Editor’s Note: Data exchange is crucial to coordinating care and services for older Californians, particularly those who have an array of health and social needs and require multidisciplinary teams to manage care and transitions between settings. Too often, however, health care and social services are siloed, which creates barriers that limit data sharing needed to improve care and outcomes.1 In a new report for the Archstone Foundation, Manatt Health provides an overview of data exchange in California as it relates to older adults, including a strategic landscape, opportunities assessment, funding priorities and key areas where investment could have maximum impact. An executive summary is below. Click here to download a free copy of the full report—and here to view our free webinar based on the report, including important lessons for other states seeking to advance data exchange and enhance team-based care for older populations.
As health and human services are increasingly delivered and supported by digital technologies, it is essential that older adults and caregivers have access to and the capability to use digital and broadband-enabled technologies. Older adults, however, still face a digital divide when it comes to the adoption and use of smartphones and the Internet, which remain lower for older adults than for younger populations.
Similarly, it is important for the health and human services providers who care for older adults to have the health information technology (HIT) and data exchange capabilities to seamlessly use and exchange data with other settings and care team members. While most acute care hospitals and physician organizations have benefited from funding programs that have enabled adoption of HIT and data exchange capabilities over the past decade, many providers who predominantly care for older adults were not eligible for those funding programs, and their capabilities have lagged.
It is important to consider a core set of funding opportunities and principles in order to accurately assess the efficacy of interventions and deploy resources to advance technology and data exchange that enable better team-based care for older adults. These core opportunities and principles, summarized in the table below, are organized into three domains: Collaboration and Partnerships, Research and Evaluation, and Pilot Programs.
Potential Challenges
In pursuing these and other initiatives to improve team-based care for older adults, there are several potential challenges to keep in mind:
- Change Management. Introducing new technologies or care models can be disruptive to existing workflows, resulting in adoption resistance from care team members.
- Workforce. Poor data and technology illiteracy among health care workers are common barriers to the digital transformation of health care.2
- Broadband Adoption. Access to high-speed Internet is not yet ubiquitous, particularly among older adults, rural settings and organizations that care for older adults.3, 4
- Unproven Initiatives, Services and Technologies. There is a constant stream of exciting new technology and data exchange solutions being introduced in the market, but many of them are largely untested. Many will fail to gain traction or will be challenging to sustain and scale.
- Remote Patient Monitoring Technologies. Without basic data exchange infrastructure in place, it is exceedingly difficult and labor-intensive to systematically incorporate data generated by remote patient monitoring technologies into workflows.
- Cost, Complexity and Business Case for Interoperable Data Exchange. The cost and complexity of implementing the technologies, tools and systems needed for interoperable data exchange have meant that the promise of better data exchange alone is not always a compelling enough business rationale to drive actual exchange.
These challenges can be addressed through careful deliberation of potential pitfalls at the outset of any initiative. Indeed, the landscape of data exchange presents significant opportunities to deploy investments that advance cross-sector, team-based care for older adults.
1 “Health information technology to improve care for people with multiple chronic conditions,” Health Services Research. Aug. 2021. Available at https://onlinelibrary.wiley.com/doi/10.1111/1475-6773.13860.
2 “A Digitally Competent Health Workforce: Scoping Review of Educational Frameworks,” Journal of Medical Internet Research. Nov. 2020. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7677019/.
3 “Internet Adoption and the ‘Digital Divide’ in California,” California Emerging Technology Fund. 2021. Available at https://www.cetfund.org/action-and-results/statewide-surveys/2021-2/.
4 “Tips for Senior Care Organizations on Upgrading Their Network Infrastructure,” Health Tech Magazine. Jul. 2022. Available at https://healthtechmagazine.net/article/2022/07/tips-senior-care-organizations-upgrading-their-network-infrastructure.