# Demonstrating the potential for electronic health record interoperability to improve patient safety research of older adults over the acute episode of care.

> **NIH NIH R01** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $897,555

## Abstract

PROJECT SUMMARY
Older adults with multiple chronic conditions (MCCs) are often hospitalized and are at risk for adverse events
(AE) during acute episodes of care. Fragmented care across different healthcare providers is common for
these patients and increases risk of AEs, especially in elderly patients with unrecognized geriatric conditions.
Patient safety research that attempts to address these risks are limited by available data and often lack of
access to electronic health records (EHR) from providers external to the health system conducting the
research. We propose leveraging emerging interoperability standards, and public policies that require their
adoption, to empower patients to locate, retrieve, and share their EHRs with our research team. We will partner
with two studies that will enroll older adults and aim to reduce AEs during acute care episodes. Both studies
have timelines suitable to consenting participants for this demonstration study. To accomplish our aims, we will
leverage and enhance our existing digital infrastructure (a web-based application and secure backend cloud
technology) that we have developed and implemented in past and ongoing work. Leadership of both partner
studies will play major roles in this work, ensuring strong coordination. In Aim 1, we will enhance our existing
digital infrastructure using two open-source projects. We will leverage infrastructure from the Sync-for-Science
(S4S) Procure project (used in the All Of Us Research Program) enabling patients to use HL7 FHIR Services
to find and share their EHRs with research teams. The MCC e-Care Plan project will supply clinical information
models and value sets, ensuring that data collected can be used for both research and clinical care. User
needs and requirements for identifying prior sites of care and sharing EHR data from those sites with the
research team will be elicited via a rigorous user-centered design process. In Aim 2, we will implement and
iteratively refine workflows defined in Aim 1 using mixed methods. In Aim 3 we will develop analytic methods
for harmonizing aggregated EHR data and metrics relevant to our partner studies. These metrics will reflect
care fragmentation based on EHR data aggregated using FHIR services, including unrecognized geriatric
syndromes identified by applying natural language processing to unstructured text in retrieved clinical notes. In
Aim 4, we will use these metrics as risk factors in a multivariable regression model to assess their effect on the
safety outcomes of our partner studies. This analysis will demonstrate how novel assessments of care
fragmentation and conditions common in geriatric populations contribute to AEs during acute care episodes.
Our expert advisors, consultants, and software developers will assist with all clinical and technology aspects of
this work. Our demonstration study will produce foundational knowledge regarding how to empower patients to
collect and share their data with research teams, ...

## Key facts

- **NIH application ID:** 10925362
- **Project number:** 5R01AG083035-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Anuj K Dalal
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $897,555
- **Award type:** 5
- **Project period:** 2023-09-15 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10925362

## Citation

> US National Institutes of Health, RePORTER application 10925362, Demonstrating the potential for electronic health record interoperability to improve patient safety research of older adults over the acute episode of care. (5R01AG083035-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10925362. Licensed CC0.

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