Tewary Sweta, Cook Nicole, Pandya Naushira, Damier Sashah, Shnayder Oksana, Dezine Marie
Department of Geriatrics, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA.
Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA.
Gerontol Geriatr Educ. 2023 Oct 2;44(4):631-640. doi: 10.1080/02701960.2022.2117171. Epub 2022 Sep 5.
Age-Friendly Health Systems (AFHS) commit to providing evidence-based, low-risk, coordinated care centered on what matters most to older adults, their families, and caregivers. Nova Southeastern University's South Florida Geriatric Workforce Enhancement Program (NSU SFGWEP) has partnered with primary care clinics to provide AFHS training and support to promote AFHS transformation in Broward and Miami-Dade Counties. NSU SFGWEP provides face-to-face and virtual training for AFHS and Electronic Health Record (EHR) documentation as part of the initiative. This project focuses on a group of primary care clinics in Broward County, Florida. In this paper, we evaluate the progress of AFHS transformation through six e-clinical measures that collectively provide indicators of the 4 M framework of AFHS (What Matters, Medication, Mentation, and Mobility). We used provider feedback and e-clinical measures aligned with the Center for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) to measure clinic outcomes. From Jan 1- Dec 31, 2019, to Jan 1-Dec 31, 2020, the clinics improved high-risk medication management (0-3.71%), advanced care planning (6.79%-20.74%), and fall risk assessment (no data- 46.72%). Results demonstrate some success and ongoing opportunities to continue and expand AFHS interventions for sustainability.
老年友好型卫生系统（AFHS）致力于提供以证据为基础、低风险且协调一致的医疗服务，重点关注对老年人、其家庭及护理人员最为重要的事项。诺瓦东南大学的南佛罗里达老年劳动力增强项目（NSU SFGWEP）已与基层医疗诊所合作，提供AFHS培训与支持，以推动布劳沃德县和迈阿密-戴德县的AFHS转型。作为该倡议的一部分，NSU SFGWEP为AFHS及电子健康记录（EHR）文档提供面对面和虚拟培训。本项目聚焦于佛罗里达州布劳沃德县的一组基层医疗诊所。在本文中，我们通过六项电子临床指标评估AFHS转型的进展，这些指标共同提供了AFHS的4M框架（重要事项、用药、认知和行动能力）的指标。我们利用与医疗保险和医疗补助服务中心（CMS）基于绩效的激励支付系统（MIPS）一致的提供者反馈和电子临床指标来衡量诊所的成果。从2019年1月1日至12月31日到2020年1月1日至12月31日，诊所改善了高风险药物管理（0%-3.71%）、高级护理计划（6.79%-20.74%）以及跌倒风险评估（无数据-46.72%）。结果表明取得了一些成功，并且存在持续且不断扩大AFHS干预措施以实现可持续性的机会。
