DIME PROJECT
Aging in Place of Choice with Connected Health Technologies
User(s)
- The user may be the older adult, the care partner, a healthcare provider, or all of the above.
- Consider what each users’ motivations are for using your AgeTech product
Buyer(s)
- A buyer may be a health system, Medicare or Medicaid, an insurance company, or the older adult and care partner themselves.
- Consider what different buyers’ motivations are for purchasing AgeTech products
Outcome(s)
The clinical or functional outcomes the technology aims to improve, along with the operational or utilization outcomes that follow as a result, such as fewer hospitalizations or reduced care team burden. This is the reason a buyer is willing to pay.
Less sustainable model
As an illustrative example, technology to support smoking cessation may sit further out from a sustainable model. Smoking cessation will lead to a beneficial health outcome for the older adult, who would be both the user and beneficiary, but the savings from fewer downstream health events often surface years past the payer’s contract horizon. As a result, without a highly motivated older adult or care partner to buy the technology, this may be a harder business path than for instance fall prevention.
Sustainable model
- Understanding where user(s) and buyer(s) motivation aligns with outcome(s) to improve and where these diverge is what makes a business model financially sustainable and clinically credible.
- As an illustrative example, fall prevention sits close to the center, since the older adult, the care partner, and the payer want the same result and see the benefit on a similar timeline.
User(s)Characterize your target user or users, and all relevant personas: older adult, care partner, healthcare provider, administrator.
For each user, define their specific motivation for using your technology, and describe how they would interact with your product to address that need in a way that supports aging in place of choice. The “of choice” in aging in place of choice is intentional. It describes an older adult’s autonomy to age where they choose, rather than being confined to their current residence, or displaced from it, by functional limitations, safety considerations, or affordability.
source: DiMe blog, “Designing for dignity: Why aging in place of choice must guide the future of care”
Learn more in the section on product design for aging in place of choice of the playbook.
Buyer(s)The buyer is whoever pays for the product, and is frequently not the user. Before evaluating specific buyer targets, in the section on commercial strategy, identify which of two broad categories the buyer(s) you’re targeting falls into. The distinction changes buyer motivation, how trust is gained, how long the sale takes, and what the purchase decision is actually based on.
| Business model | Purchase driver | How trust is gained |
|---|---|---|
| Direct-to-consumer: older adult or their family | Independence, peace of mind | Good usability and user experience, word of mouth or referral |
| B2B2C: Providers billing Medicare fee-for service, Medicare Advantage plans, health systems, clinics, or PACE organization | Return on investment, improve clinical outcomes, reduced clinician or care team burden | Clinical outcomes data, ROI data, integration into existing workflows, procurement and security review |
Identify which business model applies to your product before moving forward.
Outcome(s)As you’re developing AgeTech products, make sure they’re tied to outcomes that would make your product attractive to buyers due to cost savings while improving the lives of older adults.
At-a-glance: Define outcomes that matter to buyers and improve older adult health
- Clinical outcomes are measurable characteristics that describe or reflect how an individual feels, functions or survives. Examples include fewer falls, improved validated pain and function scores, and improved scores on standardized behavioral health symptom measures. Biomarkers are measured indicators of biological processes, pathogenic processes, or responses to an exposure or intervention. Some, such as blood pressure, HbA1c, and LDL cholesterol, are used as targets because changes in them are known to predict clinical outcomes. Payment models like CMS ACCESS, value-based or risk-bearing providers, Medicare Advantage plans, Medicaid managed care organizations, health systems, and Accountable Care Organizations (ACOs) increasingly tie payment to performance against these measures.
- Functional outcomes relate to general improvement to functions associated with a general state of health that do not make any reference to diseases or conditions. Examples include maintenance or improvement in activities of daily living, mobility, and cognitive function, which may be valuable to Program of All-Inclusive Care for the Elderly (PACE) organizations, Medicare Advantage Special Needs Plans, and value-based primary care teams.
- Secondary utilization and cost outcomes, such as emergency department visits, hospitalizations, and 30-day readmissions, are of key interest to potential buyers like Medicare Advantage plans, Medicaid managed care organizations, health systems, and ACOs. These outcomes can tie to tangible cost savings and often follow an underlying clinical event or condition rather than standing apart from it.
Misaligned commercial & buyer architecture for AgeTech products
- Common failure point Assuming the user, the beneficiary, and the payer are the same person.
- Common causes Products can fail when developers build direct-to-consumer (D2C) without realizing the purchaser is often an adult child or care partner, or they pitch health systems without accounting for longer sales cycles and complex ROI metrics.
SOLUTION: COMMERCIAL STRATEGY
Build a business that can reach older adults.
Underestimating the value of fitting into broader care ecosystems
- Common failure point Assuming that effectively addressing a single health or care need is sufficient to drive sustainable and scalable adoption, without considering how the product fits into the broader needs of older adults managing multiple conditions and the care systems supporting them.
- Common causes
- User burden and fatigue: In our interviews and surveys, older adults and care partners described losing track of multiple standalone apps, juggling separate logins, and relearning a new interface for every symptom or condition they manage.
- Business model alignment: Payers and health systems evaluate technologies not only on effectiveness, but also on their ability to integrate into existing care workflows, support informed care decisions, and help providers manage older adult patients with multiple chronic conditions.
SOLUTION: ECOSYSTEM INTEGRATION
Build connected systems.
Generic product design not informed by older adult or care partner realities
- Common failure point Assuming that technology built for the general population can be adapted for older adults and care partners without deliberate design intention.
- Common causes AgeTech products often fail to achieve adoption when interfaces neglect the physical, cognitive, and sensory needs of older adults, as well as the distinct needs and requirements of care partners, who are frequently the ones purchasing or managing the technology on the older adult’s behalf.
SOLUTION: PRODUCT DESIGN
Design for aging in the place of choice.
If you need help understanding the lived experience of older adults and care partners, we are sharing our data repository, which includes de-identified, structured quotes and narratives from interviews and surveys with older adults and care partners across the US.
What makes AgeTech different from other digital health products?
Our lived experience research added real-world context and nuance to the evidence base, highlighting how these themes show up in the day-to-day experiences of older adults and those who support them:
Older adults may resist technology adoption for reasons that are especially common in this population, including the belief that technology removes in-person interactions with healthcare providers, skepticism, and lack of (perceived) privacy or security.
Older adults are not a monolith and it is essential to co-develop and conduct appropriate usability validation testing with target user(s) to develop products that address your user(s)’ specific needs. Larger text, voice-activated components, and simplified user interfaces and user experiences (UI/UX) common starting points, to be confirmed through usability testing with intended users.
The “last mile” implementation problem: older adults have variable digital literacy and often depend on a care partner for setup and ongoing use. Without ongoing support from either technology companies (e.g., help desks) or their healthcare provider, older adults without continual support from their care partner frequently abandon the technology.
