The wider system: When Good Technology Meets a System That Isn't Ready
"Why sustainable digital transformation in aged care depends on more than organisational readiness."
Aged care providers are increasingly expected to use technology to improve care quality, strengthen operational efficiency and respond to growing workforce pressures. Yet even well-designed and carefully implemented solutions can struggle to achieve lasting results.
Sometimes the problem is not the technology, the people using it or the organisation implementing it. The problem lies in the wider system within which care is delivered.
I believe this is one of the most underestimated challenges in aged care digital transformation. Providers can invest in the right technology, establish effective governance and achieve genuine improvements in care delivery, only to discover that funding arrangements, regulatory requirements or fragmented service structures make the solution difficult to sustain.
The distinction matters because organisational readiness does not automatically translate into system readiness.
The Wider System Is Part of the Digital Strategy
The NASSS framework identifies the wider system as one of seven domains influencing whether technology is adopted, sustained and scaled. It recognises that policy, regulation, professional expectations, economic incentives and social attitudes can determine the success of technology-enabled change.
In my experience, these external influences are too often treated as constraints to be managed during implementation rather than fundamental considerations in the original investment decision.
A provider might evaluate a remote monitoring solution based on functionality, clinical benefits, integration capability and implementation costs.
These are all legitimate considerations. However, the more difficult questions concern who will fund the ongoing service, who is accountable for responding to alerts, how the technology fits within existing care arrangements and whether the operating model remains viable as funding or regulatory requirements change.
These questions are not secondary implementation details. They are central to whether the investment represents a sustainable digital strategy.
The Funding Gap Between Technology and Care Delivery
One of my strongest concerns has been the tendency to treat technology funding as though it automatically enables technology-supported care.
The two are fundamentally different.
Consider a provider introducing remote monitoring to support older people living independently. The technology might detect changes in daily routines, identify emerging risks and provide reassurance to families. A successful pilot could demonstrate improved responsiveness and potentially reduce avoidable hospital presentations.
But what happens when the pilot finishes?
Someone must continue monitoring the information, assessing alerts, coordinating interventions, maintaining devices and supporting consumers. These activities create ongoing responsibilities and operating costs that are not necessarily covered by the funding arrangements supporting the initial technology investment.
A provider may therefore demonstrate that a solution works without demonstrating that it can be sustained.
I explored this issue in my earlier writing about the limitations of technology funding under Support at Home. My concern was not simply whether funding was available to purchase equipment, but whether the broader care system adequately recognised the services, workforce and operational capabilities required to make that equipment valuable.
That distinction remains important.
A technology investment should not be considered successful merely because the technology has been deployed. Its success depends on whether the resulting service can operate sustainably and deliver measurable value.
For boards and executives, this requires evaluating the complete cost of ownership and service delivery, rather than relying on technology acquisition costs or short-term pilot outcomes.
Fragmented Care Systems Create Fragmented Digital Experiences
Another challenge is the fragmentation of Australia's care and support environment.
An older person may receive services involving aged care providers, general practitioners, hospitals, allied health professionals and informal carers. Some individuals may also interact with disability or other community support systems. Each operates within different funding, information-sharing and accountability arrangements.
From the consumer's perspective, these services should contribute to a coordinated experience of care. From an operational perspective, however, they frequently function as separate systems.
Technology can improve communication and information availability, but it cannot independently resolve the underlying fragmentation of responsibilities.
For example, sharing information between organisations is valuable only when there is clarity about who may access it, who must act on it and who remains accountable for decisions.
This is particularly relevant to remote monitoring, shared care records and emerging AI-supported services. Increasing the availability of information does not automatically improve care coordination. Without agreed responsibilities and operational processes, it can simply create more information for already stretched care teams to manage.
My view is that providers should resist the temptation to solve every coordination problem through another technology platform.
The starting point should be the care model, the relationships between participating organisations and the decisions that information is intended to support. Technology should enable those arrangements, not substitute for them.
Compliance Is Not the Same as Strategic Readiness
Aged care operates in a highly regulated environment, and appropriately so. Providers must consider privacy, consent, information security, clinical safety, recordkeeping and accountability when introducing new digital capabilities.
However, I see a meaningful difference between designing technology to satisfy current compliance requirements and developing a digital strategy capable of responding to changing regulatory expectations.
The distinction becomes particularly important as providers explore AI, predictive analytics, connected devices and increasingly integrated care platforms.
A solution may meet today's requirements while creating future challenges around data ownership, algorithmic accountability, interoperability or changing expectations of clinical oversight.
Digital governance therefore needs to look beyond compliance checklists.
Boards and executives should understand the assumptions underpinning major technology decisions, the risks created by dependencies on external suppliers and the organisation's ability to adapt when those assumptions change.
This does not mean attempting to predict every regulatory development. It means avoiding investments that leave the organisation with limited flexibility when the environment inevitably evolves.
Good digital governance should create the capacity to respond to change, not merely demonstrate compliance at a particular point in time.
Digital Inclusion Is a Strategic Responsibility
System readiness also has a social dimension.
Aged care providers serve people with different levels of digital literacy, language proficiency, cognitive capability, physical ability and confidence in technology. Their families and informal carers may have equally diverse expectations and capabilities.
These differences influence whether technology can deliver its intended benefits.
A digital service designed around assumptions of reliable connectivity, smartphone ownership or independent technology use may work well for some consumers while creating barriers for others.
I believe digital inclusion should therefore be considered during strategy and service design, not treated as a training or adoption issue after implementation.
Providers need to understand where technology genuinely improves accessibility and independence, and where alternative arrangements remain necessary.
This is particularly important when digital transformation is associated with operational efficiency. A more efficient digital process is not necessarily a better care process if it transfers complexity or responsibility to people who are unable to manage it.
Technology-enabled care must remain person-centred, including when the most appropriate solution involves human assistance rather than greater automation.
Providers Cannot Control the System, but They Can Prepare for It
It would be unrealistic to suggest that individual aged care providers can resolve every systemic barrier. Funding policy, regulatory frameworks and sector-wide interoperability arrangements are often beyond their direct control.
However, providers can make better strategic decisions by explicitly recognising those dependencies.
In practical terms, I believe every significant digital investment should be tested against four considerations:
Economic sustainability: Does the business case include the ongoing operating model, and is there a credible mechanism to fund it beyond initial implementation?
System integration: How does the solution interact with other care providers, funding arrangements, professional responsibilities and information systems?
Regulatory adaptability: Can the technology, supplier arrangements and operating processes respond to changing obligations and expectations?
Equitable access: Will the solution work for the diversity of consumers and carers the organisation serves, including those who require additional support?
These considerations should influence investment prioritisation, procurement, service design and governance decisions.
They should also inform how providers engage with government, sector bodies, technology suppliers and other care organisations. Where systemic barriers cannot be removed individually, collaboration and collective advocacy may be more productive than isolated technology investments.
From Successful Pilots to Sustainable Care Models
The aged care sector does not necessarily need more technology pilots. It needs more initiatives that demonstrate how technology can become part of a sustainable care delivery model.
Pilots remain valuable when they test meaningful uncertainties. However, they should establish more than technical feasibility and user acceptance.
They should also test whether the operating model is affordable, whether responsibilities are clear, whether the solution can function within existing service arrangements and whether the benefits can be maintained after project funding and implementation support disappear.
Otherwise, providers risk repeatedly proving that technology works without creating the conditions for it to deliver lasting value.
This is where digital strategy and governance become particularly important. They connect technology decisions to the broader realities of funding, service delivery, organisational capability and sector reform.
My Perspective: System Readiness Must Be Part of Investment Readiness
Having worked across technology and care delivery, I have become increasingly convinced that the most difficult barriers to digital transformation are rarely confined to the technology itself.
The challenge is aligning the interests, responsibilities and capabilities of everyone required to make technology-enabled care work.
The NASSS framework provides a useful way of understanding these dependencies. But the practical implication for aged care leadership is straightforward: a sound technology decision must also be a sound operating and investment decision within the wider care system.
Providers cannot wait for every external condition to become favourable. Equally, they should not ignore structural barriers and assume these will somehow resolve themselves during implementation.
My view is that the strongest digital strategies acknowledge what an organisation can control, identify what it depends upon and establish a credible path to sustainable value.
Ultimately, the question is not simply whether a technology can improve care.
It is whether the wider system can support that improvement long after the implementation project has finished.
ABOUT THIS SERIES
This is Part 7 of an eight-part series about the seven influences on care technology adoption exploring the seven domains of the NASSS framework (Non-adoption, Abandonment, Scale-up, Spread and Sustainability) and what they mean for digital transformation in aged care.
Hubert van Dalen is the founder of eHomeCare, providing independent digital strategy, governance and transformation advisory services to Australian aged care and disability service providers.
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