The Adopter System: Why Real Engagement Starts Before Go-Live
Updated: Oct 19
"Technology adoption is not achieved through communication and training alone. It begins when people are genuinely involved in shaping how technology will change their care, work and daily routines."
Across Australian aged care and disability services, technology implementations frequently place considerable emphasis on technical readiness. Systems are configured, devices are tested, processes are documented and training is scheduled before go-live.
Yet technical readiness does not guarantee adoption.
A care worker may complete training but remain uncertain about their responsibilities. A family member may welcome remote monitoring but lack confidence in responding to alerts. A care recipient may agree to use a device without fully understanding how it will affect their daily routine.
In each case, the technology may be ready, but the people expected to use or support it are not.
Adoption is not simply securing agreement to change. It is creating the conditions for people to use technology confidently, consistently and meaningfully.
In Article 1 - Why Care Technology Adoption Fails, we introduced the seven influences of the NASSS framework. The preceding articles explored the condition, technology and value proposition.
This article examines the fourth domain: The Adopter System.
UNDERSTANDING THE ADOPTER SYSTEM
The NASSS framework recognises that technology adoption depends on the people expected to use, support and interact with a solution.[1]
In care environments, three groups are particularly important.
Care staff and clinicians must understand how technology affects their responsibilities, professional judgement and established workflows. Their confidence depends on whether the solution supports care delivery without introducing unnecessary complexity.
Care recipients and end-users must be able to engage with technology in ways that reflect their capabilities, preferences, circumstances and expectations. Adoption must respect individual autonomy and the realities of everyday life.
Informal carers and families may play important roles in supporting technology, interpreting information or responding when assistance is required. Their involvement needs to be understood rather than assumed.
These groups experience technology differently, and their expectations may not always align.
A monitoring solution that reassures family members may feel intrusive to the person receiving care. A platform that improves management visibility may increase frontline administration.
Successful adoption requires understanding these different perspectives and addressing them throughout implementation.
WHY BUY-IN IS NOT THE SAME AS ADOPTION
Organisations often measure engagement through attendance at information sessions, completion of training or expressions of support.
These activities can demonstrate participation, but they do not necessarily establish readiness to adopt.
A care worker may understand the benefits of remote monitoring yet remain concerned about additional workload. A clinician may support improved access to information but question whether the data is reliable enough to inform professional decisions.
Similarly, a care recipient may initially welcome technology but become frustrated when it requires frequent interaction, charging or troubleshooting.
These responses should not automatically be interpreted as resistance.
They may indicate legitimate concerns about usability, responsibilities, workload, safety or the practical value of the solution.
"People can support the intention behind technology while remaining unable or unwilling to adopt the way it has been implemented."
Providers need to distinguish between awareness, agreement, confidence and sustained use.
Engagement should therefore focus on understanding what people need to change their behaviour, not simply persuading them that change is beneficial.
THE REALITY OF FRONTLINE WORKFORCE ADOPTION
Care workers and clinicians operate in environments where time, attention and professional judgement are already under pressure.
Introducing technology changes established routines and may create new responsibilities that are not immediately visible during project planning.
Consider a provider introducing a medication alert system connected to wearable devices.
Support workers are expected to respond when alerts are generated. However, they were not involved in designing the response process and have received limited guidance about interpreting notifications or determining when escalation is required.
When alerts begin arriving, uncertainty emerges.
Some workers respond immediately, others assume a clinician is responsible, and others delay action because the notification falls outside their understood role.
The technology functions correctly, but the operating arrangements are unclear.
Over time, inconsistent responses undermine confidence and the system risks being abandoned.
This example illustrates why frontline engagement must extend beyond training.
Workers need opportunities to test proposed workflows, identify practical difficulties and clarify responsibilities before implementation.
Their experience is essential to designing technology-supported care that works under real operating conditions.
PROFESSIONAL SCEPTICISM AND CHANGE FATIGUE
Not all concerns about technology arise from limited digital capability.
Experienced care professionals may question whether a new solution genuinely improves care, particularly when previous implementations have increased workload or failed to deliver promised benefits.
Repeated technology changes can also contribute to fatigue, especially when staff are expected to adapt without sufficient time or operational support.
In these circumstances, additional communication about the benefits of technology may have limited impact.
Trust is built through credible leadership, transparent decision-making and evidence that concerns are being addressed.
Providers should involve frontline representatives early, demonstrate how feedback influences design and acknowledge the practical implications of changing established practices.
This does not mean every preference can be accommodated.
It means explaining decisions, resolving legitimate concerns and ensuring that staff understand both the purpose of change and the support available.
"Engagement becomes meaningful when people can influence implementation, rather than simply receive information about decisions already made."
CARE RECIPIENTS AND FAMILIES NEED DIFFERENT SUPPORT
Technology adoption is equally dependent on the experiences of care recipients and informal carers.
Digital confidence, cognitive capability, language, physical accessibility and personal preferences can significantly influence how people engage with technology.
A standard onboarding process may be appropriate for some individuals but unsuitable for others.
Someone living independently with strong digital skills may require little assistance. Another person may need demonstrations, simplified instructions or ongoing support from a trusted individual.
Family involvement introduces further considerations.
Relatives may be expected to receive monitoring notifications, troubleshoot devices or coordinate responses without fully understanding the associated responsibilities.
These expectations can create additional pressure, particularly when informal carers are already managing substantial commitments.
Providers should establish what support individuals and families can realistically provide, what assistance they require and where professional responsibilities begin and end.
Effective adoption should increase confidence and independence rather than transfer poorly defined responsibilities to people who are not equipped to manage them.
ENGAGEMENT MUST BEGIN BEFORE IMPLEMENTATION
One of the most common weaknesses in technology projects is treating adoption as an activity that begins shortly before go-live.
By that stage, technology choices, workflows and operating arrangements may already be largely determined.
Opportunities to address fundamental concerns become limited.
A more effective approach incorporates engagement throughout the technology investment lifecycle.
During discovery, providers should understand how people currently deliver or receive care, the challenges they experience and the outcomes they value.
During design and evaluation, representative users should help assess usability, proposed workflows and support requirements.
During implementation, training should reflect different roles and capabilities, supported by clear responsibilities and practical assistance.
Following go-live, organisations need to monitor actual usage, respond to difficulties and adapt processes where necessary.
This approach recognises that adoption is not a single event.
It develops through experience, confidence, reinforcement and evidence that technology is making a meaningful difference.
FROM TRAINING COMPLETION TO ADOPTION READINESS
Training remains important, but it is only one component of adoption readiness.
Providers should understand whether people are willing, able and supported to use technology in practice.
Willingness depends on trust, perceived usefulness and confidence that the technology supports meaningful outcomes.
Ability depends on appropriate skills, accessible technology, practical instruction and opportunities to develop familiarity.
Opportunity depends on sufficient time, clear responsibilities, operational support and workflows that enable the intended behaviours.
These conditions must work together.
A motivated care worker cannot adopt a new process effectively if the necessary time or authority is unavailable. Similarly, comprehensive training cannot compensate for technology that does not accommodate an individual's capabilities.
Adoption readiness should therefore be assessed through practical scenarios, user feedback and evidence of operational preparedness rather than training attendance alone.
WHAT THIS MEANS FOR PROVIDER LEADERSHIP
The adopter system is relevant across residential aged care, in-home care, independent living and disability services.
Although the people involved and care environments differ, the underlying challenge remains consistent: technology must fit into the lives, responsibilities and routines of those expected to use and support it.
For executives and operational leaders, successful adoption requires more than communication plans and training schedules.
In practical terms, provider leadership should:
Engage users from the beginning, involving care recipients, frontline workers, clinicians and informal carers in understanding needs and shaping solutions.
Address concerns and change fatigue, recognising that professional scepticism may reflect legitimate operational experience.
Clarify roles and responsibilities, particularly where technology introduces monitoring, alerts or new response requirements.
Tailor adoption support, accounting for different capabilities, digital confidence, professional roles and personal circumstances.
Measure actual adoption, including sustained usage, confidence, workflow integration and feedback rather than relying solely on training completion.
These considerations should be embedded in technology governance and implementation planning.
Before committing to the next technology implementation, provider leadership should ask:
H"ave we genuinely involved the people expected to use and support this technology, and have we created the conditions for them to adopt it successfully?"
Technology adoption cannot be delivered through a project plan alone. It requires people to understand the change, trust its purpose and have the capability and support to incorporate it into everyday care.
"Technology does not become part of care when it goes live. It becomes part of care when people can use it confidently and consistently."
ABOUT THIS SERIES
Part 5 of eight in the eHomeCare series exploring the seven influences on care technology adoption.
Based on the NASSS framework, this series examines the factors influencing whether technology is adopted, abandoned, scaled or sustained in real-world care environments. Each article explores one of the seven domains and its implications for Australian aged care and disability providers.
Series introduction: Article 1 - Why Care Technology Adoption Fails
Previous article: Article 4 - The Value Proposition
Next article: Article 6 - The Organisation
Hubert van Dalen is the founder of eHomeCare, providing independent digital strategy, governance, technology and transformation advisory services to Australian aged care and disability providers.
References
Greenhalgh, T., Wherton, J., Papoutsi, C., et al. (2017). Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies. Journal of Medical Internet Research, 19(11), e367.Original NASSS research
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