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Healthcare Information Standards for Frailty: Why, When and How (2 of 5)

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Trillium II /Focus workshop at Informatics for Health2017: Manchester, April 24-27, 2017
Frailty is an age-related state of vulnerability to the risk of adverse health out-comes after a stressor event. The condition predisposes individuals to progressive decline in different functional domains, leading to falls and fractures, disability and dependency on others, hospitalization, institutional placement and ultimately death. We discuss drivers, challenges and opportunities for healthcare information standards related to frailty in old age in an effort to launch a call for coordinated action across research, policy, and academia. Key issues are selected as the back-drop for this discussion: EHR, patient summaries and frailty in a context of coor-dinated care enabled by health IT standards.
Presentation 1 of 5: Silvina Santana University of Aveiro

Published in: Health & Medicine
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Healthcare Information Standards for Frailty: Why, When and How (2 of 5)

  1. 1. Silvina Santana, University of Aveiro Frail elder citizen trajectories: user story as starting point and reflection opportunity Healthcare information standards for frailty: why, when and how? Informatics for Health 2017, Manchester, 25 April
  2. 2. John Smith A TALE IN SEVERAL ACTS • Aged 80 years old. • 1.80 m tall, he has weighed around 70 Kg for the last few years. • Lives with his wife Ann in a small house in the suburb of a small city. • The house has two floors and the bedroom and bathroom are on the 2nd floor. There is a small toilet on the 1st floor. • He is almost autonomous in the activity of daily living (ADL 5/6; -1 because of urinary incontinence) and in the instrumental activities of daily living (IADL 4/5; -1 because his drugs are prepared by his wife).
  3. 3. John Smith A TALE IN SEVERAL ACTS • Used to visit his GP regularly for check-up examination. • Took medications for a moderate hypertension and for hyperlipidemia, also acetyl salicylic acid. • Cognitive screening, physical examination and blood tests were normal. • Blood pressure was well controlled. • He paid attention to his diet and walked regularly.
  4. 4. John Smith A TALE IN SEVERAL ACTS • Three months ago, John underwent surgical removal of a prostatic adenoma and developed a serious urinary tract infection, remaining hospitalized for 2 weeks. • Since discharged, he lost 5 Kg, kept feeling tired and refused to leave his house and to perform everyday activities as he used to. • He kept falling without apparent cause and with increasing frequency. • Last time his wife has found him on the floor, he was very confused and unable to report for how long he has there. • He had a strong pain in the left leg and was unable to stand up.
  5. 5. John Smith A TALE IN SEVERAL ACTS • John arrived to the emergency department in very bad conditions. • Very agitated, unable to refer his medical history or current therapy. • He was hospitalized and underwent hip replacement with a prosthesis. • Treated with many sedatives and finally an anti-delirium therapy. • He was transferred to a specialized rehab unit and then a general geriatric rehabilitation regimen. • Lost many of his previous abilities and need a cane to walk. • He was moved to a residential home. • After 1 month there, he finally got home with prescription of physiotherapy at home, cane and wheelchair to move outside.
  6. 6. John Smith A TALE IN SEVERAL ACTS How is responsibility managed among all care professionals (doctors, nurses, social workers, caregivers, care managers etc.) What information about the patient health status would be required to ensure efficient professional help along the entire pathway?   What information about the patient is necessary to assure a smooth transfer among different health care entities? What kind of data should the patient summary provide to optimize care in planned and every day settings? What kind of data on frailty status is necessary if any? 

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