Technology: The Key to Timely and Coordinated Communication

With a mission to improve the health and well-being of older Californians and their caregivers, Archstone Foundation has recently rolled out its new strategic plan. Our three strategic funding areas – Teams, Training, and Technology,

With a mission to improve the health and well-being of older Californians and their caregivers, Archstone Foundation has recently rolled out its new strategic plan. Our three strategic funding areas – Teams, Training, and Technology, which we call the Three Ts – are built upon our legacy work in the programmatic areas of Falls Prevention, Elder Abuse and Neglect, Palliative Care and End of Life, Aging in Community, Depression in Late Life, and Family Caregiving.

Health care, social services, long-term services and supports, and related systems can and should work together to provide better care. Taken together, the Three Ts are intended to promote more equitable, high-quality, coordinated care for older adults. Further, the Three Ts draw from the lessons of our past work to support the themes that ran through our past initiatives.

My colleagues Jasmine Lacsamana and Jolene Fassbinder have already written about Teams and Training, respectively, on our Point of View blog. Please take a few minutes to read those if you haven’t already to gain a better understanding of why we chose the Three Ts and what we aim to fund.

Now, we’ll take a deeper dive into the third T: Technology.

Facilitating Teamwork and Empowering Older People and Their Families

Health care and social services silos create barriers that prevent the exchange of information and limit data sharing, which are critical building blocks to improving care. Removing these barriers are necessary steps to improving care coordination. Professionals working to support older adults and their families should have 24-7 access to care plans across all settings, where possible. At the same time, privacy concerns must be addressed.

Team care is most effective when all members of a care team, including older people and their caregivers, have real-time notice of important changes of health status, such as a hospitalization or emergency department visits. Similarly, as we have learned from our past work in end of life, palliative care, and advance care planning, goals of care and end-of-life wishes must also be immediately available to health care providers if they are to act upon those stated desires.

Technology grantmaking will focus on promoting the adoption of technologies that facilitate teamwork and empower older adults and their families to direct their own care.

As an independent party, we think that Archstone Foundation is well positioned to use advocacy, standard setting, convening, and public communication as tools to advance the technological infrastructure to achieve better care. In conjunction with our teams and training strategies, we can demonstrate the cost and quality benefits of appropriate technology use to various stakeholders.

Learning from Our Past Work

Below are several examples of how our past grantmaking has inspired or built upon technology-related solutions:

Reducing Falls in Older Adults Using Data-driven Technology

One example of the power of technology to improve care is the County of Ventura, which has implemented an alert system to notify the Ventura County Area Agency on Aging if an older adult has fallen. Ventura County Area Agency on Aging (AAA), an early Archstone Foundation falls prevention grantee, has created an automatic electronic notification system that alerts the AAA staff when Emergency Medical Services (EMS) is dispatched for an older adult who has fallen.

The AAA uses the automated contact information they receive to enable them to call people who have fallen or their family members and proactively offer services such as a home inspection, falls reduction classes, or other interventions. There is no need for the AAA to wait for the older adult or the family to hear about their services and call. In Ventura County, aging services calls you!

State Health Information Guidance Volume 2 – Sharing Information between Health Care and Food Providers

Another example of our current work is the grant to California Office of Health Information Integrity (CalOHII), in collaboration with Nourish California and the Primary Care Association, to publish the State Health Information Guidance Volume 2 to standardize and clarify federal and state law in order to address food and nutrition insecurity among Californians. The SHIG 2.0 shows a new path forward for sharing data among food and health care providers, and in interpreting state and federal laws.

In SHIG Volume 2, the State of California provides guidance about how health and social services information can be shared in the day-to-day practice of providing integrated care and services to address food and nutrition insecurity. We view our support for the creation of this roadmap to standardized sharing as a critical first step in paving the way for a digital infrastructure. Other social services for older adults may use the guidance provided by this report to help guide data and information sharing across agencies.

Care Partners – CMTS Registry

Another recent example is from our Depression in Late Life work. The project sites used the CMTS Registry system developed by the AIMS Center at the University of Washington to track progress toward treatment goals using a simple interface. CMTS keeps track of all patients currently engaged in treatment, making sure none of them inadvertently fall through the cracks. CMTS differs from Electronic Medical Records (EMRs) in that EMRs collect information about care for clinical, billing, and legal purposes, but typically don’t have the algorithms designed to assist in evidenced-based treatment. The CMTS facilitates evidence-based care for depression in older adults by supporting a treatment-to-target approach for care that is population based, measurement based, and team based.

Looking Toward the Future

We envision future grants within this strategic funding area may include:

• Developing ways for different systems and devices to communicate with one another — interoperability;
• Advocating for better regulatory frameworks;
• Promoting affordable technological devices and services that enable lower-income older adults and their families to realize the benefits of team care; and
• Demonstrating technology’s benefits to all stakeholders.

Technology is the piece of our new strategic grantmaking approach that can help get care right for older adults. It is the element that can help bring ideas to scale to make sure that communication happens in a timely and coordinated manner.

If you are working to implement programs that facilitate connections between health care and social services providers, and empower older adults and their families to direct their care, we would be interested to hear from you.

If you’d like to discuss how your work might fit into our core funding strategies of Teams, Training, and Technology, my fellow program offers and I will be holding weekly virtual office hours to connect. We look forward to hearing from you and the work we will do together to improve care for older Californians and their caregivers.