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URMC / Emergency Medicine / Research / Geriatrics


Goals & Description

The goal of this research area is to evaluate and improve the system of medical care for older adults with acute healthcare needs. There are many factors that limit these patients' access to safe, patient-centered, efficient, high-quality, acute care. These factors foster unnecessary ED use, adverse events in the ED for which older adults are particularly at-risk, and unnecessary medical costs. This research is particularly important due to the increasing number of older adults.

Ongoing Projects

EMS Provider Decision-Making - Medical Simulation 

Evaluating EMS provider decision-making processes for patients with traumatic brain injury through the use of medical simulation and situational awareness.  Our current work focuses on understanding how EMS providers evaluate injured patients including the application of and adherence to protocols and decision tools and how patient and system factors influence care decisions.

Community Paramedicine - Care Transitions

Evaluating the ability of emergency medical technicians and paramedics to identify older adults with unmet needs.  Our current research focuses on developing and refining a paramedic-coached care transitions programs for older adults discharged home after an emergency department visit.

Access to Care - Older Adults with Depression

Experimental study examining potential barriers to primary care for older adults with depression.  Our recent survey work has shown significantly greater perceived barriers to care for individuals with depression, and this current work seeks to identify true individual- and system-level causes for these observed disparities.

Syncope - Improving Risk Stratification in Older Adults

Observational study of older adults with unexplained syncope to describe existing care, derive and validate a novel risk prediction model for significant outcomes, and estimate diagnostic yield and costs of implementing risk-based decision algorithms. The long-term goal is to eliminate unnecessary admissions of older adults with unexplained syncope by improving risk prediction.


Shah MN, Wasserman EB, Wang H, Gillespie SM, Noyes K, Wood NE, Nelson D, Dozier A, McConnochie KM. High-Intensity Telemedicine Decreases Emergency Department Use for Ambulatory Care Sensitive Conditions by Older Adult Senior Living Community Residents. Journal of the American Medical Directors Association. 2015;16(12):1077-81 doi: 10.1016/j.jamda.2015.07.009

Shah MN, Wasserman EB, Wang H, Gillespie SM, Noyes K, Wood NE, Nelson D, Dozier A, McConnochie KM. High-Intensity Telemedicine Decreases Emergency Department Use by Senior Living Community Residents. Telemedicine and e-Health. 2016:22(3);1-8. doi:10.1089/tmj.2015.0103

Ichwan B, Darbha S, Thompson L, Shah MN, Thompson L, Evans DC, Boulger C, Caterino JM. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults. Annals of Emergency Medicine.  2014 June 5.

Hwang U, Shah MN, Carpenter CR, Han J, Adams J, Siu A. The CARE SPAN—Transforming emergency care for older adults.  Health Affairs.  2013 Dec;32(12):2116-21.

Shah MN, Gillespie SM, Wood N, Wasserman EB, Nelson DL, Dozier A, McConnochie KM.  High-intensity telemedicine-enhanced acute care for older adults:  an innovative health care delivery model. Journal of the American Geriatrics Society.  2013; 61: 2000-2007.

Shah MN, Morris D, Jones CMC, Gillespie SM, Nelson DL, McConnochie KM, Dozier A.  A qualitative evaluation of a telemedicine-enhanced emergency care program for older adults. Journal of the American Geriatrics Society. 2013;61:571–576.

Shah MN, McDermott R, Gillespie SM, Philbrick EB, Nelson D.  Potential of telemedicine to provide acute medical care for adults in senior living communities.  Academic Emergency Medicine. 2013;20(2):162-8.

Shah MN, Swanson P, Nobay F, Peterson LKN, Caprio TV, Karuza J. A novel internet based geriatric education program for emergency medical services providers. Journal of the American Geriatrics Society. 2012;60(9):1749-54. NIHMS385596.

Archived Publications

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Source Type Description
AHRQ R01 Telemedicine for Acute Illnesses and Injuries
CDC U01 Prehospital Triage of Older Adults with Injuries
NIH/NHLBI R01 Improving Syncope Risk Stratification in Older Adults
NIH/NIA R03 Deriving a Prehospital Triage Decision Scheme for Injured Older Adults
SAEM   Institutional Research Training Grant