Use of Digital Tools to Support Aging and Long-Term Care

 

Health Information Exchange to Improve Outcomes in Complex Older Patients
Sponsor: National Institute on Aging

It is critical to ensure that prior health information follows patients across care delivery settings in order to avoid poor outcomes from missing information. Older adults, particularly those with dementia and multimorbidity, are at disproportionate risk of poor outcomes from missing information and therefore should disproportionately benefit from efforts to increase electronic health information exchange. Our project will generate evidence that speaks to whether the nation is pursuing electronic health information exchange in ways that improve clinical outcomes for these populations and will thereby inform ongoing policy and practice-based efforts to help healthcare providers coordinate their services to older adults to optimize health status.

Health Information Exchange to Improve Outcomes in Complex Older Patients
Sponsor: National Institute on Aging

To improve information sharing across healthcare delivery organizations, there has been a substantial effort over the past eight years to promote adoption of electronic health records and the ability to share patient data between them (“health information exchange” or HIE). However, there is surprisingly little evidence about whether HIE is occurring in ways that will benefit older adults, both in terms of ensuring that the healthcare organizations that treat the same patient populations are able to engage in HIE with each other and, when they are, that they use HIE in ways that improve clinical outcomes (e.g., reduce repeat testing and hospitalization). This project will provide a national picture of the extent to which healthcare delivery organizations that routinely treat the same older patients are able to share patient information electronically with each other, and the impact of that connectivity on patient outcomes. 

Implementation, Scaling and Impact of the 4Ms in an IT-enabled Healthcare System
Sponsor: The John A. Hartford Foundation

The Age-Friendly Health System (AFHS) movement aims to transform our delivery system by advancing adoption of evidence-based priorities that improve care for older adults, focusing on What Matters, Medication, Mentation, and Mobility (4Ms). Our project will used mixed methods to understand contributors to implementation and scaling of the 4Ms in four diverse health systems as well as study the impact on outcomes for older adults. 

Understanding Information Continuity and its Impact on Care for Older Adults
Sponsor: The John A. Hartford Foundation

Substantial effort over the past decade has resulted in greater electronic availability of outside records for frontline clinicians.  However, most approaches to enabling such availability require clinicians to go outside of their local EHR (e.g., by logging in to a community longitudinal record) or to go to a separate tab in their local EHR that houses outside records. Under either approach, clinician workflow is interrupted and cognitive effort is required to marry local EHR data with data available in outside records. Newer approaches seek to co-mingle local EHR data with data from outside records, such that clinicians stay within their workflow and are presented with an integrated list of encounters, lab results, problems, medications, etc. Given the substantial work required to achieve this “last mile” step of integrating data from local and outside records, it is critical to assess the impact of such integration.  We therefore undertook the first-ever study to specifically investigate whether the frequency of outside record viewing increases after such integration as well as characterize for which types of encounters, viewers, and patients any increases accrued.