CDC Strategies for Protecting Older Americans Grant Baldwin, PhD, MPH Director, Division of Unintentional Injury Prevention National Center for Injury Prevention and Control Centers for Disease Control and Prevention National Council on Aging CDSME Falls Prevention National Resource Centers Annual Meeting 2016
1.6 M Falls Falls are the leading causes of non-fatal injuries among adults over the age of 65 Falls Struck by/against Motor Vehicle-Occupant Overexertion Cut/Pierce Bite/Sting Other Transport Unspecified Foreign Body Fire/Burn NCHS, WISQARS, 2014 Falls cause 800,000 hospitalizations and 2.8 million ED visits 0 1,000,000 2,000,000 Number of Injuries Year = 2014 Total = 2.5 million injuries
27,044 Fall Deaths Falls are the leading causes of injury death among adults over the age of 65 Falls Motor Vehicle Suffocation Poisoning Fire/Burn Drowning Other Unspecified 0 5,000 10,000 15,000 20,000 25,000 Number of Deaths Fall-related deaths have increased 163% since 2000 NCHS, 2014 Year = 2014 Total = 53,672
STEADI: Stopping, Elderly Accidents, Deaths and Injuries
STEADI Implementation Focus on four priority areas to making fall prevention a routine part of clinical care 1 Health System Implementation Develop EHR and other clinical decision support tool integration, prevent fall-related hospital readmissions, promote team-based care, link to community-based programs 2 Billing, Reimbursement, and Provider Incentives Develop CPT Category 1 Codes, generate CMS Quality Measures and incentive programs, support USPSTF recommendations 3 Training and Education Educate providers through various continuing medical education activities (CME) and the provision of educational tools and resources 4 Translation and Communication Conduct research on the burden of falls and effective interventions, develop tools & resources for a variety of audiences including providers, health systems, and the public
Integrating STEADI into Electronic Health Records Oregon Health & Science Univ Epic s Clinical Program for STEADI University of Oklahoma STEADI module Medication management module
STEADI connects... Clinical Practice Community-Based Fall Prevention Programs
Making it easier to implement effective community-based fall prevention programs +
Developing a CPT Code Ongoing Feb Mar Apr May Aug Nov 2010s Jan Applications submitted by any member of the public throughout the year CPT Editorial Panel considers the applications and develops CPT codes Specialty societies collect data for new CPT codes Special committee makes recommendation to CMS Release of new CPT codes CMS announces new Medicare payment rates CPT codes and new Medicare payment rates implemented CPT = Current Procedural Terminology Informing Research to Update Vitamin D Multifactorial Intervention
Steps to save lives and save costs 1 SCREEN for fall risk Getting Started 2 3 REVIEW and manage medications linked to falls RECOMMEND daily vitamin D supplements Trainings that Target Multiple Audiences Insights from current users
STEADI Materials http://www.cdc.gov/steadi/
Vision for Better Fall Prevention Advance these strategies for more effective prevention Strengthening health systems Health systems embedding STEADI elements would improve practice consistency, increase accountability, provide patient-centered care, and foster innovative prevention strategies. Engaging entire health care team Academic and professional associations would expand STEADI training opportunities for pharmacists, nurses, physical therapists, occupational therapists, and physician assistants and reward participants with continuing education credit. Educating older Americans, caregivers and the public Leveraged partnerships would develop educational awareness campaigns. Materials would highlight real seniors making changes to reduce their risk of falling and feature seniors talking about why they took charge of their own health and safety. Optimizing data systems to improve medical practice Collaborate with state health departments to coordinate partnerships among health systems, health IT companies, and public health.
Other CDC work addressing Older Americans Older Adult Mobility Traumatic Brain Injury Prescription Drugs
Myself A PLAN TO KEEP ME HEALTHY MyHouse A PLAN TO KEEP ME SAFE INSIDE MY HOME MyCommunity A PLAN TO STAY MOBILE IN MY COMMUNITY Mobility-related deaths are the leading cause of injury death for adults aged 65 years and above Mobility Planning Tool Targets adults age 60-74 Plan for mobility changes as you age in the same way that you may plan financially for retirement Leverages broad array of partner resources
Primary care Patients > 18 Years with chronic pain Outpatient settings Outside of active cancer, palliative, and end of life care
Proposed National Concussion Surveillance System Unmatched detail on concussion in America Prevention Have you had a head or neck injury in the past 12 months? How did your injury occur? Care Where did you seek care after you experienced this injury? What types of symptoms did you have? Recovery Do you still experience the effects from the injury? How long did it take to go back to work or school? All Ages All Mechanisms of Injury Medical Services Received Return to Learn, Play, and Work TBI Disability Lifetime Prevalence
For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Special thanks to Hilary Eiring for her assistance preparing this presentation