Why Understanding 'The Condition' is Foundational for Smart Care Technology Adoption

Hubert van Dalen
Jul 7
5 min read

Updated: Jul 31

Funding without fit leads to failure. The first step toward sustainable adoption isn’t training, tech, or trust, it’s a nuanced understanding of who the user is, what condition they live with, and how that condition shapes their needs, capacities, and context.

As funding opens up for assistive technologies through the Support at Home program and its dedicated Assistive Technology and Home Modifications (AT-HM) stream, (see also Funding Alone Won’t Drive Assistive Technology Adoption: Managing the Seven Influences is Critical), aged care providers face a pivotal question: Will the technologies we implement truly support our clients—or will they be abandoned, underused, or fail to scale?

To answer this, we turn to the NASSS Framework 1), a tool for understanding the 7 influences why health and care technologies are not adopted, abandoned, or fail to spread and sustain. In this first article in the care tech adoption series, we examine the first influence or domain: The Condition, is often underestimated in implementation planning but is foundational to long-term success.

Domain 1: The Condition

What is the nature of the condition the technology is designed to support? This includes:

1A. Clinical complexity – Is the condition stable, intermittent, or unpredictable?
1B. Comorbidities and sociocultural factors – How do cognitive status, language, mental health, or family structure affect technology use?

What the NARI Implementation Framework Addresses – and Where It Falls Short

A practical starting point is the Implementation Framework for Enabling Technology-Supported Aged Care at Home 2), developed by the National Ageing Research Institute (NARI). It rightly encourages a person-centred approach, referencing client preferences and digital literacy. However, when it comes to the complexity of “the condition,” its treatment is High-level but lacks operational depth.

What NARI Covers well:

Consideration of client preferences in technology design
Attention to digital literacy and technical confidence
Recognition of the need for tailored onboarding

What the NARI Framework Does Not Cover (in relation to ‘The Condition’):

Clinical variability and diagnostic complexity are not addressed. NARI does not distinguish between conditions that are stable (e.g. vision impairment) and those that are progressive, fluctuating, or volatile (e.g. dementia, Parkinson’s, heart failure). This limits its usefulness for care planning, as different conditions introduce vastly different demands on usability, safety, continuity, and response design.
There is no stratified implementation guidance based on severity, risk, or prognosis. The framework assumes a uniform baseline of client suitability, yet real-world clients range from fully independent to highly vulnerable. Without risk stratification tools or triage logic, providers lack a way to match technologies to functional level, cognitive ability, or stage of illness, leading to misalignment and failed uptake.
The impact of cognitive decline, mental health, and decision-making capacity is overlooked. Many aged care clients experience reduced executive function, memory loss, or fluctuating mental health, all of which impair their ability to engage with even simple technologies. NARI does not address how to adapt technology choices or consent processes for these users, or how to safeguard their autonomy and safety.
Cultural, linguistic, and social diversity is acknowledged but not operationalised. While the framework references inclusive design, it lacks practical tools or guidance for tailoring implementation to clients from culturally and linguistically diverse (CALD) backgrounds. This includes issues like language barriers, digital marginalisation, health beliefs, and family dynamics that often determine acceptance or rejection of technology.
Technology selection is disconnected from clinical judgement or allied health input. NARI positions technology primarily as a consumer support tool rather than a clinical intervention. There is no guidance on how occupational therapists, GPs, or case managers should be involved in evaluating suitability based on condition complexity, safety concerns, or expected benefit, missing an important layer of professional accountability.

These omissions matter. In case studies, technologies are often abandoned not because they didn’t work, but because they weren’t appropriate for the real-world variation in clients' health, literacy, or context.

Why This Matters Now

With growing access to funding for smart care solutions in the home, it’s tempting to treat technology procurement as a checklist. But unless we start by deeply understanding the condition and the lived experience of clients, we risk deploying the right solution to the wrong user, or no user at all.

It Starts with the Person, Not the Product

Imagine installing a voice-activated safety alarm in the home of a person with advanced dementia who no longer understands verbal prompts. Or offering a touchscreen medication reminder to a client with Parkinson’s who can no longer control fine motor movements. Or sending mobile alerts to a CALD client who reads little English and has never used a smartphone.

Each of these technologies is functional. But none of them fits.

This is where many well-intended smart care initiatives falter, not due to a lack of funding or innovation, but because they move too quickly from procurement to deployment, without fully engaging with the complexity of “the condition.”

As assistive technology funding grows under Support at Home, we must avoid the trap of assuming “more technology = better care.” The first, and often overlooked, question should be:

Does this technology truly align with the cognitive, clinical, and cultural reality of the person using it?

The second, and equally critical, question is:

Which technology has been pre-selected based on a structured understanding of clinical variability, diagnostic complexity, triage logic, client capability over time, social & linguistic context, and the professional judgement of allied health practitioners?

In other words: Has the right technology been carefully selected, tested and integrated, matched for the right reasons, both now and as the person’s condition evolves, and only then applied to the right individual, within the realities of the available budget?

These are not abstract considerations, hey are the difference between scalable, person-centred care and a disconnected collection of underused devices and data.

In my 2nd article, we’ll turn our attention to the technology itself: how its design, usability, and support model influence its success or failure in the real world.

Until then, reflect on your own (potential) services:

Who chooses the technology—and how?
What frameworks or triage logic guide that decision?
Is your organisation equipped to make those choices dynamic, inclusive, and clinically informed?

Let’s start the conversation, because person-centred care requires more than good technology. It requires good decisions.

Article 1/7: By Hubert van Dalen, Managing Director of eHomeCare, where he advises on the implementation of smart care technologies across the health, aged care, and disability sectors.