Presented at Conference on Data in Health and Social Care, 5 Oct 2016

1. E-Frailty Research Analysis –
Identifying Risk
Brian Brown, Director for Scotland, CM2000
Adrian Smales, PhD Researcher, ENU

2. CM2000 In Scotland

3. 80+
Local Authorities
& NHS Trusts
800+
Independent
Providers
3,000,000
Visitsaweek
235,000
Service Users
120,000
Carers

4. Population Demographics
Projected change in proportion of population aged 75 and over from 2010 to 2035 taken from National Records for
Scotland inquiry submission to the Scottish Parliament Finance Committee, 2013. 2nd Report, 2013 (Session 4):
Demographic change and an ageing population, The Scottish Parliament.

5. Homeostatic Stasis
Old (simple) diagram New “Dynamic” Diagram

6. Risk Stratification Abstraction
High Level
Metrics
Metrics Mood
Device Question
Data
Body Fat
(%)
Muscle
Mass
Bone
Mass
Body
Mass
Index
(BMI)
Daily
Calorie
Intake
(DCI)
Metaboli
c Age
Body
Water
(%)
Visceral
Fat
Weight
Grip
Strength
Reading
1
Grip
Strength
Reading
2
Grip
Strength
Reading
3
Date Resting Sitting Low medium high
Total
sleep
restfull
sleep
Restless
sleep
inactivity
stamps
Distance
walked
Steps
taken
How is
service
user
feeling
today
Heart
rate BPM
R-R
Interval
(ms)
IoRN v2
score
Beginnin
g
IoRN v2
score
Middle
IoRN v2
score End
MobilityDaytime Activity
Wellness/ Frailty
Body Composition Grip Strength Cardiac Activities of Daily Living
Performance
Sleep Pattern
Activity LevelPhysical Condition
CM2000 InFormsTanita Scales Grip strength meter H7Polar loop
Trust Level
• Tier 1 – Mandatory Public Sector Data Stores
• Tier 2 – Personal Data store (Devices, IoT, Non-Medical equipment)
• Tier 3 – Personal Data store (Subjective information, how do you feel?)

7. MEASUREMENTS:
Weight
Segmental body fat %
Segmental muscle mass
Body fat % (age 5 – 99 years)
Healthy body fat indicator
Total body water %
Muscle mass in kg
Bone mineral mass
Visceral fat indicator
Daily Calorie Intake
Metabolic age
BMI
What we are using…

9. • Assessment developed to capture Tanita scale information
• Assessment developed to capture Strength Grip information
• IoRN 2 information captured directly via an InForm assessment
• Data extracted and presented within CMBI for Council and Service User/Family members
InForm Assessment Builder / CMBI

11. Date of visit
Planned
start
time
planned
end time
Planned
duration
Actual
Start
time
Actual
end time
Actual duration
01/03/2016 17:00:00 17:30:00 30 17:24:35 17:48:16 24
02/03/2016 09:00:00 09:30:00 30 08:49:07 08:59:50 10
03/03/2016 09:00:00 09:30:00 30 10:10:22 10:28:31 18
04/03/2016 17:00:00 17:30:00 30 17:15:17 17:31:12 16
05/03/2016 17:00:00 17:30:00 30 17:01:27 17:14:56 13
06/03/2016 09:00:00 09:30:00 30 09:18:57 09:44:16 18
07/03/2016 09:00:00 09:30:00 30 09:10:17 09:26:07 16
08/03/2016 17:00:00 17:30:00 30 17:55:28 18:12:13 17
09/03/2016 09:00:00 09:30:00 30 10:30:27 10:48:59 18
10/03/2016 09:00:00 09:30:00 30 09:15:06 09:34:35 19
11/03/2016 17:00:00 17:30:00 30 17:47:40 18:20:23 33
12/03/2016 09:00:00 09:30:00 30 10:14:37 10:42:28 28
13/03/2016 09:00:00 09:30:00 30 09:07:24 09:39:41 32
14/03/2016 17:00:00 17:30:00 30 18:46:00 19:01:01 15
15/03/2016 09:00:00 09:30:00 30 09:59:22 10:34:07 35
16/03/2016 09:00:00 09:30:00 30 09:39:53 09:55:13 16
17/03/2016 17:00:00 17:30:00 30 18:02:39 18:15:45 13
18/03/2016 09:00:00 09:30:00 30 08:34:13 08:48:04 14
19/03/2016 09:00:00 09:30:00 30 09:59:27 10:27:23 28
20/03/2016 09:00:00 09:30:00 30 10:15:32 10:36:14 21
21/03/2016 09:00:00 09:30:00 30 09:28:55 09:58:14 30
22/03/2016 09:00:00 09:30:00 30 09:33:51 09:56:20 23
23/03/2016 17:00:00 17:30:00 30 17:02:33 17:14:50 12
24/03/2016 09:00:00 09:30:00 30 09:10:13 09:36:29 26
25/03/2016 09:00:00 09:30:00 30 09:43:49 10:12:43 29
26/03/2016 17:00:00 17:30:00 30 18:31:11 18:47:11 16
27/03/2016 09:00:00 09:30:00 30 09:30:06 09:54:17 24
Using Quantitative Monitoring Data – person 10

12. Polar Wearables – Data Metrics

13. Risk Identification
• Identification of client who was significantly de-hydrated
• Identification of risk trends through client weight loss
• Identification of client restlessness at night therefore
ongoing risk during the day
• Reduction in muscle mass
• Reduction in strength grip
• Increasing risk identified by the client themselves

14. Target Patient Groups -
Where Risk Identified
• Known fallers
• Patients going through a reablement process
• Patients on the periphery with some low level telecare equipment e.g.
community alarm
• Younger adults with mental health /memory problems
• Learning disability/ Supported Living where challenge has been in
person expressing how well / unwell they are feeling

16. • Synergy with Falls Prediction project in terms of data modelling being used to enable
prediction
• Project being completed in conjunction with Birmingham City University & Westminster
Homecare
• UNTAPPED - Utilising Novel Techniques to Assess Predictive Patterns in Early
Dementia
• Identifying “Social Markers” recognise and enable early detection of dementia
Project Synergy – Dementia Prediction
By 2020, there will be nearly a million people with dementia in the UK.
Despite recent improvements, the diagnosis rate is less than 50%

17. Wellness/Frailty Scale - Physical Condition
High Level
Metrics
Metrics
Device
Data
Body Fat
(%)
Muscle
Mass
Bone
Mass
Body
Mass
Index
(BMI)
Daily
Calorie
Intake
(DCI)
Metaboli
c Age
Body
Water
(%)
Visceral
Fat
Weight
Grip
Strength
Reading
1
Grip
Strength
Reading
2
Grip
Strength
Reading
3
Date Resting Sitting Low
Daytime Activ
Wellness/ Frailty
Body Composition Grip Strength
Physical Condition
Tanita Scales Grip strength meter

18. Wellness/Frailty Scale - Activity Level
Mood
Question
sceral
Fat
Weight
Grip
Strength
Reading
1
Grip
Strength
Reading
2
Grip
Strength
Reading
3
Date Resting Sitting Low medium high
Total
sleep
restfull
sleep
Restless
sleep
inactivity
stamps
Distance
walked
Steps
taken
How is
service
user
feeling
today
Heart
rate BPM
R-R
Interval
(ms)
IoRN v2
score
Beginnin
g
IoRN
scor
Midd
MobilityDaytime Activity
Wellness/ Frailty
Grip Strength Cardiac Activities of D
Performance
Sleep Pattern
Activity Level
CM2000 IGrip strength meter H7Polar loop

19. Wellness/Frailty Scale - Performance
Mood
Question
Total
sleep
restfull
sleep
Restless
sleep
inactivity
stamps
Distance
walked
Steps
taken
How is
service
user
feeling
today
Heart
rate BPM
R-R
Interval
(ms)
IoRN v2
score
Beginnin
g
IoRN v2
score
Middle
IoRN v2
score End
Mobility Cardiac Activities of Daily Living
Performance
Sleep Pattern
Level
CM2000 InFormsH7oop