CDC Strategies for

Grant Baldwin, PhD, MPH

Director, Division of Unintentional Injury PreventionNational Center for Injury Prevention and ControlCenters for Disease Control and Prevention

National Council on Aging CDSME Falls Prevention National Resource Centers Annual Meeting 2016

Protecting Older Americans

Falls are the leading causes of non-fatal injuries among adults over the age of 65

0 1,000,000 2,000,000

Fire/Burn

Foreign Body

Unspecified

Other Transport

Bite/Sting

Cut/Pierce

Overexertion

Motor Vehicle-Occupant

Struck by/Against

Falls

Number of Injuries__________

NCHS, WISQARS, 2014 Total = 2.5 million injuries

Falls cause 800,000 hospitalizations and2.8 million ED visits

1.6 MFalls

Year = 2014

Falls are the leading causes of injury death among adults over the age of 65

0 5,000 10,000 15,000 20,000 25,000

Unspecified

Other

Drowning

Fire/Burn

Poisoning

Suffocation

Motor Vehicle

Falls

Number of Deaths__________

NCHS, 2014 Total = 53,672

27,044Fall Deaths

Fall-related deaths have increased 163%

since 2000

Year = 2014

STEADI: Stopping, Elderly Accidents, Deaths and Injuries

1

2

3

4

STEADI ImplementationFocus on four priority areas to making fall prevention a routine part of clinical care

Health System ImplementationDevelop EHR and other clinical decision support tool integration, prevent fall-related hospital readmissions, promote team-based care, link to community-based programs

Billing, Reimbursement, and Provider IncentivesDevelop CPT Category 1 Codes, generate CMS Quality Measures and incentive programs, support USPSTF recommendations

Training and EducationEducate providers through various continuing medical education activities (CME) and the provision of educational tools and resources

Translation and CommunicationConduct 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

Oregon Health & Science Univ Epic’s Clinical Program for STEADI

University of Oklahoma STEADI module Medication management module

Electronic Health Records

Clinical PracticeCommunity-Based

Fall Prevention Programs

STEADI connects. . .

Making it easier to implement effective community-based fall prevention programs

+

Developing a CPT Code

Ongoing FebMarApr May

Aug Nov 2010s

• 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

Jan

Informing Research to Update

Vitamin D Multifactorial Intervention

• CPT = Current Procedural Terminology

Trainings that Target Multiple Audiences

SCREEN for fall risk

REVIEW and manage medications linked to falls

RECOMMEND daily vitamin D supplements

Steps to save lives and save costs

1

2

3

Getting Started

Insights from current users

STEADI Materials

http://www.cdc.gov/steadi/

Vision for Better Fall Prevention

Strengthening health systemsHealth systems embedding STEADI elements would improve practice consistency, increase accountability, provide patient-centered care, and foster innovative prevention strategies.

Engaging entire health care teamAcademic 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.

Advance these strategies for more effective prevention

Older Adult Mobility

Traumatic Brain InjuryPrescription Drugs

Other CDC work addressing Older Americans

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

Myself– A PLAN TO KEEP ME HEALTHY

MyHouse–A PLAN TO KEEP ME SAFE INSIDE MY HOME

MyCommunity–A PLAN TO STAY MOBILE INMY COMMUNITY

Primary care

Patients > 18 Years with chronic pain

Outpatient settings

Outside of active cancer, palliative, and end of life care

Proposed National Concussion

All Ages

All Mechanisms of Injury

Medical Services Received

Return to Learn, Play, and Work

TBI Disability

Lifetime Prevalence

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 workor school?

Unmatched detail on concussion in America

Surveillance System

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