Preoperative Frailty Assessment

Frailty on FHIR

mFI-5 and VQI-11 frailty indices, computed from data already in the patient’s chart

A SMART on FHIR app for Epic Hyperspace

Overview

Frailty predicts surgical outcomes. Scoring it by hand, chart by chart, is why it so rarely gets done.

Frailty on FHIR launches from a patient’s chart in Epic Hyperspace. It reads the problem list, encounter diagnoses, vital signs, and functional-status assessments that are already in the record, computes two validated preoperative frailty indices, and shows the clinician each contributing item with the evidence that triggered it.

It is read-only and stores no clinical data. The two items coded data rarely captures, functional dependence and non-home residence, are pre-filled from whatever evidence exists and then confirmed by the clinician rather than silently defaulted. If the app is unavailable, care proceeds exactly as it would have.

It was built by Brandon Gaston, MD, a vascular surgery resident at Massachusetts General Hospital, alongside research directly comparing frailty scores and their association with outcomes after lower-extremity revascularization.

Launch
EHR launch, SMART v1
Standard
FHIR R4
Access
Read-only
Stored
No clinical data
mFI-5
Modified Frailty Index · 5 items
2 / 5
  • Diabetes mellitus
  • Hypertension
  • Congestive heart failure
  • COPD
  • Functional dependence
VQI-11
Vascular Quality Initiative · 11 items
4 / 11
  • Diabetes mellitus
  • Hypertension
  • Coronary artery disease
  • Peripheral vascular disease
  • + 7 further items
The score cards as rendered in the chart. Illustrative values, not a real patient.
Clinical decision support tool For research and educational purposes. Not approved for clinical use without appropriate validation and regulatory approval. Frailty assessment should be considered alongside other clinical factors and patient-specific considerations.

Contact

For pilots, integration questions, documentation requests, or research collaboration. The architecture document, clinical logic and code mappings, Epic onboarding packet, and compliance set are available to Epic customers and reviewers on request.

Email About the developer GitHub
Security reports Start the subject line with [SECURITY] and report privately first. Use synthetic test data only; never include real patient data, chart screenshots, or FHIR bundles. Reports are triaged ahead of feature work.