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DIME PROJECT

Aging in Place of Choice with Connected Health Technologies

From AgeTech innovation to sustainable implementation

AGETECH DEVELOPER: ECOSYSTEM INTEGRATION

Building connected systems

AgeTech companies with a vision for sustainable scaling should design with the broader ecosystem in mind, considering opportunities for product bundling and clinical workflow integration from the early stages of development.

Technology that solves a single daily problem or health challenge for older adults can be a reasonable goal. However, a single technology in isolation may not be enough to encourage sustained, long-term product use. Older adults usually manage several health conditions at the same time, and institutional buyers often choose technology that fits into a larger connected network. 

This playbook section focuses on two key challenges:

Technology option fatigue

Technology option fatigue

First, older adult users describe fatigue from too many technology options. Older adults and care partners lose track of separate applications, and they struggle with multiple login credentials and learning new interfaces for every technology or software update.

Learn more about technology option fatigue →

Aging in Place

Health system integration

Second, payers and health systems often look beyond a single product that operates in isolation. They evaluate how easily a product shares data with existing care workflows to help manage multiple conditions at once.

Learn more about health system integration →

This AgeTech playbook section addresses both problems as separate strategies.

Your product might need a strategy for one or both challenges. The decision depends on your product design and your target buyer, but thinking about these challenges early will enable you to develop informed product strategies.

TECHNOLOGY OPTION FATIGUE

Older adults are frustrated with multiple standalone technologies

Map out how your end user interacts with your product. Design the user journey to remove friction and reduce daily effort interacting with your technology.

Based on our older adult and care partner surveys and interviews, consider these bundle features for your product to simplify the user experience:

“The main hurdle for me is always, that [using technology] requires signing up for this and that, so I already have a long list of accounts. And creating just another account and another user account, another password, another app … that’s going to be my main hurdle.”

– Older adult interviewed

Where relevant, combine tracking for multiple health conditions into one unified app interface.

Consider the feasibility of streamlining access across your product suite by implementing single sign-on (SSO), allowing users to authenticate once while maintaining strict health data privacy and security standards.

Maintain a consistent design layout across all features so users do not have to relearn how to navigate your interface.

Consolidate alerts and reminders into a single notification feed.

Allow care partners to view shared information from one central dashboard.

HEALTH SYSTEM INTEGRATION

Technical & data integration: FHIR & TEFCA

Older adults and care partners value digital health tools when the data improves care decisions and strengthens their personal connection with their healthcare provider.

If your business is pursuing a B2B2C model, institutional buyers also evaluate whether your tool fits into existing clinical workflows. They check if your product reduces or increases their daily operational burden.

Your clinical evidence might be strong. However, your product still acts like a standalone tool if it creates extra work. This happens when a product requires a separate login or fails to integrate data into the electronic health record in a way that allows for timely, data-driven decision-making.

“Is that not miraculous how those two things [i.e., output from technology and healthcare provider decision-making] can come together to a solution? That’s all I want technology to do, is to come to a solution. I do not want technology to control [my] life.”

– Older adult interviewed

The core question for developers can be: does your product work within the health care system where it’s meant to be implemented?

If your business model targets institutional buyers, prepare a strategy early in development for technical and data integration, starting with the following:

Fast Healthcare Interoperability Resources (FHIR) Release 4 is a standardized set of rules and formats designed to help different healthcare software systems share patient data securely and instantly. FHIR R4 is the floor, and two different regulators set it depending on your buyer. 

  • If your buyer is a health system or clinic, its certified EHR is required under ASTP/ONC’s Health IT Certification Program to support FHIR R4-based APIs and USCDI data  content. 
  • If your buyer is a Medicare Advantage, Medicaid, or other CMS-regulated health plan,the requirement comes from CMS’s own interoperability rules, CMS-9115-F and CMS-0057-F, which separately mandate FHIR R4 APIs for patient data access. 
  • Know which one your buyer sits under before you scope the integration.

The Trusted Exchange Framework and Common Agreement (TEFCA) enabled interoperability can be a procurement differentiator. As health systems and other institutional buyers increasingly prioritize interoperability and patient access, TEFCA connectivity can demonstrate that a product is designed to securely exchange health information across organizational boundaries, rather than operate within a single health system. This can support a more seamless experience for patients who want to access health information from multiple providers through a single application or interface, rather than navigating fragmented portals.

Learn more about TEFCA and how to participate

TEFCA is a US federal framework designed to establish common legal and technical rules for securely exchanging health information across otherwise disconnected health networks. Historically, hospitals, clinicians, health plans, and other organizations often relied on separate networks and systems, making it difficult to exchange information across organizational boundaries. TEFCA helps connect these networks through a common set of rules and requirements. 

Qualified Health Information Networks (QHIN) serve as the major networks that connect to one another and facilitate exchange across the TEFCA network. As an AgeTech developer, you do not need to become a QHIN to participate in this ecosystem. You can connect directly to a QHIN or work through an interoperability partner, health information network, technology provider, or other organization that already participates in TEFCA.

Consider TEFCA connectivity as part of your interoperability strategy. Your pathway will depend on your use case, exchange purpose, technical capabilities, and business model. An interoperability partner can abstract the complexity of connecting to multiple health data networks and provide standardized APIs through which your product can access data. When evaluating an interoperability partner, ask whether it provides TEFCA connectivity and which exchange purposes and data sources it supports.

Potential connectivity pathways:

  • Direct QHIN connection: 
    • AgeTech developer → QHIN → TEFCA network → health data
  • Connection through an interoperability partner:
    • AgeTech developer → interoperability partner (e.g., Flexpa, Fasten, b.well) → QHIN / HIE / EHR / payer networks → health data

Key takeaways:

  • If you’re targeting an institutional buyer, then strongly consider roadmaps for technical and data integration in your development strategy.
  • AgeTech buyers (health systems, ACOs, Medicare Advantage plans, PACE organizations) often operate on slim margins and tight clinical workflows. Leverage existing FHIR endpoints and TEFCA channels.
  • Because many high-need older adults are dual-eligible (Medicare + Medicaid), their data spans both state and federal systems. TEFCA-aligned exchange can reduce the need for custom integrations with each organization, depending on your exchange purpose and which organizations participate.

CASE STUDY

Enabling real-time collaborative decision-making for aging in place of choice

Telemedicall demonstrates that interoperability extends beyond exchanging data between systems. By connecting care partners, primary healthcare providers, and specialists in real time, the platform illustrates how coordinated workflows can support faster, more informed clinical decisions for older adults receiving care at home.

THE LAST-MILE PROBLEM

Who owns the “C” in B2B2C

In our workshops with Agetech developers and industry experts, we identified a major gap limiting clinical integration of AgeTech which occurs when companies fail to assign clear ownership for onboarding and educating older adults.

Developers often assume the health system handles onboarding as part of daily care. At the same time, healthcare providers assume the product is intuitive enough that setup requires no extra training. Without clearly defining roles and responsibilities for training and supporting older adults and care partners, older adults are left without clear support, even though they often need direct instruction.

“If someone just explains it to me, I’m fine. Don’t give me a whole sophisticated system and tell me I’m on my own… I need the written directions and a demonstration. Once I see how it is done, I can do it.”

– Older adult interviewed

“[On setting up smart devices], if they [the older adult] need to search too hard for [help], then they might just give up and be like, I don’t care anymore.”

– Care partner interviewed

Why this breaks down in B2B2C specifically

Winning an institutional contract is only the first step. Developers who ignore onboarding risk low activation rates, poor usage, and canceled subscriptions. The health system only gets value when the older adult uses the product successfully. Healthcare providers are often overburdened and lack the bandwidth to act as technology customer support.

The fix is shared ownership and clearly defining who onboards the older adult, whether support is self-guided material, a remote help desk, or in-person, and who older adults or care partners call when something breaks. Create clear operational plans for onboarding and support before launching.

  • Define who guides the older adult through initial setup.
  • Choose the right delivery format, such as printed guides, video calls, or in person support.
  • Establish a dedicated support contact for technical troubleshooting.

CASE STUDY

Connecting remote monitoring with ongoing human support

DirectCare AI addresses the last-mile onboarding problem by taking direct ownership of patient support through an end-to-end model that pairs monitoring technology with dedicated human health coaching. This personal guidance bridges the gap between technology access and usability by actively walking older adults through device setup, follow-ups, and ongoing care without relying on overburdened healthcare providers.

View case study

ILLUSTRATION

Comparing isolated technologies vs AgeTech that integrates into a care ecosystem

AgeTech products that lack integration into a larger ecosystem
Information moves only between the developer and the older adult with little impact on care decisions.

Developer Owns and stores all app data | Sends generic tips to user
EHR No data received
Care provider No visibility into data
Older adult Uses technology | Views own data alone
Care partner Not typically looped in
Community partners Not typically looped in

*Note: Swim-lane diagram emerged from a June 2026 workshop exercise with AgeTech key stakeholders (n=36)

AgeTech that integrates
Same data, but it moves through a network that allows for more informed clinical decision-making.

Developer FHIR R4 integration | alert logic defined | onboarding support | continual help desk support | maintains data pipeline
EHR Receives structured clinical data | shares record across team
Care provider Potential in-person onboarding support | Reviews data in existing workflow | acts only on flagged alerts | loops in specialists as needed
Older adult Uses technology | onboarded with support | shares data with consent | Is contacted if care action is needed
Care partner Daily use help | notified for non-clinical issues | coordinates with care and community resources
Community partners In-person support for tech and health available in some states

*Note: This is an illustration of how roles and responsibilities can be organized, not a prescription. It emerges from findings from a workshop conducted among a multi-stakeholder group of AgeTech subject matter experts (n=36, see evidence).

CASE STUDY

Implementing person-centered technology in skilled nursing

SimpleC partnered with A.G. Rhodes to demonstrate how thoughtful implementation, personalization, workflow integration, and ongoing support can improve adoption while strengthening person-centered care. While the case study is set in a skilled nursing setting, its implementation lessons can be applied across home and community settings, while also offering insights into how technology can better support individuals for whom skilled nursing is their place of choice to age.

View case study

Next step

Now that you’ve considered how your technology fits into the broader care ecosystem, you’re ready to design products and experiences with older adults and care partners.

Go to Product design