare providers, to collect CGA data and automate FI-CFA calculation. The ultimate goal is to support early identification and management of frailty at points-of-care, and make uptake in Electronic Medical Records (EMR) feasible and transparent. Methods: An electronic CGA (eCGA) form was implemented to operate on Microsoft's WinForms platform and coded using C# programming language. Users complete the eCGA form, from which items under the CGA evaluation are automatically retrieved and processed to output an eFI-CGA score. A user-friendly interface and secured data saving methods were implemented. The software was debugged and tested using systematically designed simulation data, addressing different logic, syntax, and application errors, and then tested with clinical assessment. The user manual and manual scoring were used as ground truth to compare eFI-CGA input and automated eFI score calculations. Frontline health-provider user feedback was incorporated to improve the end-user experience. Sepehri et al. Standalone eFI-CGA Results: The Standalone eFI-CGA software tool was developed and optimized for use on personal computers. The user interface adapted the design of paper-based CGA form to facilitate familiarity for clinical users. Compared to known scores, the software tool generated eFI-CGA scores with 100% accuracy to four decimal places. The eFI-CGA allowed secure data storage and retrieval of multiple types, including user input, completed eCGA form, coded items, and calculated eFI-CGA scores. It also permitted recording of actions requiring clinical follow-up, facilitating care planning. Application bugs were identified and resolved at various stages of the implementation, resulting in efficient system performance. Discussion: Accurate, robust, and reliable computerized frailty assessments are needed to promote effective frailty assessment and management, as a key tool in health care systems facing up to frailty. Our research has enabled the delivery of the standalone eFI-CGA software technology to empower effective frailty assessment and management by various healthcare providers at points-of-care, facilitating integrated care of older adults.

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Using an Electronic Comprehensive Geriatric Assessment and Health Coaching to Prevent Frailty in Primary Care: The CARES Model

Cited by 9 publications

References 32 publications

Geriatric Helper: An mHealth Application to Support Comprehensive Geriatric Assessment

Geriatric Helper: An mHealth Application to Support Comprehensive Geriatric Assessment

Web-based software applications for frailty assessment in older adults: a scoping review of current status with insights into future development

A Computerized Frailty Assessment Tool at Points-of-Care: Development of a Standalone Electronic Comprehensive Geriatric Assessment/Frailty Index (eFI-CGA)

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