You probably know someone in their 70s or 80s who has had a fall. Maybe a parent slipping on the stairs, or a neighbor catching themselves on the kitchen counter. For many families, that one moment changes everything that comes next.
A large US trial published in October 2026 in JAMA Network Open tested a quiet tweak to the computer system in 22 primary care clinics. The tool, called eSTEPS, cut falls by about 9 percent in nearly 12,000 adults aged 65 and older.
The system did not add a new appointment or a new drug. It added a prompt inside the electronic health record, so clinicians could prescribe tailored strength and balance exercises during a routine Medicare Wellness visit.
How a prompt inside the software changed what happened at the visit
The eSTEPS tool was embedded in Epic, the electronic health record software many US clinics use. When an at-risk older patient came in, the system flagged a care gap and offered the clinician a short, personalized plan.
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The plan drew on the Otago program, a set of home strength and balance exercises originally developed in New Zealand. It also offered an optional physical therapy referral, printed handouts, a patient portal link with videos, and a mobile app for self-tracking.
Over an average of nearly two years, the clinics using eSTEPS saw fewer falls. The fall rate was 19.3 per 100 patient-years, against 21.2 in the control clinics. Fall-related injuries followed the same pattern, dropping from 16.7 to 15.7.
Only about one in five eligible patients actually received an eSTEPS exercise prescription during the study. The researchers at Brigham and Women's Hospital and Harvard Medical School say the benefit could grow if more clinicians use the tool.
What to ask your doctor at your next annual visit
The eSTEPS prompt uses the same screening questions the CDC built into its national Stopping Elderly Accidents, Deaths and Injuries program, known as STEADI. The approach rests on three simple questions.
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Have you fallen in the past year? Are you worried about falling? Do you feel unsteady when standing or walking? A yes to any of them triggers a closer look at fall risk.
For yourself or an aging parent, those three questions are a useful starting point. If any answer is yes, bring it up at the next appointment and ask about a referral for a strength and balance program.
The Otago exercises at the heart of eSTEPS are everyday moves done at home. Lower-body work like sit-to-stand repeats and heel raises. Balance moves like tandem walking, standing on one leg, and sideways walking.
Walking sessions fall in between. In the first Otago trial, published in 1995, participants who completed the program fell 35 percent less than peers who did not, according to the National Council on Aging.
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Each year, about 4.5 million emergency room visits in the US involve older adults who have fallen, according to federal data. Those visits lead to 1.4 million hospitalizations.
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This article is made and published by Aksel Kryhlmand, who may have used AI in the preparation.