A new review of digital health in Australian aged care has uncovered why many technology projects struggle to deliver lasting change – and offers a practical framework to support safer, more connected and more equitable care for older people.
The scoping review, published in the International Journal of Medical Informatics, examined 48 Australian studies spanning residential, home and community aged care. The research team was led by Dr Naser Pourazad (Flinders University), with co-authors Dr Mahnaz Samadbeik (Queensland Digital Health Centre, The University of Queensland), Dr Peivand Bastani and Dr Madhan Balasubramanian (Flinders University).
The work comes at a time when aged care services are managing increasing demand, workforce shortages and rising complexity in residents’ needs.
“Digital health is now part of the basic infrastructure of aged care,” said Dr Naser Pourazad. “But technology only improves care when organisations have the skills, leadership and systems to embed it into everyday practice. Buying new tools is the starting point, not the end point.”
“Technology implementation isn’t a one-off event – it’s a continuous process,” added Dr Mahnaz Samadbeik. “Organisations that treat digital adoption as simply a technical upgrade are not setting themselves up for success.”
The review identified five critical domains that determine whether digital health technologies are successfully implemented:
- User capabilities and attitudes
- Organisational support and culture
- Technological design and reliability
- Contextual factors, such as geography and regulation
- Implementation processes, including planning, training and evaluation
Together, these domains form a framework that aged care organisations can use to plan, monitor and refine digital health initiatives.
From an implementation perspective, the review shows that a one-off training session is rarely enough.
“Staff need ongoing opportunities to build confidence, ask questions and troubleshoot real problems that arise when new systems are introduced,” Dr Samadbeik said. “When people are expected to ‘just get on with it’ after minimal training, we see frustration, workarounds and, ultimately, projects that fail to deliver their promised benefits.”
The study also highlights the impact of geography on digital health adoption. Many rural and regional services face gaps in internet coverage, ageing infrastructure and limited on-site technical support, on top of existing workforce pressures.
“Digital tools can help providers monitor residents, coordinate care and reduce unnecessary transfers – but only if the basics are in place,” said Dr Peivand Bastani. “Closing the digital divide means making sure regional and remote services can rely on these systems in day-to-day care, not simply giving them access to software licences.”
Building on this, Dr Pourazad stressed that investment in technology has to be matched with investment in people and policy settings.
“We saw clear examples where services technically had access to digital systems but lacked stable connectivity, governance or workforce support to use them well,” he said. “If we want digital health to genuinely improve equity – particularly in rural and regional communities – we need long-term support for infrastructure, staff capability and sensible policy, not just a one-off injection of hardware and software.”
“User experience emerged as another key driver of sustained use,” Dr Samadbeik noted. “Positive early experiences reinforce continued use, while negative experiences can undermine even well-resourced efforts. That’s why usability, reliability and support from leaders matter just as much as the technical features on paper.”
The authors also point to specific benefits when digital health is implemented well.
“Telehealth and virtual consultations can reduce avoidable hospital transfers and help older adults stay connected to clinicians from where they live, whether that’s in residential facilities or at home,” said Dr Madhan Balasubramanian. “Electronic health records and other digital tools can also support safer medication management and better coordination between services.”
Across the 48 included studies, the team found that most research has focused on residential aged care, with technologies such as electronic health records, telehealth, virtual and augmented reality and online training platforms. Less work has been done in home and community care, particularly in rural and remote settings.
“Our framework treats digital health implementation as an ongoing organisational change process, not just a technical project,” Dr Samadbeik said. “This isn’t about choosing between technology and people – it’s about bringing them together effectively.”
The full study, “Lived experiences of health professionals using digital health in Australian aged care: A scoping review”, is published in the International Journal of Medical Informatics (2026), Volume 206, Article 106145 (DOI: 10.1016/j.ijmedinf.2025.106145).
