On September 23, 2024, the Thai Orthopedics Association together with Siriraj Health Policy Unit at Faculty of Medicine, Siriraj Hospital held a press conference to announce the collaboration on a preliminary project for developing surveillance and prevention system for falls, hip fractures and recurrent fractures among the elderly population in Thailand. The event included addresses by Squadron Leader Thanut Valleenukul, Board Member of the Thai Orthopedics Association, who provided an overview of the background for the development of this collaborative project. Additionally, Professor Keerati Chareancholvanich, the President-Elect of the Royal College of Orthopedic Surgeons of Thailand and President of the Thai Orthopedics Association, discussed the objectives of this collaboration and officially inaugurated the event held at the Intercontinental Hotel, Bangkok.

The event was also attended by senior executives from nine supporting organizations, including Faculty of Medicine, Siriraj Hospital; Royal College of Orthopedic Surgeons of Thailand; Thai Orthopedic Association; Thai Health Promotion Foundation; Ministry for Interior; Ministry of Public Health; National Health Security Office; Thailand Center of Excellence for Life Sciences and Krung Thai Bank Public Company Limited. They participated in the event and discussed their collaboration in the preliminary project for developing surveillance and prevention system for falls, hip fractures and recurrent fractures among the elderly population in Thailand.

Squadron Leader Thanut Valleenukul, Executive Member of the Thai Orthopedics Association and the Project Director, expressed his sincere gratitude to the Royal College of Orthopedic Surgeons of Thailand; the Thai Orthopedic Association; Siriraj Health Policy Unit at Faculty of Medicine, Siriraj Hospital; the Thai Health Promotion Foundation; the National Health Security Office, Ministry of Interior, Ministry of Public Health, Thailand Center of Excellence for Life Sciences and Krung Thai Bank Public Company Limited for their invaluable collaboration and support in the preliminary project for developing surveillance and prevention system for falls, hip fractures and recurrent fractures among the elderly population in Thailand. 

He revealed that Thailand currently lacks a systematic data collection system for elderly individuals with hip fractures resulting from falls, particularly in the context of integrated prevention, promotion, and rehabilitation, the project team has analyzed the "Nan Model." Consequently, they propose a pilot project aimed at developing a monitoring and prevention system for falls, fractures, and recurrent fractures in the hips of elderly individuals in Thailand. This initiative will focus on a target study area encompassing 11 provinces and 1 district, with a proposed duration of 2 years. The objectives of this project are as follows:

1.    Develop a screening system for the diagnosis and monitoring of patients with osteoporosis, who are at risk for falls and hip fractures.
2.    Establish a registry system for patients with hip fractures to connect patient data across various healthcare facilities, facilitating continuous care, home rehabilitation, and the prevention of recurrent fractures.
3.    Create an analytical system to identify factors related to falls and recurrent falls, as well as those affecting the effectiveness of implemented measures, access to services, and various impacts.
4.    Develop strategies for scaling the pilot project to ensure its suitability within diverse local contexts for nationwide implementation.
5.    Investigate the economic impacts, including the budgetary burden on the government in providing care for this patient population.

The project team hopes that this initiative will successfully reduce the incidence of falls, decrease mortality rates associated with hip fractures, and enhance the quality of life for patients suffering from such injuries. Furthermore, it aims to alleviate the financial burden associated with medical treatment and long-term care for these patients.

Professor Keerati Chareancholvanich, President-Elect of the Royal College of Orthopedic Surgeons of Thailand and President of the Thai Orthopedics Association, explained that the purpose of this project is to establish effective and sustainable care standards for the elderly people who are at high risk for falls and hip fractures. These issues significantly impact the quality of life for seniors and represent a major health burden. The Thai Orthopedics Association, in collaboration with Siriraj Health Policy Unit at Faculty of Medicine, Siriraj Hospital, recognized the importance and results of the “Nan Model” project and, therefore, intended to expand on developing a surveillance system for high-risk elderly individuals, utilizing community health volunteers, and implementing a tracking system for elderly patients with a history of falls and fractures through local health promotion hospitals. This approach effectively integrates primary and secondary prevention measures and can be adapted for implementation in other provinces.

Professor Thananya Boonyasirinant, Deputy Dean of Innovation, Excellence and Corporate Value, Faculty of Medicine, Siriraj Hospital, asserted that this collaboration not only supports research for the development of information technology systems capable of communicating knowledge and self-care practices in the elderly people, but it also facilitates the collection of treatment data and ongoing home care, as well as the transmission of information to relevant healthcare service networks at all levels. Furthermore, it serves to enhance "health innovations for the elderly," which will contribute to improving the quality of life for elderly individuals and creating a sustainable healthcare system in Thailand.

Assistant Professor Police Major Thongchai Suntharapa, 1st Vice President of Thai Orthopedic Association, announced that on behalf of all orthopedic surgeons throughout the nation, "we are pleased to offer our support in facilitating collaborative networks to establish operational mechanisms at the policy level, community level, and inter-agency level, in addition to providing consultation and knowledge regarding care systems, monitoring, and surveillance for elderly individuals at risk of falls and fragility fractures, particularly recurrent fractures around the hip joint. Our goal is to create an effective system for preventing and reducing risks in this patient population."

Dr. Chawetsan Namwat, Director of the Thai Health Promotion Foundation, affirmed that the Thai Health Promotion Foundation has implemented the preliminary project for developing surveillance and prevention system for falls, hip fractures and recurrent fractures among the elderly population in Thailand. This initiative focuses on developing care skills among healthcare personnel, village health volunteers (VHVs), as well as family members and their intimates. The primary objectives of this project are to establish a model system for preventing and reducing falls and hip fractures, including new cases and recurrent fractures; to develop strategies for scaling up these efforts; to create an information technology system for managing and monitoring Thai elderly individuals in the risk group; to study the economic impact, such as costs incurred by patients and their families, as well as the budgetary burden on the government. Elderly individuals who experience falls and hip fractures are likely to experience recurrent hip fractures. Therefore, developing the skills of healthcare personnel and VHVs in the community will be considered as proactive approach which can effectively reduce the number of patients. 

Mr. Sutthiphong Chuncharoen, Permanent Secretary of the Ministry of Interior, states that it is a crucial mission for us at the Ministry of Interior to collaborate with Siriraj Health Policy Unit at Faculty of Medicine, Siriraj Hospital; Royal College of Orthopedic Surgeons of Thailand and Thai Orthopedics Association. We will enhance proactive health promotion together for citizens through mechanisms that cover every square inch of Thailand, corresponding with the vision of Ministry of Interior "76 Provinces, 76 Commitments for Sustainable Thailand." 

Dr. Direk Khampaen, Deputy Director General of Department of Disease Control, mentioned that this project is immensely beneficial. If it continues to be promoted and integrated into other provinces, it will enhance the quality of life for all citizens, particularly the elderly. It will establish a system for assessing the fall risk among at-risk individuals, as well as mechanisms to prevent recurrent fractures in the elderly.

Dr. Chakkrit Ngo-siri, Expert from the National Health Security Office, indicated that promoting health, preventing disease, providing care, and facilitating rehabilitation after surgery are essential and should be integrated into the healthcare system. The National Health Security Office serves merely as a supportive entity, offering assistance with budget and data as needed. We are fully committed to supporting this initiative, as it benefits both the community and the overall healthcare system. Accordingly, credit must be given to Faculty of Medicine, Siriraj Hospital, for developing this innovative approach, and we believe that all relevant agencies are prepared to implement this project together.

Ms. Sunicha Chanvatik, Head of the EPI Task Group from Thailand Center of Excellence for Life Sciences (TCELS), declared that TCELS will actively participate in the development and promotion of medical technology innovations. We are prepared to provide budgetary support to ensure the continued progress of this project for enhancing the quality of life of elderly individuals in all dimensions. This initiative serves as a strong foundation for future projects. 

Mr. Thawatchai Chiwanon, Chief Product and Business Solutions Officer and Acting Executive in Financial Management for Business and Technology from Krungthai Bank Public Company Limited, reported that Krung Thai Bank, as a state-owned commercial bank, is committed to leveraging technology and innovation to enhance healthcare services, which is one of the five key ecosystems that Krung Thai Bank prioritizes to promote a better quality of life for the Thai population. Through a digital platform that connects various data and services, the bank has recently joined forces to drive a project aimed at developing innovative health management, monitoring, and surveillance solutions for elderly individuals at risk of falls and fractures, including recurrent fractures. This initiative brings together leading organizations from multiple sectors, including the medical field, government agencies, and financial institutions, to create innovations that benefit Thai society as a whole, particularly in the health of the elderly—one of the most vulnerable groups at risk of injury from falls and fractures. The rapid and effective development of a surveillance and prevention system will strengthen Thailand’s healthcare system, elevate healthcare standards, and improve the quality of life and safety for the elderly, corresponding with the vision of Krung Thai Bank “Growing Together for SUSTAINABILITY”.