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Checklist for acquiring a technology product or solution

'The Checklist Manifesto' has applicability to buying tech for aging. I just finished reading "The Checklist Manifesto: How to Get Things Right" by Atul Gawande, a surgeon who developed a checklist to improve surgery safety for WHO and his own operating room. Which brings me to the question of whether caregivers and organizations with caregiving responsibility -- like families, home care organizations, senior housing, GCMs, doctors, non-profits, etc. -- have a checklist they follow when purchasing a product or service? So here's a proposed checklist which needs revision, I'm sure. Input is most welcome!

You're considering buying tech -- first do an assessment. The first part of this checklist should clarify why, for whom, and what changes are implied by introducing technology.

  1. Clearly define the problem's true nature.  At the problem end of the spectrum, some take on a new degree of urgency for professional or family caregivers following a discharge from a rehab or when an individual has fallen repeatedly. But what may appear as a risk of falling is really a problem with medication non-compliance and low blood pressure. And on the opportunity end, perhaps a non-profit senior center wants to enhance the quality of life of center visitors, but could also help fix a budget shortfall.
  2. Clarify the broader context around the solution. Organizations may want to implement a tool connecting caregiving aides to management to verify start and end times of visits, for example. While that problem may be well-defined, is there an opportunity to link in family members and provide them a status about- or a communication from the care recipient? Would that be a differentiator and even an upsell opportunity?
  3. Document and gain advance agreement on new processes.  Bought-and-not deployed is a characteristic of purchases since the dawn of technology optimism (defined as 'a solution exists, we need that, let's buy it!').  The biggest barrier is managing behavioral change to incorporate new tech into a day-to-day process.  A rule of thumb -- expect 5 times the cost to fully deploy across a multiple person organization.  If you're a family caregiver, of course, the only behaviors you need to change are those of siblings and care recipient. But if you attached a cost to that effort, no doubt it would be 5 times the cost of any tech you purchased. Just one scenario, who sets up the new solution, who is notified when there's a problem, what if they are not available, then who will be notified? If notified, what happens? Whose responsibility is it to do any of this?

Now you are scanning the market for alternatives.  So the prerequesites for considering technology are all met and you or assigned organizational staff are looking out in the marketplace.  What are your criteria for including an alternative in your search?

  1. What solutions exist to solve the problem or seize the opportunity? Trade shows and consumer events, advertising, and web searches may turn up a number of choices in a particular domain. Ideally, there are multiple choices because vendors recognize a viable market they want to enter.  But is the price (if it is visible) a reasonable fit with budget and expectation? How do you set an expectation of cost in an emerging market? (Answer, with extreme difficulty). Does the cost match the scope of the problem (think smoke alarm, for example) or opportunity? Does the required infrastructure match the existing environment (wireless network, broadband, landline phone, computer operating system, etc.)?
  2. Is the manufacturer or solution provider reputable and competent? This is particularly vexing in a lengthy referral chain -- Organization A uses Organization B to source technologies, who in turn buys from Distributor C, who acquires technology from Manufacturer D. Or a family caregiver receives a recommendation from Doctor E about a product.  In this multi-tiered world with no likely 'Consumer Reports' to verify quality, you're left with indicators -- consider robustness and recency of web content, the prior track record of executives, chats with call centers, proven product pilots, quantification of sales success, and best of all, verifiable references.
  3. Is the customer service for the solution or product adequate? For those who have tried to get support for 'free' e-mail or mobile tools, it may be exclusively found in online support forums -- no one to call, no one else to ask. But for purchased technologies or services, there should always be staff, integrators, customer service personnel, or someone at the other end of e-mail or phone support to help buyers or first-time users.
  4. What are the payment options? I always have a sinking feeling when I hear about solutions that cost multiple thousands of dollars per unit, where products are intended to help frail seniors who may be the neediest because of their chronic disease or frailty. Can these technologies be leased directly or through an intermediary for a defined and renewable term? Tried out with option to buy? Re-used for others than the initial recipients? Recycled as with cell phones? Terminated as a subscription service? Is the process for this well-documented or explained? 

The product or solution has arrived or the subscription has begun.  Meeting expectations is the next phase of the checklist, regardless of whether it is a business relationship, the product is delivered, or individuals are signing up for a new subscription to X or Y service.

  1. Test to make sure that it works as described. Aquiring a technology solution or service should not be an unwelcome surprise, whether it is the packaging, the ease of startup and implementation, or the user experience. The good news is that initial research and process documentation identified who to call when a product or service doesn't match expectation.
  2. Verify ongoing support processes or individuals. For any uncertainties or ambiguities, invoke the support processes identified in the solution research phase and verify that someone (or something) can help smooth out any problems or misunderstandings. This is even more critical when an organization is now in the business of reselling tech products to family members or seniors.
  3. Communicate your experience to others. You've done the research for yourself or on behalf of an organization, you've acquired solutions and you're very happy (or not). Make sure that you communicate your experience back out and up to the sources that referred you -- it's absolutely vital as a resource to help others make similar selections. 






We've been spending a lot of time evaluating a variety of aging-in-place technologies in a lab setting and are getting ready to push some out to pilot volunteers. It's quite fascinating and, too often, disappointing to listen to the claims of manufacturers about the wonders of their technology and then compare it to real world practice. Some of the simplest tech gadgets may end up being the most effective.

I do hope organizations can begin to share their experiences with the technologies, especially the tech that doesn't perform as hyped. In addition, since many of these systems collect sensitive private data, I'm finding it hard to stomach that many of the vendors have absolutely no privacy policy in place. When Joe the Junior Programmer has access to all your data - weight, blood pressure and ADL - you really want to know that his employer has schooled him on privacy and that he is not going to give away or sell that data.

With regard to payment options, we've been pleased that many vendors seem to have adopted a rental model with low upfront costs and many have a money-back trial period. This is truly a benefit for seniors as it gives them an opportunity to see if the tech can work in their environment.

But, all vendors should understand that lots of this gear is a high-touch installation and a $50 fee isn't going to cut it. We have a ways to go to make this a viable ecosystem for everyone involved.

Laurie, Thank you for reminding us that the products and recommendations we make must solve a problem, provide a benefit or at least maintain the status quo. The thought of a good technology vendor should be the same as a doctor. The first rule should be "do no harm". It would also help if vendors draw a solid line between those products that meet the needs of a facilitiy and the adminitration, versus those that meet the needs of an individual. Requirements are very different in many cases and reasons for buying can be drastically different.

Our biggest challenge continues to be education. From the customer to the vendor and from the vendor to the customer. LEt's all try to listen better.

Checklists are not only important for high-tech solutions, but low-tech ones as well (from daily living aids to home modifications and remodeling). It’s all about getting to the root of the problem and finding the solution that’s right for you and your family. Aging in place is a complicated prospect and it differs for every family, every home and every situation.

At Dynamic Living Inc. we think checklists are absolutely the way to go. Just as Laurie points out, the first thing that needs to be done when coming up with a solution is a thorough assessment. We have recently developed a home assessment survey: a list of probing questions that will help you identify problem areas in your home so that you can plan a new home or remodel your current one more effectively for your specific needs and budget.

Like Laurie’s checklist above, this is a work in progress and we welcome any comments or suggestions.


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