Aging and Technology: Taking the Research into the Real World

Introduction

Information and communication technologies (ICTs) are increasingly being used to support the health, well-being, and independence of seniors, and to open up business opportunities for service providers and industry (Sixsmith, 2013). The use of ICTs may also provide new solutions to the increased demands on health services that result from rising service costs and population aging. Most importantly, ICTs can be used to extend the care and support options in the community to meet the desire of most seniors to age in place (Sixsmith and Sixsmith, 2008). Despite this potential, the actual social and economic impact of research has so far been limited. This paper looks at how (Aging Gracefully across Environments using Technology to Support Wellness, Engagement, and Long Life NCE Inc.) AGE-WELL, a Canadian Network of Centres of Excellence (http://www.agewell-nce.ca), aims to take the outcomes of research from the laboratory into real-world devices and applications.

The Challenge of Aging and Technology

At the present time, around 10% of the world’s population are aged 60 years and over, but this is set to increase to about 20% by 2050. Globally, the 60–79 and 80 plus age groups are growing the fastest. While the population worldwide is growing at around 1% per annum, the number of people aged over 80 is growing at 4% per annum and by 2050 it is expected that people aged over 60 will outnumber children aged 14 and under. In much of the world, the number of children has already peaked and is now declining. Moreover, the phenomenon of population aging is not limited to developed countries. Currently 64% of older people live in less developed regions, but this figure will rise to 80% by 2050 (HelpAge International, http://www.helpage.org/resources/ageing-data/).

The aging of global populations presents many challenges, not least how services can be improved in order to enhance the health and quality of life of older people in the context of limited financial resources both at the individual and governmental levels. In view of this, there has been growing recognition of the potential for ICTs to improve services and enhance the well-being and social participation of older people.

ICTs for older people have emerged as a major component of research and development programs worldwide, such as the Active Assisted Living Joint Program (AALJP, 2017) in Europe and the recently established AGE-WELL Network of Centres of Excellence in Canada. For example, the AAL-JP invested over 700 million euros to date in this area as part of an eInclusion social agenda to improve access to and participation in ICT-based products and services by disadvantaged groups, such as older people, and capitalize on the opportunities this brings for European industry (Sixsmith, Carillo, Phillips, Lansley, & Woolrych, 2013). There is also growing evidence that technological supports can bring about significant benefits for older people, while at the same time improving the cost-effectiveness of health and social services (Sixsmith, 2013). However, the research in this area has so far been limited in terms of real-world products and services getting into the marketplace.

AGE-WELL Network of Centres of Excellence

AGE-WELL NCE Inc. is a federally-funded network of industry, non-profit organizations, government, care providers, caregivers, end-users, and academic partners working together using high-quality research to drive innovation and create technologies and services that benefit older adults. The vision is to harness emerging and advanced technologies in areas such as artificial intelligence, e-health, ICTs, and mobile technologies to stimulate technological, social, and policy innovation. For example, can technologies help to create more sustainable healthcare systems and at the same time help people to live independently at home—a “win-win” scenario.

AGE-WELL has a core research program of 25 projects in areas such as monitoring the health status of older people at home; robotics for improving mobility, independence, and rehabilitation; as well as applications for helping people to remain active and socially connected. The goal is to find new ways of harnessing technology to assist the growing number of older Canadians and caregivers to live full, independent, and dignified lives as well as generate new commercial products and services. AGE-WELL’s research agenda is complemented by a range of supporting activities that have been implemented to ensure real-world impact. While there are compelling arguments for investment in the aging and technology sector, a number of challenges still need to be addressed. The purpose of this paper is to articulate some of these challenges and describe how AGE-WELL is developing solutions to strengthen efforts in this sector to ensure the full potential of ICTs is realized.

Challenge 1—Innovation is Complex

The first challenge is simply put, but the whole discussion revolves around this one issue. The recent Naylor Report on fundamental science in Canada suggested that there is a naïve view in the research funding world that sees innovation as a straightforward, linear process that assumes “investments in basic and applied research should somehow cascade quickly into more goods and services along with healthier and happier populations” (Naylor Report, 2017). It is important to recognize that innovation is not just about creating new products or technologies. These are the end points of a complex process that is about thinking and doing things differently. In this way, innovation is inherently a social process that connects individuals and organizations together in creative and often unpredictable ways. Unless we take this seriously and mobilize resources appropriately, then the desired return on investment of research dollars is not going to materialize in terms of real-world benefits. In particular, compartmentalizing the innovation process into discrete packages of activities, such as basic science, applied research, knowledge translation, etc., is a flawed approach. Equally flawed is the notion that this can be managed in a technocratic way and that ideas can be forced to flow through a pipeline from discovery to realization. In AGE-WELL we are addressing the challenge of innovation on multiple fronts and we will look at each of these challenges in turn:

• Changing the culture of research within our community to combine both scientific excellence and real-world impact;

• Increasing the capacity of receptors to innovate and adopt new solutions and technologies;

• Providing the right kinds of help and support to researchers for commercialization and knowledge mobilization; and

• Creating a new generation of researchers to drive innovation.

Challenge 2—Changing the Culture of Research

Within the research community there is a “publish or perish” philosophy where researchers are incentivized to produce publications and research grants in order to obtain promotions and tenure-track positions. Other criteria, such as service to the academic community and social and economic outputs and impacts, are noted, but are typically relegated to a nugatory position in practical decision-making about career opportunities. On the other hand, research funders increasingly require researchers to have concrete plans for knowledge mobilization. For example, the most recent call of the AAL-JP was targeted at post-discovery projects on near-to-market integrated ICT to support active, healthy, and independent living of older adults. As an NCE, AGE-WELL is expected to deliver tangible impacts and its continued funding depends on tangible outcomes that benefit seniors and the Canadian economy. This places researchers in a dilemma, and even those who are motivated to work on translating their research findings into products and services often lack the necessary skills and institutional support. We need a shift in research culture from science and innovation as separate entities to a culture of innovative science that combines research excellence and practical outcomes and impact.

In our network, we have started to develop our “AGE-WELL way” of doing research that comprises a number of pillars:

• Co-production of technologies, where end-users are involved in all stages for the research—this ensures that solutions are developed with users right from the beginning;

• Meaningful stakeholder involvement—for example in setting the research agendas, reviewing research applications, or even carrying out the research; and

• Partnerships, where researchers and industry and community partners work together to develop technologies—all our projects are co-funded and require significant in-kind cash investment by partners.

While the academic community has never embraced a strong managerialist approach, some culture change is required. AGE-WELL is putting in place a management structure that emphasizes impact and performance. Projects are expected to demonstrate a commitment to knowledge mobilization. Their continued funding will depend on a successful annual progress review and effective forward planning using a balanced scorecard that sets out specific goals, outputs, and related activities and resources. In addition, our funding programs are increasingly targeted at the different stages of the innovation lifecycle to ensure there is a good balance between discovery and application.

A key to culture change is breaking down of the silos that exist within the research world. Recent years have seen a movement away from smaller individual research projects, to larger inter-disciplinary team-based projects that are able to mobilize the diverse skills, knowledge, and resources required to address complex problems. Even with very talented individuals and teams, the challenge is to get them to work effectively together. This is far from a straightforward process and technocratic approaches have often failed to recognize that these kinds of enterprises have social and political dimensions. Moreover, the development of new solutions is a creative process that needs the right kinds of opportunities and support for inter-disciplinary teams to thrive. There is also support for team-working and knowledge sharing to leverage synergies and flow of knowledge between groups. Team-building activities are aimed at getting researchers, partners, and stakeholders to work closely together to develop a transdisciplinary approach that involves scientists from different disciplines and stakeholders (e.g. older adults and caregivers, industry) as co-researchers or partners. The aim of this type of approach is to creatively solve complex problems by jointly developing innovations and knowledge that have real-world impact.

Challenge 3—Innovation is Difficult in the Health Sector

There is a growing realization that existing healthcare systems are not sustainable and that new approaches are required. However, there are numerous institutional and attitudinal barriers to innovation within healthcare systems (Sebastianski et al, 2015). Researchers cannot assume that their technologies will be readily adopted into existing care processes and service models. For research to have impact, then we have to move away from the typical end-of-project knowledge translation to an integrated knowledge mobilization approach, where researchers work closely with stakeholders at all stages in a project to co-create solutions and ensure the research is aligned with their needs and business processes. Innovation in this sector needs to be based on partnerships between researchers, industry, and knowledge users, working together towards culture change at a practice level. Researchers also need to work with policy-makers and thought leaders to address the many barriers to adoption (e.g. lack of funding mechanisms) and develop system-level incentives for innovation.

Researchers and research funders need to ensure that adequate time and resources are made available to do these kinds of activities. Researchers typically lack the skills and experience for meaningfully engaging with the knowledge using community, and AGE-WELL is addressing this by providing support and mentorship to develop partnerships, manage intellectual property, mobilize knowledge, and engage stakeholders in decision-making within the network.

Increasing receptor capacity is key here. At AGE-WELL, we are of the mind that a “partner and prosper” approach lends itself to a more dynamic working environment where sharing knowledge and developing solutions are at the core of how the network functions. New ideas and technologies need to be adopted by people and organizations that are going to use them. However, there are many barriers to adoption. For example, older people may lack the economic resources and skills to access and use ICTs and mobile technologies for health applications. In the long-term care sector, there is little incentive to innovate and the capacity to adopt new technologies into existing care practices is limited. AGE-WELL is working closely with stakeholders and partner organizations to address this. For example, we have partnered with a major long-term care provider in Canada to act as their “innovation arm” and to work closely with them to co-develop solutions and try out new devices and systems to adapt them into the care process as they emerge.

A lot of this is done by individuals, project teams, and partner organizations, but we also realize that AGE-WELL’s critical mass is important in leveraging the aging, technology, and innovation agenda. For example, our government relations plan positions AGE-WELL as the go-to expert Canadian organization in technology, aging, and innovation in order to have access to government representatives and opportunities, and to be able to ensure formalized, reliable engagement with decision-makers.

Challenge 4—Commercialization and Knowledge Mobilization

If new devices, applications, and practices are going to get into the hands of people who will actually benefit from them, then these technologies need to be commercialized or turned into new working practices and services. This is something that is outside the skillset and experience of most academics and researchers, but it is a reality that cannot be ignored. There are different pathways for this: AGE-WELL requires all research projects to have clear plans for knowledge mobilization and technology commercialization and exploitation up front, rather than as an afterthought. For example, early-stage projects and teams should consider market issues prior to embarking on a program of research. This may help to avoid building in barriers to adoption that will undermine commercial viability later on.

In AGE-WELL we have been attempting to build capacity in our research teams through various activities, including a series of “Innovation Workshops” and training resources that help teams to visualize and plan for knowledge mobilization and technology transfer. Our projects are expected to define products, such as technologies, services, policies, and practice guidelines around which their knowledge mobilization plans are organized. Bringing the right mix of research and commercial expertise into the team at an early stage can also help with the longer-term impact of a technology. In AGE-WELL, training of students equips them with the right sorts of knowledge and skills to exploit intellectual property. For most, this means exposure to the basics of commercialization, but for some students this has involved extensive additional training in postgraduate programs. There is support and funding to encourage start-ups, while strong partnerships will open opportunities through licensing of intellectual property.

There is also recognition that creativity, innovation, and entrepreneurship happen through fostering relationships, either through collaborative co-creation of technologies or by encouraging face-to-face local ecosystems of innovation. AGE-WELL is also investing in “innovation hubs” where researchers and stakeholders can work together in a highly collaborative and agile way that is able to build on local connections and expertise. These local face-to-face connections are vital to help innovators, investors, and entrepreneurs work closely together to transform their ideas into market successes by connecting them with policy-makers and service providers and nurturing the transfer and early adoption of new technologies. These connections will give stakeholders ready access to the latest research findings and information on emerging tools and health technologies.

Challenge 5—Training a New Generation of Researchers

The final and perhaps the most significant challenge is to provide the type of training to students and trainees that encompasses all of the above. Trainees or “Highly Qualified Personnel” (HQP) are the major investment and output of AGE-WELL. Indeed, it is the capacity to innovate, rather than the development of specific solutions, that is likely to have the biggest long-term impact. Our HQP will be the innovators of tomorrow either in future academic posts, or more likely in jobs and positions where their training and experience within AGE-WELL will increase receptor capacity to innovate and adopt the technologies that are being developed within the NCE. We expect the skills and insights from being in the AGE-WELL NCE will be an important component of knowledge transfer and technology exploitation in the longer-term, which will impact on lives of older adults and caregivers.

Our training complements that which is already available through the academic community by focusing on non-core training on co-creation methods, transdisciplinary teamwork, social and economic impact, and ethical aspects of research. The training is experiential and our HQP must be involved in all aspects of the research and innovation lifecycle, from ideation to implementation. We are driving innovation now by supporting HQP-led start-ups and opening up new employment opportunities. We expect our HQP to move into high-responsibility positions in areas that are related to the health and aging sectors. We expect our industry and community partners to open up new positions related to aging and technology and for partners to hire HQP who have worked on collaborative projects. Already we are seeing successes in this respect. AGE-WELL funded an HQP to complete a graduate-level certificate in technology commercialization. The HQP worked collaboratively with one of our core projects and contributed to the development of their technology commercialization plan as her capstone project. She successfully graduated and was chosen as one of the top graduates to present at their end-of-year award and has now accepted a position with a health authority as their knowledge mobilization specialist. This HQP will now be in an excellent position to apply the knowledge and experience gained from her time with AGE-WELL and build on the strong research-community partnerships in that location to apply the kinds of technology solutions being developed in the NCE.

Conclusion

These innovation challenges represent a “wicked problem” that requires creative, collaborative approaches to develop real-world technology solutions (Sixsmith, 2016). AGE-WELL’s mission is to develop and implement ICTs to benefit seniors and the Canadian economy, but if this is to be realized, then the challenges discussed in this paper need to be addressed. Impact has so far been elusive despite significant public and private investment, but a number of trends are aligning that indicate the time is now, while robust, low-cost technologies, near-market devices, and systems are emerging to meet the demands of a growing baby-boomer market. There is a need for strong leadership in this sector and initiatives such as AGE-WELL will play a crucial role, particularly in those areas where research struggles to move evidence into practice and the market place and by sustaining a “knowledge community” based on strong partnerships, support for innovation, and training.

Acknowledgements

AGE-WELL is funded through the Network of Centres of Excellence Program, and through Canadian Institutes of Health Research, Natural Sciences and Engineering Research council of Canada, and Social Sciences and Humanities Research Council.

References

Author notes