PROJECT SUMMARY/ABSTRACT This K01 application is for Sunny C. Lin, PhD, MS, whose research focuses on improving the equity, efficiency, and effectiveness of health information technology use for adults with Alzheimer’s disease and related dementias (ADRD). Adults with ADRD account for over 40% of all emergency department (ED) visits among patients over age 64, and are more likely to experience poorer quality ED care than those without. Adults with ADRD who are racialized as Black may be especially at risk of experiencing poor quality care due to racial prejudice, structural racism, and stereotyping. Among older populations, especially those with ADRD, access to patient data is often critical to providing high quality ED care. However, obtaining reliable data from adults with ADRD is often difficult or impossible. To fill this gap, many ED providers rely on health information exchange (HIE) to access patient data. HIE can aid in diagnoses, reduce medication errors, and reduce time spent in the ED. Moreover, studies have highlighted the potential for HIE to improve racial equity in ADRD care by reducing physician bias in diagnostic and treatment decisions, increasing access to specialty care, and identifying social needs. However, prior work has found that HIE efforts are often fragmented by upstream determinants such as competition and resources, limiting data flows and potentially leading to racial inequities in data access. There is a critical need for research on racial equity in HIE, especially among adults with ADRD, a growing and vulnerable patient population. The aim of this proposal is to assess racial equity in HIE connectivity and use and determine whether HIE is associated with better ED quality for adults with ADRD. Utilizing two novel and complimentary datasets on adults with ADRD (i.e., Medicare claims and Electronic Health Record event log data), Dr. Lin will 1) characterize racial disparities in ED quality, 2) identify patterns of HIE use and its impact on ED process measures of quality, and 3) identify patterns of HIE connectivity and its impact on ED outcome measures of quality. Dr. Lin’s career goal is to become an independent investigator and nationally-recognized expert on equity in health information technology. Through this award, Dr. Lin will achieve the following goals: 1) learn how social systems lead to and reinforce racial inequities in ADRD and ED care, 2) become familiar with systems science techniques for understanding how racial inequities in HIE data flows emerge, and 3) gain skills and experience in analyzing EHR event-log data. The proposed research and training activities are made possible through the resources and expertise housed in Dr. Lin’s home institution, Washington University in St. Louis, including: the Center for Advancing Health Services, Policy & Economics Research, the Institute for Informatics, Data Science, and Biostatistics, and the Knight Alzheimer’s Disease Research Center. Dr. Lin has the supp...