Web-based eFI-CGA
Welcome to the electronic Frailty Index based on the Comprehensive Geriatric Assessment (eFI-CGA) web application!
A software tool in support of early detection and management of frailty.
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May 25, 2023 Frailty Symposium
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About Us
This research project represents a collaborative effort between the Fraser Health Authority (FHA) and the Nova Scotia Health Authority (NSHA) in validating the electronic Frailty Index calculation based on the electronic Comprehensive Geriatric Assessment (eFI-CGA). The project received research funding support from the Canadian Institute of Health Research (CIHR-PJT-156210). In partnership with the Community Action and Resources Empowering Seniors (CARES) program, a clinical program that empowers seniors to age well and live a higher quality of life within their community for longer, our goal is to enable widespread application of the eFI-CGA for more effective early detection and management of frailty at points of older-adult care. The Web-based eFI-CGA was built based on the Standalone version of the software tool for more convenient access and effective data collection. The web application development received funding support from the Canadian Frailty Network (CFN-CARES2020: Dr. Grace Park, project lead and principal investigator; Dr. Xiaowei Song, co-principal investigator and scientific lead; Dr. Kenneth Rockwood, co-investigator and creator of the Frailty Index and the CGA form). A group of computer science students from Simon Fraser University (SFU) and the University of British Columbia (UBC) who were research assistants for the FHA worked on the web software development, supported by additional student research assistants at the FHA.
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Project Investigators
Grace Park, MD, CCMP, MBA
Dr. Park is the FHA Medical Director of Primary Care who led the CARES program, allocated the CFN funding, provided primary care consultation, and user feedback.
Xiaowei Song, PhD, MSCS
Dr. Song is a senior Clinical Scientist who conceptualized the application, managed the project development and the research team, and supervised the students.
Kenneth Rockwood, MD, FRCPC
Dr. Rockwood is the NSHA Senior Director of Acute Medicine who defined the FI approach and the CGA form, provided geriatric medicine consultation, and user feedback.
Project Development and Support Team
Kash Khodabakhshi
SFU student research assistant at the FHA, who led the software development, development environment set up, and coded the web application including the assessment page.
Kiarash Kianpoor
SFU student research assistant at the FHA, who co-led the software development towards its first release, and coded the web application including user and data access controls.
Kattie Sepehri
UBC student research assistant at the FHA, who co-led the software development towards its first release, and coded the Standalone and web applications.
Erin Desaulniers
SFU student research assistant at the FHA, who searched for the choice of the web application platform, and coded the web application including the system structure and user interface.
Stanley Kwok
SFU student research assistant at the FHA, who coded and optimized multiple functionalities of the web application including user feedback and forms display.
Hilary Low
Research Coordinator at the FHA, who provided support for project and team management, and for software testing, debugging, and documenting.
Kuljeet Atwal
Research Coordinator at the FHA, who provided valuable end-user feedback and perspectives to improve the design, user interface, and usability for clinical applications.
Riley Chang
Student research assistant at the FHA, who helped with project administration, technical development activities, documentation, and the displayed website materials.
Margit Glashutter
SFU student research assistant at the FHA, who helped with project administration and document preparation, and the update of the displayed website materials.
Our Partners
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eFI-CGA FAQ
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Email us at support@efi-cga.ca.
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Electronic Frailty Index based on the Comprehensive Geriatric Assessment (eFI-CGA) web application
Terms & Conditions
This Web-based eFI-CGA software was initiated and developed for the assessment of frailty using the deficit accumulation-based Frailty Index. It is meant to be used by geriatricians, primary care providers, and health care providers participating in the CIHR supported research project “Frailty assessment for older adults at points of care: Validating the electronic Comprehensive Geriatric Assessment / Frailty Index (eFI-CGA)”. The software development is in collaboration with the Fraser Health Authority [FHA] Community Actions and Resources Empowering Seniors (CARES) program, a community-based initiative to manage frailty in at-risk older adults. The software tool may also be used for research and clinical assessments by other interested parties, provided additional formal agreements concerning privacy and risk management, data sharing and management, and other legal matters at the organization level have been made and all the related documentations are in place. End users intending to use this web eFI-CGA software tool are responsible for obtaining separate approvals for their projects (e.g., research ethics, data privacy).
The Web-based eFI-CGA is a collaborative effort with multiple contributors. The eCGA form is developed based on the paper version of the Comprehensive Geriatric Assessment Form (Capital Health CD0184MR_06_09), originated by Dr. Kenneth Rockwood (Capital Health Geriatrician and world-renowned expert in frailty), which has served as a template as permitted by Dr. Rockwood. This implementation of the Web-based eFI-CGA was adapted from the previously released Standalone eFI-CGA software created by research teams at the FHA. The project’s design and development of the software tools are conceptualized, supervised, and managed by Dr. Xiaowei Song (FHA; nominated Principal Investigator [PI] of the research project – CIHR Grant #CIHR-PJT-156210). The Canadian Frailty Network supported the implementation of the web application (CFN-CARES2020) with Dr. Grace Park (FHA Medical Director of Primary Care) as the clinical lead and Dr. Xiaowei Song (FHA Senior Clinical Scientist) as the scientific lead.
The software development team included a team of computer science students from Simon Fraser University, the University of British Columbia, and other universities in Canada. Kash Khodabakhshi, Katayoun Sepehri, Erin Desaulniers, Kiarash Kianpoor and Stanley Kwok coded the web application, with testing, debugging, documenting, and administrative support from Riley Chang, Margit Glashutter, Jenny Hoang, and Hilary Low as directed by Dr. Song. Andrew McDonald, Hilary Low, and Riley Chang conducted a market survey to determine the required components for the Web-based eFI-CGA tool under supervision. Dr. Grace Park, Dr. Kenneth Rockwood, Dr. Alison Rodger, Dr. Leah Nemiroff, Dr. Olga Theou, and Dr. Barry Clarke provided critical input regarding usage requirements and user guide. Dr. Belinda Rodis, Dr. Peter O’Connor, and Dr. Anson Li provided valuable feedback for improving clinical assessments of frailty using electronic tools. Kuljeet Atwal (Research Coordinator at the FHA), Margaret Lin (CARES Manager), Yukiko Robinson (former CARES Manager), Lorraine Graves (Caregiver Representative), Annette Berndt (Patient Partner), Annette Garm (former CARES Executive Leader), and Dr. Brian Greeley provided valuable end-user feedback and perspectives to improve system design, user interface, and usability.
The Department of Evaluation and Research Services (DERS), Primary Care, and Information Technology of the FHA provided research management, administrative, and technical support for the project. Multiple clinics at the FHA provided user feedback of the eFI-CGA web-application using mock patient assessments (Tsawwassen Medical Clinic, Mission Oaks Medical Centre, Peace Arch Hospital Primary Care Access and Specialized Seniors Clinics, JPOCSC Seniors Clinic, Highroads Medical Clinic, Aboriginal Health Primary Care Clinic, New Westminster Specialized Seniors Clinic, Inwell Medical, Gateway Healthcare, Burnaby New Canadian Clinic, and Fraser Medical Clinic). Sincere appreciations also go to the patient participants in the eFI-CGA research projects.
All rights reserved. This software is not for sale, nor commercial distribution. Although the FHA’s Web-based eFI-CGA website may include links providing direct access to other Internet resources, such as websites, the FHA (including the eFI-CGA Research Project Team) is not responsible for the accuracy or content of information contained in these sites. The Web-based eFI-CGA is not to be modified, adapted, or used for any other derivative work in any way without written agreement and permission from the FHA. Once permitted, an authorized general user account can be created to access and use the software tool.
The user may publish scientific articles, other publications, presentations, media releases, and conduct other disseminations based on the data and information obtained using the eFI-CGA software tools (including the Standalone or the Web-based versions), provided that the user acknowledges their use of the software in said publications. Acknowledgement of use of the Web-based eFI-CGA tool should be as following: “The eFI-CGA Research Project Team (CIHR Grant #CIHR-PJT-156210 and CFN Grant #CFN2020-CARES) 2021: Frailty assessment for older adults at points of care: Validating the electronic Comprehensive Geriatric Assessment / Frailty Index (eFI-CGA).”
General users requesting to access and use the Web-based eFI-CGA tool should send all inquiries to support@efi-cga.ca. The corresponding email address is subject to change.
By agreeing to the terms and conditions, the user gives this web application permission to:
- Sign in the user and access the user’s profile.
- Maintain access to and store all inputted data.
- Decline responsibility for external data breaches including but not limited to loss or theft of the device in use, unauthorized use of a user’s account, or unauthorized viewing of a user’s account information.
- Suspend user account if inappropriate use of the website is exhibited (i.e., failure to follow the above guidelines).
Note: Users are also responsible for keeping their password safe.
References:
- Chang, R., Low, H., McDonald, A., Park, G., & Song, X. (2021). Web-based software applications for frailty assessments in older adults: a scoping review of current status with insights into future development. BMC Geriatrics, 21, 723. https://doi.org/10.1186/s12877-021-02660-6
- Garm, A., Park, G., Song, X. (2017). Using an electronic comprehensive geriatric assessment and health coaching to prevent frailty in primary care: the CARES model. Medical & Clinical Reviews, 3, S1-9. https://doi.org/10.21767/2471-299X.1000051
- Hubbard, R.E., Peel, N.M., Samanta, M., Gray, L.C., Fries, B.E., Mitnitski, A., & Rockwood, K. (2015). Derivation of a frailty index from the interRAI acute care instrument. BMC geriatrics, 15, 27. https://doi.org/10.1186/s12877-015-0026-z
- Jones, D.M., Song, W., Mitnitski, A., Rockwood, K. (2005). Evaluation of a frailty index based on a comprehensive geriatric assessment in a population based study of elderly Canadians. Aging clinical and experimental research, 17(6), 465-71. https://doi.org/10.1007/BF03327413
- Jones, D. M., Song, X., & Rockwood, K. (2004). Operationalizing a frailty index from a standardized comprehensive geriatric assessment. Journal of the American Geriatrics Society, 52(11), 1929-33. https://doi.org/10.1111/j.1532-5415.2004.52521.x
- Rockwood, K., & Mitnitski, A. (2011). Frailty Defined by Deficit Accumulation and Geriatric Medicine Defined by Frailty. Clinics in geriatric medicine, 27(1), 17-26. https://doi.org/10.1016/j.cger.2010.08.008
- Sepehri, K., Braley, M. S., Chinda, B., Zou, M., Tang, B., Park, G., Garm, A., McDermid, R., Rockwood, K., & Song, X. (2020). A Computerized Frailty Assessment Tool at Points-of-Care: Development of a Standalone Electronic Comprehensive Geriatric Assessment/Frailty Index (eFI-CGA). Frontiers in public health, 8, 89. https://doi.org/10.3389/fpubh.2020.00089
- Sepehri, K., Low, H., Hoang, J., Park, G., & Song, X. (2022). Promoting early management of frailty in the new normal: An updated software tool in addressing the need of virtual assessment of frailty at points of care. Aging medicine (Milton (N.S.W)), 5(1), 4–9. https://doi.org/10.1002/agm2.12198
(CIHR Grant #CIHR-PJT-156210 and CFN Grant #CFN2020-CARES).
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