Involving older adults in the development of care technologies is key to creating effective technologies, yet many tech solutions are built without that input. The landscape of building a new tech tool is complex, involving developers, investors, and payers as well as end users.

“Perspectives on AI and Novel Technologies Among Older Adults, Clinicians, Payers, Investors, and Developers,” published on the JAMA Network earlier this month, sheds light on this situation.  “Little is currently known about these key partners’ perspectives regarding the use of AI [artificial intelligence] and novel technologies for older adults …Understanding the extent of agreement of priorities across key partner groups can inform strategies to proactively align incentives and facilitate engagement,” say study authors, who offer recommendations for a path forward to ensure that all parties are aligned on the needs that underlie these technologies.

The research covers new ground by incorporating input from diverse partners, including older adults, payers, and investors on their priorities. It identifies priorities for future AI development, to highlight areas of need to developers, investors, and payers who affect the creation and adoption of technologies.

The study included feedback from 49 participants across five groups:

• 15 older adults (aged 60 years and up) or caregivers,
• 15 clinicians caring for older adults,
• Eight payers (health system or health insurance leaders),
• Six developers of aging-related technologies or AI, and
• Five investors in these technologies.

A striking finding was the gap in priorities between the developers and investors who provide access to new technologies and the end users. For example, older adults and caregivers prioritize direct care for activities of daily living, for which there are very few technology tools. A better understanding of priorities can direct developers and investors to areas that need innovation and ensure that each end product is useful for older adults, clinicians, and caregivers.

To address what they call “priority misalignment among key partner groups,” authors recommend various solutions:

• Government and public health agencies can serve an important role in setting priorities and providing incentives to attract innovation. For example, the National Institutes of Health and other government funders can explicitly invite technology innovations focused on priority areas such as activities of daily living (ADL) support and direct care that have been shown to be important for end users.
• Regulatory bodies can encourage early-stage end user engagement that is distinct from prototype testing to ensure that end users are involved in the design and development phase of the innovation. For example, the Patient-Centered Outcomes Research Institute (PCORI) requires key partner engagement as an obligatory component of research proposals.
• Other funders and regulatory bodies can similarly encourage or require early engagement of end users as part of the criteria for funding or approval of medical devices. Dissemination of best practices for key partner engagement can further facilitate this effort. Resources are available through PCORI, including an engagement rubric that provides guidance on methods for engaging partners and an engagement plan template with step-by-step instructions.
• Organizations that represent the interests of older adults, caregivers, and clinicians can play a role in promoting awareness of their priorities among technology developers and investors.
• Building forums such as Artificial Intelligence and Technology Collaboratories (AITCs) that foster collaboration and engagement across disciplines is essential.

“Public health, regulatory, and advocacy strategies are needed to raise awareness about these priorities, foster interdisciplinary engagement, and align incentives to ensure that we leverage the full potential of AI and novel technologies to improve care for older adults,” the researchers wrote.