How Oregon Health and Science University Built STEADI Into Its Health Record

Falls are a serious health problem for older adults. Millions of Americans 65 and older fall every year — one in four — but fewer than half tell their doctor. Falls are the leading cause of injury deaths among older adults, and the most common cause of traumatic brain injuries and hip fractures.

STEADI

CDC created STEADI (Stopping Elderly Accidents, Deaths, and Injuries) to help health care providers screen for fall risk and reduce it. The STEADI algorithm has three steps:

• Screen patients: have they fallen in the past year, do they feel unsteady, or worry about falling?
• Assess their modifiable risk factors.
• Intervene with effective clinical and community strategies.

Oregon's approach

In 2011, Oregon Health and Science University (OHSU) partnered with the Oregon Health Authority to build STEADI into a clinic over five years, to reduce falls at the community, health system and practice levels.

• Built into the workflow: STEADI was folded into the clinic's existing screening routine using a health maintenance modifier — an alert on a patient's chart prompting needed screenings. An "annual falls screening" alert was applied automatically to every patient 65 and older.
• Coded in the record: the electronic health record (EHR) tool let staff assign falls-related codes by each patient's risk, so the clinic could track falls-related quality measures — tools that measure the quality and outcomes of care.

What made it work:

• clinic champions;
• a workflow customized to fit normal routines;
• EHR tools built for falls screening and prevention;
• a partnership with the state health department for a community resource for patients;
• asking for feedback, keeping partners informed, and engaging collaborators.

National reach

The OHSU work had national impact. In December 2015, Epic, a health care software company, released Preventing Falls in Primary Care Using STEADI, showing any health system on Epic's EHR how to adopt STEADI. The EHR remains key to helping providers identify high-risk patients, screen them and prevent injuries, and preventing falls is now part of standard care.

Sources

Based on "Electronic Health Record System Adopts STEADI Algorithm," STEADI success stories, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The source's two photographs are stock pictures and are not reproduced.