In the realm of healthcare and STEM (Science, Technology, Engineering and Mathematics), there are individuals whose steadfast commitment and innovative thinking have the potential to impact the lives of countless people. Located in Winston-Salem’s Innovation Quarter, Dr. Kate Callahan, a geriatrician, educator and researcher, aims to inspire women pursuing careers in STEM. Her journey is a testament to her dedication to improving healthcare and her passion for teaching, research and patient care.
Rooted in Education
Dr. Callahan’s career has involved perseverance, dedication and a commitment to transform the care of older adults through the field of geriatrics. Her journey began even before medical school, as her parents, both teachers, imbued respect for the importance of education.
“Education is not just about imparting knowledge; it’s about fostering curiosity and critical thinking. ”
During her training, It became clear that education was the lifeblood of a medical institution, as no substantial change could occur without it. This realization set the foundation for Dr. Callahan’s mission to enhance the tools available to educators and healthcare providers.
The Birth of a Vision in the iQ
The Innovation Quarter is known for its focus on research, technology and healthcare innovation. Dr. Callahan’s work and research on frailty closely align with the Innovation Quarter’s mission to advance healthcare through cutting-edge solutions. The supportive ecosystem of the Innovation Quarter fosters collaboration, sparking new ideas and accelerating the translation of research findings into practical solutions. Dr. Callahan’s access to these resources underscores the critical role that the Innovation Quarter plays in pushing the boundaries of healthcare research.
Working as a geriatrician, Dr. Callahan has witnessed that healthcare systems may lack the means to comprehensively assess and address the unique needs of the vulnerable older adult population. Despite decades of research, educational, and clinical innovation, barriers still limited the integration of identified best practices into routine care. This realization prompted her to embark on a journey of research and innovation to find a better way.
Dr. Callahan’s quest led her to explore how the concept of frailty—a condition often underestimated or overlooked in medical practice – could assist healthcare providers and healthcare systems in meaningfully improving the lives of older adults.
What is Frailty?
Frailty is a complex, multidimensional syndrome often observed in older adults that has been likened to accelerated aging. It is characterized by a decreased ability for a person’s physiology to withstand stressors, leading to increased vulnerability to adverse health outcomes. Frailty is not solely based on age but rather on a combination of physical, cognitive, and medical factors. Frailty can manifest in several ways, such as reduced muscle strength, diminished mobility, or increased fatigue; but in many people with frailty, it is not immediately apparent. Nearly any way it is measured, frailty tracks with a higher risk of falls, healthcare needs, hospitalizations, and even higher rates of mortality.
Frailty as a concept was originated by geriatricians Linda Fried (Frailty Phenotype) and Ken Rockwood (Frailty Index) over 20 years ago; despite the value of understanding frailty in older adults, healthcare providers were not routinely using the available tools. Traditional assessments were time-consuming, required specialized equipment and were limited predominantly to research settings. Dr. Callahan saw the potential for change and collaboration.
“Innovation often arises at the intersection of different disciplines. When we come together to solve complex problems, the possibilities are endless.”
One pivotal moment for Dr. Callahan came during a meeting in the IQ where she was seated next to Dr. Nicholas Pajewski, a biostatistician also interested in frailty. While collaborating on a project focused on the challenges posed by electronic health records, they agreed on the need for a practical tool to assess frailty in older adults. Together, they envisioned a bold solution: embedding frailty assessment within the electronic health record system.
The Electronic Frailty Index (eFI): A Product of Collaboration in the IQ
Building upon work by Ken Rockwood (Canada) and Andrew Clegg (UK), Drs. Pajweski and Callahan adapted prior frailty tools into the Electronic Frailty Index (eFI), a potentially groundbreaking tool that uses data elements generated by routine clinical care to yield a score indicating an individual’s level of frailty. Dr. Callahan’s dedication to improving patient care and Dr. Pajewski’s bio-statistical skills, along with their shared language of research and innovation, had enabled the adaptation and implementation of this powerful tool.
The eFI holds the potential to revolutionize healthcare for older adults. It offers several key advantages:
- Accessibility: Unlike traditional frailty assessments that require specialized tests and time, the eFI uses readily available electronic health record data to generate a passive digital marker for frailty. This means that it can be implemented and retrieved easily across various healthcare settings, making it accessible to a wide range of providers.
- Timely Intervention: The eFI provides a quick snapshot of an individual’s frailty level. This timely information enables healthcare teams to identify at-risk individuals and intervene proactively; for example, Population Health Care Navigators have worked proactively with high-eFI patients to improve health outcomes.
Personalized Care: Dr. Callahan’s work with the eFI also highlights the importance of personalized care in healthcare. The construct of frailty allows older adults and their healthcare providers to recognize the health status of an individual, as a means of contextualizing their medical condition, disease process, or health event. In the world of aging and geriatrics, frailty assessment is a valuable tool to help healthcare providers tailor their approach to patient care.
Off the Shelf
The eFI isn’t a theoretical concept—it has been put into practice and is available in the EHR. Dr. Callahan’s research with Dr. Pajewski demonstrated that frail individuals had significantly more adverse health events, including acute healthcare utilization (emergency department visits and hospitalizations), injurious falls, institutional care and mortality. Engaging support from healthcare providers and specialists across the healthcare system, Dr. Callahan secured support from the President’s office to prioritize EHR implementation of the eFI.
Thanks to key informatics support from the Center for Healthcare Innovation, Drs. Callahan and Pajewski led the integration of the eFI into the EHR. Insights from their research empowered healthcare teams during the COVID-19 pandemic to proactively reach out to frail older adults, providing timely support. To date, the eFI has been applied in multiple quality improvement and research projects, and is being tested as a means of understanding vulnerabilities of older adults in real time. This innovation allows healthcare providers to identify frail individuals in the moment, paving the way to test targeted interventions and personalized care.
“In healthcare, it’s not enough to treat diseases; we must also understand and address the unique needs of each patient. Frailty assessment is a critical step towards achieving that goal.”
A Champion of Personalized Care
Dr. Callahan’s work with the eFI also highlighted the importance of personalized care in healthcare. She recognized that understanding the unique needs of each patient is as critical as understanding their medical conditions. While the mission of advancing frailty research continues, Dr. Callahan’s contribution has been a catalyst for change. The eFI has opened doors for further exploration and intervention, offering hope for a future where older adults receive more personalized and effective healthcare.
Dr. Callahan’s work with the eFI also highlighted the importance of personalized care in healthcare. She recognized that understanding the unique needs of each patient is as critical as understanding their medical conditions. While the mission of advancing frailty research continues, Dr. Callahan’s contribution has been a catalyst for change. The eFI has opened doors for further exploration and intervention, offering hope for a future where older adults receive more personalized and effective healthcare.
A Heart of Gratitude
Throughout her journey, Dr. Callahan’s gratitude for her mentors, colleagues and team members shines through. She credits Drs. Helen Fernandez and Rosanne Leipzig at Mount Sinai for modeling physician-scholars; Dr. Jeff Williamson with recognizing her curiosity and drive as reflecting a nascent research drive; and Dr. Nick Pajewski with forging a strong research collaboration. Just as important has been peer and near-peer mentors and mentees, women she refers to as her “science sisters.” She emphasizes that mentorship has been a vital component of her personal and professional growth, and she pays it forward by mentoring young researchers and scientists. Her advice to those seeking mentors is to seek diverse perspectives, look for mentors’ successful collaborations and mentees, and be prepared to bring your own questions to the table.
Dr. Kate Callahan’s journey from medical student to geriatrician and researcher exemplifies what can be achieved through teamwork, collaboration, dedication, innovation, and a commitment to improving the lives of others. She hopes that the Electronic Frailty Index can contribute to transforming the way healthcare providers assess and care for frail older adults.
Beyond her professional accomplishments, Dr. Callahan’s philosophy of work-life integration and gratitude reminds us all of the importance of nurturing relationships, maintaining balance and being grateful for the opportunities we have.
“Life is a delicate balance, and our careers are just one part of it. Nurturing our personal relationships and maintaining our well-being are equally important journeys.”
Empowering the Future Generation of Women in STEM
In celebrating the career of Dr. Kate Callahan, we not only honor her individual achievements but also recognize her as a role model for the broader landscape of Women in STEM. Dr. Callahan’s journey from medical student to geriatrician and researcher exemplifies the immense contributions women make to the fields of science, technology, engineering and mathematics.
Her unwavering dedication to improving healthcare, her persistence in achieving implementation of the Electronic Frailty Index and her advocacy for personalized patient care serve as a testament to the transformative impact women continue to have in shaping the future of healthcare. Dr. Callahan’s story reminds us that diversity and innovation go hand in hand, and that by nurturing talent and pushing boundaries, we can create a world where Women in STEM continue to make meaningful differences in the lives of individuals and the broader community.
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