Written by Dr Siân de Bell, University of Exeter.
Dr Siân de Bell and colleagues reviewed studies on data sharing in the care of older people in response to a Social Care Wales research priority setting exercise on care and support for older people. This was done in association with Health Care Research Wales and the James Lind Alliance. The research priority setting identified a gap in evidence about how social care and health services can work together more effectively to meet the needs of older people. In this post, Dr de Bell outlines some of the key findings of their review.
As people grow older, they are more likely to have multiple health conditions and complex health needs. They may have various types of healthcare professionals such as GPs, nurses and occupational therapists involved in their care, as well as social care professionals like carers and social workers.
These different people, who come from a variety of organisations, need to work together to make sure that care is delivered in the best way for the individual. An important part of this is data sharing.
Data sharing is the transfer of information about a person (for example, an electronic patient record) between healthcare and social care organisations or care professionals.
Our review focused on the topic of data sharing. It aimed to answer the question ‘what are the factors perceived as influencing effective data sharing between healthcare and social care, including private and voluntary sector organisations, regarding the care of older people?’
You can see the main findings in our report, published in the NIHR Journals Library, and the evidence briefing available on our webpage. However, to give a brief summary, 24 studies were included in the review, and within these studies we found four main themes.
Goals: We identified five purposes of data sharing in the included studies: joint assessment of health and social care needs, integrated case management, transitions from hospital to home (for residents of care homes and for palliative care).
Relationships: Building interprofessional relationships, and therefore trust and respect, between professionals supported data sharing, whilst the presence of professional prejudices and mistrust made it difficult.
Processes and procedures: Organisations needed to develop processes to help them share data, such as a shared vision of care and formal agreements such as on data governance. These supported data sharing.
Technology and infrastructure: When factors from the other two themes were in place, such as trusting relationships between individuals, technology was a tool that could support data sharing. Professionals’ awareness of the wider care system - for example, the information that other people needed, also helped data sharing.
There were specific factors that influenced data sharing depending on its purpose - for example, a lack of legal frameworks in the area of palliative care.
Qualitative research involves reading and re-reading the data that you’re working with. This can make it easy to forget that the people who will be reading the results won’t necessarily have the familiarity you have with the data.
We found data sharing between health and social care a complex topic to understand and explain, so we wanted to present our results in a way that was as easy to understand as possible.
Whilst the themes above identify important factors that influence data sharing between health and social care, we wanted to go beyond them. And show a data sharing model that would make it more obvious where the system can be influenced to create change.
The model shows the factors that help data sharing to happen occur at different levels: from the individual, to the organisation, and the external such as the policy and funding context. These factors then interact with each other in ways that support or prevent data sharing.
For example, there needs to be external legislation in place that enables organisations to share data, whilst at an organisational level, there needs to be agreements between organisations that allow data sharing and agreed ways of doing this. Individual staff then need training and support so that they know how and when to share data.
For more information on the project and its conceptual model, visit the report.
University of Exeter