e-Frality - Adrian Smales and Brian Brown (CM2000)
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Transcript of e-Frality - Adrian Smales and Brian Brown (CM2000)
E-Frailty Research Analysis – Identifying RiskBrian Brown, Director for Scotland, CM2000Adrian Smales, PhD Researcher, ENU
CM2000 In Scotland
Ove
rvie
w 80+ Local Authorities
& NHS Trusts
800+ Independent
Providers 3,00
0,00
0 Vi
sits
a w
eek
235,000
Service Users
120,000
Carers
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.
Homeostatic Stasis
Old (simple) diagram New “Dynamic” Diagram
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)
Metabolic Age
Body Water
(%)
Visceral Fat
Weight
Grip Strength Reading
1
Grip Strength Reading
2
Grip Strength Reading
3
Date Resting Sitting Low medium highTotal 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
Beginning
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?)
MEASUREMENTS:
WeightSegmental body fat %Segmental muscle massBody fat % (age 5 – 99 years)Healthy body fat indicatorTotal body water %Muscle mass in kgBone mineral massVisceral fat indicatorDaily Calorie IntakeMetabolic ageBMI
What we are using…
• 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
Date of visitPlanned
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 2402/03/2016 09:00:00 09:30:00 30 08:49:07 08:59:50 1003/03/2016 09:00:00 09:30:00 30 10:10:22 10:28:31 1804/03/2016 17:00:00 17:30:00 30 17:15:17 17:31:12 1605/03/2016 17:00:00 17:30:00 30 17:01:27 17:14:56 1306/03/2016 09:00:00 09:30:00 30 09:18:57 09:44:16 1807/03/2016 09:00:00 09:30:00 30 09:10:17 09:26:07 1608/03/2016 17:00:00 17:30:00 30 17:55:28 18:12:13 1709/03/2016 09:00:00 09:30:00 30 10:30:27 10:48:59 1810/03/2016 09:00:00 09:30:00 30 09:15:06 09:34:35 1911/03/2016 17:00:00 17:30:00 30 17:47:40 18:20:23 3312/03/2016 09:00:00 09:30:00 30 10:14:37 10:42:28 2813/03/2016 09:00:00 09:30:00 30 09:07:24 09:39:41 3214/03/2016 17:00:00 17:30:00 30 18:46:00 19:01:01 1515/03/2016 09:00:00 09:30:00 30 09:59:22 10:34:07 3516/03/2016 09:00:00 09:30:00 30 09:39:53 09:55:13 1617/03/2016 17:00:00 17:30:00 30 18:02:39 18:15:45 1318/03/2016 09:00:00 09:30:00 30 08:34:13 08:48:04 1419/03/2016 09:00:00 09:30:00 30 09:59:27 10:27:23 2820/03/2016 09:00:00 09:30:00 30 10:15:32 10:36:14 2121/03/2016 09:00:00 09:30:00 30 09:28:55 09:58:14 3022/03/2016 09:00:00 09:30:00 30 09:33:51 09:56:20 2323/03/2016 17:00:00 17:30:00 30 17:02:33 17:14:50 1224/03/2016 09:00:00 09:30:00 30 09:10:13 09:36:29 2625/03/2016 09:00:00 09:30:00 30 09:43:49 10:12:43 2926/03/2016 17:00:00 17:30:00 30 18:31:11 18:47:11 1627/03/2016 09:00:00 09:30:00 30 09:30:06 09:54:17 24
Using Quantitative Monitoring Data – person 10
Polar Wearables – Data Metrics
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
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
• 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%
Wellness/Frailty Scale - Physical Condition
High Level Metrics
Metrics Mood
Device Question
Data
Body Fat (%)
Muscle Mass
Bone Mass
Body Mass Index (BMI)
Daily Calorie Intake (DCI)
Metabolic Age
Body Water
(%)
Visceral Fat
Weight
Grip Strength Reading
1
Grip Strength Reading
2
Grip Strength Reading
3
Date Resting Sitting Low medium high
Daytime Activity
Wellness/ Frailty
Body Composition Grip Strength
Activity LevelPhysical Condition
Tanita Scales Grip strength meter Polar loop
Wellness/Frailty Scale - Activity Level
Metrics Mood
Device Question
Data
Weight
Grip Strength Reading
3
Date Resting Sitting Low medium highTotal sleep
restfull sleep
Restless sleep
inactivity stamps
Distance walked
Steps taken
How is service
user feeling today
MobilityDaytime Activity
Wellness/ Frailty
Grip Strength
Performance
Sleep Pattern
Activity LevelPhysical Condition
Grip strength meter Polar loop
Wellness/Frailty Scale - Performance
Metrics Mood
Device Question
Data
Weight Date Resting Sitting Low medium highSteps taken
How is service
user feeling today
Heart rate BPM
R-R Interval
(ms)
IoRN v2 score
Beginning
IoRN v2 score
Middle
IoRN v2 score End
Mobility
Wellness/ Frailty
Cardiac Activities of Daily Living
PerformanceActivity Level
CM2000 InFormsH7Polar loop