The Condition: Understanding Care Needs Before Selecting Technology
Funding without fit leads to failure. Technology should respond to the needs of people receiving care, not the other way around.
Technology decisions in aged care and disability services often begin with an available product, an emerging innovation or a funding opportunity. The risk is that organisations invest in solutions before fully understanding the needs, circumstances and complexity of the people expected to benefit.
A solution may be technically reliable, financially accessible and supported by a compelling business case, yet still fail because it does not accommodate the person's cognitive, physical, social or environmental circumstances.
Successful care technology adoption begins with a more fundamental question:
What problem are we trying to solve, and for whom?
In Article 1 - Why Care Technology Adoption Fails, we introduced the NASSS framework and its seven influences on technology adoption. This article examines the first domain: The Condition.
WHAT DOES THE CONDITION MEAN FOR CARE TECHNOLOGY ADOPTION?
The NASSS framework identifies the condition as a critical influence on whether health and care technologies are adopted, abandoned, scaled or sustained.[1]
A condition may involve a particular health issue, disability, functional limitation or combination of care needs. Importantly, the framework considers two dimensions that influence technology suitability.
Clinical complexity concerns the nature and predictability of a condition. Is it stable, progressive, intermittent or unpredictable? How might symptoms, functional capabilities and care requirements change over time?
Comorbidities and sociocultural factors concern the interaction between multiple conditions and the person's broader circumstances. Cognitive capability, mental health, language, family structure and available support can all influence whether technology is appropriate and usable.
These dimensions are interconnected. Someone with a relatively stable physical condition may have predictable support requirements, while a person experiencing progressive cognitive decline or multiple chronic conditions may require considerably greater flexibility.
The technology may be identical, but the circumstances in which it must operate can be very different.
UNDERSTANDING THE PERSON, NOT JUST THE DIAGNOSIS
Two people living with the same condition may have substantially different capabilities, preferences and support requirements.
For example, a person living with early-stage dementia may independently use a medication reminder or personal safety device. Another person with more advanced cognitive impairment may struggle to recognise alerts, follow instructions or understand when assistance is required.
Similarly, someone with Parkinson's disease may initially use a touchscreen application successfully but experience increasing difficulty as tremors or reduced fine motor control affect their ability to interact with the device.
These differences demonstrate why technology suitability cannot be determined by diagnosis alone.
Providers must understand how the condition affects daily activities, decision-making, communication and the person's ability to engage with technology.
This assessment should also consider the person's living environment, preferences, available support and the circumstances in which technology will be used.
Person-centred technology adoption requires understanding the individual, not simply matching a product to a diagnostic category.
WHEN TECHNOLOGY WORKS BUT DOES NOT FIT
Consider three practical examples.
A voice-activated safety alarm is installed for someone living with advanced dementia who no longer consistently understands verbal prompts.
A touchscreen medication reminder is introduced for a person with Parkinson's disease whose fine motor control makes the interface increasingly difficult to operate.
A remote monitoring service sends smartphone notifications to someone with limited English literacy, little digital experience and no reliable support person to interpret the information.
In each situation, the technology may function exactly as designed. The difficulty is that its operating assumptions do not match the person's capabilities or circumstances.
These mismatches can result in low adoption, frustration, additional support requirements or technology being abandoned altogether.
They can also create safety risks when a provider assumes that an individual can recognise, interpret or respond to information that is not accessible to them.
The lesson is straightforward: technical functionality does not establish individual suitability.
SELECTING THE RIGHT TECHNOLOGY BEFORE MATCHING IT TO THE PERSON
Understanding the condition has implications beyond individual assessment. It should also influence how organisations select and approve technologies for their services.
There are two distinct but connected decisions.
The first is organisational technology selection. Providers must determine which solutions are appropriate for the diversity and complexity of the populations they support. This requires evaluating clinical variability, functional limitations, cognitive requirements, accessibility, adaptability and the likely progression of care needs.
The second is individual technology matching. Once appropriate solutions have been identified, providers must determine which option best suits a particular person's needs, preferences, capabilities and circumstances.
Both decisions require structured assessment and appropriate professional judgement.
For example, an organisation selecting remote monitoring technology should first establish whether its solutions can accommodate different levels of cognitive capability, changing mobility, variable support arrangements and diverse living environments.
Only then should an individual assessment determine which configuration, monitoring arrangements and response processes are appropriate.
Where relevant, occupational therapists, clinicians, care coordinators and other allied health professionals should contribute to these decisions, particularly when technology suitability has implications for safety, independence or clinical care.
This distinction matters when organisations seek to standardise technology offerings across multiple services.
Standardisation can improve procurement efficiency, integration and support. However, it must preserve sufficient flexibility to accommodate individual needs.
CLINICAL COMPLEXITY CHANGES TECHNOLOGY REQUIREMENTS
Technology selection must also consider how care needs may evolve.
A solution that is appropriate today may become less effective as a person's condition progresses, functional capabilities change or additional health conditions emerge.
For people living with progressive conditions, cognitive decline or reduced mobility may eventually make previously accessible technology difficult to use.
Conditions characterised by fluctuating symptoms create different challenges. Technology that works effectively during periods of stability may be less suitable when symptoms intensify or care requirements become unpredictable.
Consider remote monitoring for someone living independently.
For a person with relatively stable needs, a straightforward monitoring solution may provide reassurance and support. For someone experiencing cognitive decline, multiple chronic conditions or frequent changes in care requirements, the same solution may introduce additional complexity.
Alerts may require clinical interpretation. Family members may have different expectations, and responsibility for responding may be shared between several care providers.
In these circumstances, selecting the right device is only one part of the decision. Providers must also consider monitoring responsibilities, escalation processes, service coordination and the ability to adapt the solution as needs evolve.
Technology suitability is therefore not a one-time decision. It must be reviewed as care needs and circumstances change.
SOCIAL AND CULTURAL CONTEXT MATTERS
Clinical suitability is only one dimension of successful adoption.
Technology is introduced into people's homes, routines, relationships and personal circumstances.
Language preferences, cultural expectations, digital confidence, financial circumstances and informal support arrangements can significantly influence whether a solution is accepted and sustained.
A monitoring service that assumes family members will respond to alerts may be unsuitable for someone without an available support network.
Similarly, technology requiring reliable internet connectivity, smartphone access or regular interaction may create barriers for individuals with limited digital resources.
Privacy and personal autonomy are equally important. Some people welcome monitoring because it supports independence and reassurance. Others may perceive the same technology as intrusive.
Providers must therefore consider not only whether technology can meet a care need, but whether it aligns with the person's preferences, circumstances and expectations.
This is particularly relevant across In-Home Care Perspective and Independent Living Perspective, where individuals often manage technology within their own homes and support arrangements.
WHAT THIS MEANS FOR PROVIDER LEADERSHIP
Understanding the condition has implications across residential aged care, in-home care, independent living and disability services.
Although these environments differ, the underlying challenge remains consistent: ensuring technology investments accommodate the diversity and changing needs of the people they support.
For executives and operational leaders, this requires a structured approach to technology evaluation and deployment.
In practical terms, providers should:
Establish clear selection criteria that consider clinical complexity, cognitive capability, accessibility and changing care requirements.
Apply individual suitability assessments before deployment, including the person's preferences, living environment and available support.
Involve relevant professionals in decisions where clinical judgement, functional assessment or safety considerations are important.
Build flexibility into technology choices so solutions can accommodate different needs and adapt as circumstances change.
Review suitability over time, integrating technology reassessment into existing care planning and service review processes.
These considerations should form part of technology governance and investment decisions, rather than being left entirely to individual implementation teams.
Before selecting or expanding a technology-supported care service, provider leadership should ask:
Have we selected technologies based on a structured understanding of the people we support, and can we confidently match those technologies to individual needs as circumstances change?
The distinction matters.
A technically capable solution is not necessarily an appropriate solution. Sustainable adoption begins with understanding the person, their condition and the environment in which care is delivered.
The right technology starts with the right understanding of care needs, not the product catalogue.
ABOUT THIS SERIES
Part 2 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
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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