{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T02:27:44Z","timestamp":1776652064281,"version":"3.51.2"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Objective Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls.<\/jats:p>\n               <jats:p>Methods The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data.<\/jats:p>\n               <jats:p>Results In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification.<\/jats:p>\n               <jats:p>Conclusions Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables.<\/jats:p>","DOI":"10.1093\/jamia\/ocv061","type":"journal-article","created":{"date-parts":[[2015,6,24]],"date-time":"2015-06-24T00:14:52Z","timestamp":1435104892000},"page":"276-282","source":"Crossref","is-referenced-by-count":35,"title":["Improving prediction of fall risk among nursing home residents using electronic medical records"],"prefix":"10.1093","volume":"23","author":[{"given":"Allison","family":"Marier","sequence":"first","affiliation":[{"name":"Abt Associates, U.S. Health Division, Bethesda, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren E.W.","family":"Olsho","sequence":"additional","affiliation":[{"name":"Abt Associates, U.S. Health Division, Cambridge, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Abt Associates, U.S. Health Division, Cambridge, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William D.","family":"Spector","sequence":"additional","affiliation":[{"name":"Agency for Healthcare Research & Quality, U.S. Department of Health & Human Services, Rockville, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2015,6,22]]},"reference":[{"key":"2020110612595704700_ocv061-B1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1093\/gerona\/60.9.1157","article-title":"Diabetes mellitus is associated with an increased risk of falls in elderly residents of a long-term care facility","volume":"60","author":"Maurer","year":"2005","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"2020110612595704700_ocv061-B2","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/0002-9343(86)90717-5","article-title":"Fall risk index for elderly patients based on number of chronic disabilities","volume":"80","author":"Tinetti","year":"1986","journal-title":"Am J Med."},{"key":"2020110612595704700_ocv061-B3","doi-asserted-by":"crossref","first-page":"442","DOI":"10.7326\/0003-4819-121-6-199409150-00009","article-title":"Falls in the nursing home","volume":"121","author":"Rubenstein","year":"1994","journal-title":"Ann Intern Med."},{"key":"2020110612595704700_ocv061-B4","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1136\/ip.2005.011015","article-title":"The costs of fatal and non-fatal falls among older adults","volume":"12","author":"Stevens","year":"2006","journal-title":"Inj Prev."},{"key":"2020110612595704700_ocv061-B5","first-page":"6319","article-title":"Preventing falls in the nursing home","volume":"10","author":"Kamel","year":"2006","journal-title":"Annals of Long-Term Care."},{"key":"2020110612595704700_ocv061-B6","doi-asserted-by":"crossref","first-page":"S53","DOI":"10.1016\/j.jamda.2005.12.016","article-title":"Falls in the nursing home: are they preventable?","volume":"7","author":"Vu","year":"2006","journal-title":"J Am Med Dir Assoc."},{"key":"2020110612595704700_ocv061-B7","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S0749-0690(18)30206-4","article-title":"Falls and fall prevention in the nursing home","volume":"12","author":"Rubenstein","year":"1996","journal-title":"Clin Geriatr Med."},{"key":"2020110612595704700_ocv061-B8","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/j.1532-5415.2007.01088.x","article-title":"Intervening to prevent falls and fractures in nursing homes: are we putting the cart before the horse?","volume":"55","author":"Magaziner","year":"2007","journal-title":"J Am Geriatr Soc."},{"key":"2020110612595704700_ocv061-B9","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1111\/j.1532-5415.2005.53304.x","article-title":"Insomnia and hypnotic use, recorded in the minimum data set, as predictors of falls and hip fractures in Michigan nursing homes","volume":"53","author":"Avidan","year":"2005","journal-title":"J Am Geriatr Soc."},{"key":"2020110612595704700_ocv061-B10","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jamda.2006.08.005","article-title":"A multivariate fall risk assessment model for VHA nursing homes using the minimum data set","volume":"8","author":"French","year":"2007","journal-title":"J Am Med Dir Assoc."},{"key":"2020110612595704700_ocv061-B11","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1046\/j.1532-5415.2003.51404.x","article-title":"Dementia as a risk factor for falls and fall injuries among nursing home residents","volume":"51","author":"Van Doorn","year":"2003","journal-title":"J Am Geriatr Soc."},{"key":"2020110612595704700_ocv061-B12","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Institute of Medicine (US) Committee on Quality of Health Care in America","year":"2001"},{"key":"2020110612595704700_ocv061-B13","article-title":"Adoption of electronic health record systems among US non-federal acute care hospitals: 2008\u20132013","author":"Charles","year":"2014"},{"key":"2020110612595704700_ocv061-B14","article-title":"Use and characteristics of electronic health record systems among office-based physician practices, United States, 2001\u20132012","author":"Hsiao","year":"2012"},{"key":"2020110612595704700_ocv061-B15","article-title":"Survey questions for EHR adoption and use in nursing homes: final report","author":"Kramer","year":"2010"},{"issue":"2","key":"2020110612595704700_ocv061-B16","first-page":"179","article-title":"Use of Electronic Information Systems in Nursing Homes: United States, 2004.","volume":"16","author":"Resnick","year":"2009","journal-title":"JAMIA."},{"issue":"11 Spec No. 17","key":"2020110612595704700_ocv061-B17","first-page":"eSP53","article-title":"Trending health information technology adoption among New York nursing homes","volume":"20","author":"Abramson","year":"2014","journal-title":"Am J Managed Care."},{"key":"2020110612595704700_ocv061-B18","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.mcna.2006.05.013","article-title":"Falls and their prevention in elderly people: what does the evidence show?","volume":"90","author":"Rubenstein","year":"2006","journal-title":"Med Clin North Am."},{"key":"2020110612595704700_ocv061-B19","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1111\/j.1532-5415.2007.01081.x","article-title":"Risk factors associated with the occurrence of fractures in U.S. nursing homes: resident and facility characteristics and prescription medications","volume":"55","author":"Spector","year":"2007","journal-title":"J Am Geriatr Soc."},{"key":"2020110612595704700_ocv061-B20","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1600-0404.2005.00474.x","article-title":"Epilepsy, osteoporosis and fracture risk\u2014a meta-analysis","volume":"112","author":"Vestergaard","year":"2005","journal-title":"Acta Neurol Scand."},{"key":"2020110612595704700_ocv061-B21","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/j.1600-0404.1999.tb00675.x","article-title":"Fracture risk is increased in epilepsy","volume":"99","author":"Vestergaard","year":"1999","journal-title":"Acta Neurol Scand."},{"key":"2020110612595704700_ocv061-B22","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S0966-6362(03)00098-5","article-title":"Can use of walkers or canes impede lateral compensatory stepping movements?","volume":"20","author":"Bateni","year":"2004","journal-title":"Gait Posture"},{"key":"2020110612595704700_ocv061-B23","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.cger.2010.06.002","article-title":"Vision and falls in older people: risk factors and intervention strategies","volume":"26","author":"Lord","year":"2010","journal-title":"Clin Geriatr Med."},{"key":"2020110612595704700_ocv061-B24","first-page":"30","article-title":"Vitamin B12 deficiency: recognizing subtle symptoms in older adults","volume":"58","author":"Dharmarajan","year":"2003","journal-title":"Geriatrics."},{"key":"2020110612595704700_ocv061-B25","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1136\/bmj.315.7115.1049","article-title":"Development and evaluation of evidence based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies","volume":"315","author":"Oliver","year":"1997","journal-title":"BMJ."},{"key":"2020110612595704700_ocv061-B26","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1111\/j.1532-5415.2011.03646.x","article-title":"Gait velocity versus the timed up and go test: which one to use for the prediction of falls and other adverse health outcomes in primary care?","volume":"59","author":"Montero-Odasso","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"2020110612595704700_ocv061-B27","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1056\/NEJM199809243391303","article-title":"Antidepressants and the risk of falls among nursing home residents","volume":"339","author":"Thapa","year":"1998","journal-title":"N Engl J Med."},{"key":"2020110612595704700_ocv061-B28","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/j.1532-5415.2012.03931.x","article-title":"Falls in newly admitted nursing home residents: a national study","volume":"60","author":"Leland","year":"2012","journal-title":"J Am Geriatr Soc."},{"key":"2020110612595704700_ocv061-B29","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1001\/jamainternmed.2013.14764","article-title":"Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults","volume":"174","author":"Tinetti","year":"2014","journal-title":"JAMA Intern Med."},{"key":"2020110612595704700_ocv061-B30"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/23\/2\/276\/34147665\/ocv061.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/23\/2\/276\/34147665\/ocv061.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T18:40:38Z","timestamp":1604688038000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/23\/2\/276\/2572361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,22]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2015,6,22]]},"published-print":{"date-parts":[[2016,3,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocv061","relation":{},"ISSN":["1527-974X","1067-5027"],"issn-type":[{"value":"1527-974X","type":"electronic"},{"value":"1067-5027","type":"print"}],"subject":[],"published-other":{"date-parts":[[2016,3]]},"published":{"date-parts":[[2015,6,22]]}}}