Presenter(s)
A. S. Qian1, A. Manchanda1, L. Williams1, C. C. Park2, and N. D. Prionas2; 1University of California San Francisco, San Francisco, CA, 2Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
Purpose/Objective(s):
The Institute of Healthcare Improvement (IHI) Age-Friendly Health Systems initiative promotes reliably addressing a patient’s 4Ms (What Matters, Medications, Mentation, Mobility). Cancer diagnoses grow with advanced age, and this population will increase in the coming years. The majority of radiation oncology cares for older adults, but specialty workflows to operationalize the 4Ms are not well described. We describe baseline demographics and a Mobility-first plan to pursue Level 2 Age-Friendly designation.Materials/Methods: We conducted an Age-Friendly planning project in a tertiary academic radiation oncology department. We summarized demographics for adults receiving care and, among patients age =65, stratified by visit modality (video vs in-person). We designed a Medical Assistant–administered Timed Up and Go (TUG) workflow performed at CT simulation with discrete EHR documentation; stop criteria include abnormal vitals, observed instability/impending fall, or symptoms, with “unable” documented using a brief reason. A staged roadmap was created to incorporate the remaining Ms using iterative PDSA cycles and EHR-integrated documentation.
Results: In calendar year 2025, 4,783 adults underwent consultation (age 18–64: 2,024; age =65: 2,759). Among age =65 visits, 1,647 (59.7%) were video and 1,112 (40.3%) in-person; because Age-Friendly reporting focuses on in-person encounters, we prioritized this population. In the age =65 cohort overall, language was English 88.9%, Chinese 4.5%, Spanish 3.3%; ethnicity was not Hispanic/Latino 82.8%, Hispanic/Latino 7.0%, unknown/declined 10.3%; race was White 62.0%, Asian 14.6%, Black/African American 7.2%, other 15.2%. In the in-person age =65 subset, English was 85.3%, Chinese 6.5%, Spanish 4.8%; ethnicity was not Hispanic/Latino 78.8%, Hispanic/Latino 8.1%, unknown/declined 13.1%; race was White 51.8%, Asian 16.9%, Black/African American 11.9%, other 18.5%. Non-English speakers and non-white patients were significantly more represented at in-person consultation (OR ~2.1, p<0.006 and OR 1.4-3.2, p<0.006) as compared to video.
Conclusion: We developed a pragmatic, EHR-integrated roadmap to operationalize IHI Age-Friendly 4Ms care in radiation oncology, beginning with a planned CT simulation–based MA-administered TUG workflow to generate three months of Mobility data needed for Level 2 Age-Friendly designation. Reporting demographics by visit modality highlights potential disparities in assessing 4Ms of under-represented populations when establishing in-person Age-Friendly workflows. To our knowledge, this work represents the first radiation oncology department achieving IHI Age-Friendly Health Systems designation.