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