1. Austin, Robin R. PhD, DNP, RN-BC

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By 2060, approximately 23% of the population in the United States will be older than 65 years of age.1,2 Innovative approaches are needed to support older adults' overall health and well-being, including multiple chronic conditions, and access to home health or hospice services. However, healthcare policies have influenced the uptake of information technology by healthcare organizations. Given the current global COVID-19 pandemic, virtual care delivery methods, data interoperability, and information technology infrastructure to support nursing care have become vital to clinical care.3-5 In this article, we share highlights from a collaborative symposium during the Virtual Midwest Nursing Research Society (MNRS) conference held last March 31 to April 3, 2020. This collaborative symposium was a partnership between the Health Systems, Policy, and Informatics (HSPI) and the Gerontological Nursing Science (GNS) Research Interest Groups (RIGs). The MNRS HSPI RIG is a member of the Alliance for Nursing Informatics. The purpose of this symposium was to draw from expertise of the two RIGs (HSPI and GNS) to present and discuss innovative use of healthcare technology, relevant to the care of older adults. Topics included consumer-generated health data, health data sharing among stakeholders, and nurse activities related to telehealth monitoring. This virtual symposium, attended by approximately 83 conference participants, featured a moderated session with three presenters from different academic institutions, representing both RIGs.


The first presentation, "Opportunities and Challenges of Health Data Sharing in Nursing Homes," focused on sharing health data as an innovative approach to engaging patients and promoting person-centered care of older adults. While there is growing evidence for the benefits of data sharing in acute and outpatient settings, little is known about data sharing in post-acute settings like nursing homes (NHs).6,7 This study employed a qualitative, descriptive design using semi-structured interviews with NH administrative leaders (N = 12). Three broad themes emerged: (1) general perceptions of data sharing: with residents and family members, and with external clinical partners; (2) challenges to data sharing: privacy and security, transparency and control, fear of lawsuits, and organizational factors slowing uptake of technology; and (3) potential opportunities from data sharing: improved communication, care planning, and anticipation of future demand. This study highlighted an understanding of perceived opportunities and challenges to health data sharing, an important first step for stakeholders to achieve potential gains such as having more complete clinical data to make informed care decisions, promoting transparency, and improving quality of care.


The second presentation, "Picturing Whole-Person Health Using Consumer-Generated Health Data of Older Adults," showed how structured data can be used to represent a whole picture of health to include strengths, challenges, and needs. A consumer-facing application, MyStrengths+MyHealth (MSMH), using the multidisciplinary health terminology of the Omaha System, was developed to enable individuals to self-report strengths, health challenges, and needs.8,9 This study evaluated MSMH data collected at a Midwest state fair in 2017 (N = 345). Of the data from the 345 participants, we identified a cohort of adults 65 years and older (n = 76) for analysis. This study showed older adults, on average, had more strengths (mean number of strengths, 21.6 +/- 13.9) than challenges (8.1 +/- 8), and more challenges than needs (1.5 +/- 3.5) (analysis of variance [ANOVA], F = 87.26, P < .001). This is consistent with previous studies and suggests the potential usefulness of consumer-generated strengths for healthy aging and managing chronic conditions.9-11 Additionally, we found those that reported 21 to 30 strengths were more likely than others to report needs (ANOVA, F = 2.92, P = .04). This may suggest possible patient engagement and activation as individuals are sharing ways to improve their health.12,13 Overall, the ability to quantify a whole-person perspective using standardized consumer-facing language has the potential to include the consumer voice in health data. Such data may allow individuals to engage in new conversations with the care team and participate in healthcare decisions.


The third presentation, "Primary Care Clinic Nurse Activities with a Telehealth Monitoring System," discussed ways that patient self-management support via home-based technologies can provide data to primary care providers, which may be used to increase between-visit monitoring and make more timely changes to patient care.14 The purpose of this study was to evaluate differences in the types of nursing activities reported in a primary care clinic between patients who used a home-based monitoring system to electronically communicate self-monitored blood glucose and blood pressure values and those who assumed usual care. This study provides evidence of greater nursing activity reported in a primary care clinic in patients who utilized a home-based monitoring system. It is important to evaluate nursing activities performed to gain a better understanding of workflow implications in a real-world setting. This will allow for improved integration of home-based monitoring systems into primary care clinics.


This collaborative symposium brought together research experts from two MNRS RIGs (HSPI and GNS) to present and discuss innovative uses of healthcare technology, relevant to the care of older adults. Specific topics included health data sharing among family members and stakeholders, the use of consumer-generated health data, technology usability issues, and nurse activities related to telehealth monitoring implementation. The recent global health crisis centered on the COVID-19 pandemic was seen as a catalyst to further accelerate the need for technology innovation and health policy changes to influence current and future care delivery for older adults. Specifically, the rapid deployment of virtual healthcare during COVID-19 highlights technology opportunities, challenges, and new health policies needed to improve care delivery for this population.14,15


There was a consensus among presenters that emerging technologies will be important in caring for older adults. For example, personal monitoring devices such as Fitbits and other smart devices can be used to track health remotely and in turn share these data with providers.16


Another example, sensor technology, will have a significant impact especially for the ability to safely age in place with a sense of security and well-being.17 Finally, the ability to connect these technologies with social and behavioral determinants of health (SBDH) data is a transformational change needed in healthcare delivery to provide context for a comprehensive whole-person picture of health.18,19 Combing all data (personal monitoring, sensor technology, SBDH, and clinical data) will be invaluable to achieve shared understanding of whole-person health, reveal new data to individuals and their care team, and inform population health outcomes. This collaborative symposium was a timely opportunity to share science across disciplines (ie, gerontology and informatics) to build partnerships to transform healthcare for older adults.



The author thanks Kimberly Powell, PhD, RN; Chelsea Howland, MSN; Sarah Brzozwski, MSN; Clayton Shuman, PhD, RN; and Kimberly Oosterhouse, PhD, RN.




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