# Health Information Exchange to Improve Outcomes in Complex Older Patients

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $305,852

## Abstract

Project Summary Abstract
Due to our fragmented healthcare delivery system, sharing patient health information across healthcare delivery
organizations is an essential component of high-quality care but does not occur routinely. When critical health
information is missing, care continuity is impeded, with increased risk of poor patient outcomes. Older adults
have a disproportionate share of complex health conditions that result in their needing to see multiple providers
in different organizations. They are therefore at disproportionate risk of poor outcomes that result from lack of
information sharing, including repeated testing and avoidable hospitalization. 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).
Our 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. Today, no such
measures exist, creating a problematic blindspot in terms of understanding whether there is connectivity where
it is most needed. In addition, where healthcare delivery organizations are engaging in sharing patient
information electronically, we will assess whether it is improving key outcomes for the older patients that receive
care from those organizations. These outcomes include repeat testing, hospitalization and rehospitalization, and
mortality. Importantly, we will assess whether the benefits from electronic information sharing disproportionately
accrue to two populations of patients who are most at risk of poor outcomes from lack of information sharing:
those with dementia and those with multiple health conditions. By focusing on these populations, we will be able
to determine whether the current “one-size-fits-all” approach to electronic health information sharing is working
or whether it requires customization to the unique needs of different patient populations.
By generating new evidence on the current state of electronic health information sharing across healthcare
delivery organizations, study results will guide key stakeholders on how to combat the risks of care fragmentation
by sharing information in ways that improve outcomes for older adults in general, and for the most vulnerable
older adults in particular.

## Key facts

- **NIH application ID:** 10385686
- **Project number:** 5R01AG062563-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** JULIA Rose ADLER-MILSTEIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $305,852
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10385686

## Citation

> US National Institutes of Health, RePORTER application 10385686, Health Information Exchange to Improve Outcomes in Complex Older Patients (5R01AG062563-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10385686. Licensed CC0.

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