In the last month or so there has been a flurry of information on webinars and most recently the New World Conference (27-29 October, Brisbane) from the NDIA. As I indicated in an earlier post, this may reflect the ‘next phase’ for the Agency after a period of reflection in the last 6mths or so, and particularly as some key personnel have changed.
Unfortunately there is always the risk when something becomes as big as the NDIS, particularly as it has to grow with speed, that if you miss some key briefing/presentation you may find future information confusing. I think that is what has happened for some in the AT sector with the release in the last couple of weeks of its New World Conference info. The Agency has been doing some of the background work on this event since early 2015 – but internally. Usually such an event would have been publicly announced 6 months or more out, but that has been delayed so it now seems quite a rush. If you are pondering whether to put in a paper or attend context is everything.
We need to remember that the CEO, David Bowen, is keen on using innovation and ICT to deliver better outcomes (see for example the NDIS Year 2 Progress Report). So the role of technology (such as AT, but also some of the new and emerging technologies) are recognised as valuable, even key, in enhancing outcomes for NDIS participants – ARATA members have known that for years. But it also means that the NDIA is looking at how ICT/technology can help it deliver a cutting edge Scheme including:
- Better websites and assisting those with intellectual and other disability to use websites etc. to connect to the Agency, find information, choose a provider etc.;
- Smarter, connected, business systems – for payments, tracking, data collection, analysis & research, reporting etc.;
- Capitalising on the accessibility/support features in mainstream technologies (and some just around the corner), rather than building special solutions for ‘people with disability’;
- Using the commercial buying power of the Australian government to challenge big technology players (e.g. Microsoft, Google etc.) to enhance offerings or tailor for the diverse Australian market. (Gunela Astbrink & William Tibben have a nice paper on this online)
With that context and the briefing given to Australia’s ICT sector by the NDIA, the Dept of Human Services (Medicare/Centrelink experts) and Dept of Social Services in June (see my previous post), the four themes of the New World Conference make more sense. This is how I see it:
The whole Conference is within the context of better outcomes for NDIS participants, and thence society generally.
- Informed: This is the Agency and others ‘enlightening’ mainstream technology providers on the opportunity within the NDIS for their innovation,
- Engaged: Opening up discussion between providers of supports (e.g. in home care etc.) and technology providers to find ways of using/tailoring technology to enhance their services/efficiency.
- Focused: This is perhaps not too far from an ARATA/AGOSCI/ATSA Expo, or some of the more recent ‘hack fests’ where vendors and participants come together to solve problems with technology already available, or just around the corner.
- Digital Aspiration Spotlights: This is what some call the ‘Blue Sky’ or ‘Visioning’ sessions. Mainly delivered by participants (current and future) speaking, showing, demonstrating about the issues they want a solution to and ideas they have ‘cobbled together’ to address a need, with the aim of getting the technology vendors to take them up.
So it is clearly going to have a strong focus on ICT, and there could be some fun and exciting discussions. Remember that ‘co-design’ is a key word for the Agency at the moment so discussions are unlikely to be one-sided! NDIA staff have indicated that there are likely to be side events and meetings to bring interested stakeholders together during the Conference to facilitate future planning.
The NDIS 2015 New World Conference could be a really interesting event, providing all the stakeholders can get their skates on; it’s only 3 months away!
I previously mentioned the briefing I attended by the National Disability Insurance Agency and Dept of Human Services on their new ICT plan on 16 June. It is clear there were some important messages in there that the wider sector may want to hear. Unfortunately the Agency has taken down links to the event although they’ve sent out a copy of their slides to participants.
Sean Fitzgerald did a great job as MC and provided a very good introduction to the role of AT in his life and full participation.
David Bowen (NDIA CEO) talked about the ‘NDIA Journey to Date’. One slide caught my attention as current hot topics:
This reflects the NDIS Progress Report: Year 2. The 2015-2016 Federal budget announced $143M over 4 years to provide the NDIA with an ICT system to support full rollout. So ICT is a big ticket item at this point, but the Agency is very conscious (I think) that some participants and their advocates have felt a bit ‘out of the loop’ as things have developed. So ‘co-design’ is a bit of a buzzword, and the Agency (and the Federal Government Departments generally) are looking for ways to influence and ‘gearing’ their investment. ‘Facilitate, shape and inform’ based on the evidence, and intervene only when necessary is seen as the way NDIA will deliver on its objectives when the markets have matured.
This was reflected in the presentation by the Dept of Human Services (DHS; currently responsible for Medicare, Centrelink and many of the Federal Government ‘front office’ interactions with citizens) who are designing & planning the ICT solution. The DHS spoke of its capacity and experience, but then shifted gear to speak of it’s Dandelion program for traineeships for people with disability in their ICT Hub, co-design and testing with participants, and innovation for future human-machine interfaces.
Esther Kerr-Smith encouraged the ICT industry to bring their innovation and technology to enhancing the experiences of participants in technology they encounter every day. Rather than specialised technology (AT), can aspects be built into mainstream technologies and system? The NDIA is exploring ways to help catalyse innovation, and then create a ‘pull through’ of new technology with their (and government’s) purchasing power. She outlined the innovation strategy I’ve previously mentioned. The ICT program was seen as a ‘central platform’ to engage the “eMarket” as they’re calling it:
So there is lots going on, but this seems to set an agenda for the way the Agency is moving forward. If you are really interested in this stuff, I’d suggest getting in contact with the NDIA ICT team for any future updates they may put out.
On this website you can see details of an Innovation for AT plan that we crafted (with input from several others from around Australia and abroad) for the National Disability Insurance Scheme. A learned colleague in the USA, Joseph Lane, has provided a critique of sorts. Primarily he challenges the value of ‘innovation’ in AT when really the fundamentals aren’t sorted out. It is perhaps a wake up to us all:
Thank you for the opportunity to comment on your characterization for the process of technological innovation. Your framework is very well constructed, thoughtful and thorough. It is everything one could ask of a plan to progress from the current state of a product, service or process to a new and improved state. All such models of the innovation process presume the necessity of innovating and then outlines the process through which innovations can be achieved.
Since the mid-18th century (see Vaclav Smil (2005), Creating the 20th Century) most technological innovation has occurred within the organizing framework of industrial corporations. They either fund the necessary R&D internally or they conduct the necessary R&D sponsored by government agencies. Unlike government agencies and public universities, corporations can go out of business, so they are careful to focus their R&D efforts on activities that lead directly to product/service improvements or next generation replacements. This focus requires higher level managers to track the progress of internal R&D as well as to monitor the external state of science and state of practice (see John Gertner (2012), The Idea Factory: History of Bell Labs). The industrial sector pursues innovation opportunities through the free market mechanisms within fields where the available supply and demand revenues support a business case. That is why we see unrelenting technological innovation in lucrative fields such as military weapons, sports equipment and entertainment media.
The reality is that the field of Assistive Technology devices and services does not (yet) meet the business case for sustained innovation. Most AT manufacturers, suppliers and service providers are small businesses which are hard pressed to stay solvent. These small companies valiantly strive to serve Persons with Disabilities who represent small, distributed and virtually anonymous markets, of largely underserved, highly varied and relatively underprivileged human beings. We know that large numbers of People with Disabilities do not yet have access to existing AT products and services. Identifying these consumers and delivering to them the existing AT products and services is the highest priority. Until the AT industry builds an adequate customer base they lack adequate data (sufficient numbers, socio/geo/demographic distribution) — let alone customer feedback — to formulate good business decisions. Once corporations have a sustainable customer base for existing products, they can turn their attention to making improvements where and if such improvement are warranted. There are plenty of opportunities to apply science and engineering within the context of delivering, customizing and supporting AT products and services in the community. If and when such client-based interventions form a pattern, they would serve as a template for AT product or service improvement.
Fact: There is no shortage of ideas for technological innovations within AT corporations. There are concepts, wireframes and even functional prototypes stacked up in most corporations, that simply lack the financial justification to refine and deploy within the marketplace. I have seen no reports where AT corporations have said, “We are simply out of ideas for how to improve our products!”
Fact: When corporations need expertise beyond that of internal staff, they seek out and fund that expertise in universities, government laboratories or other sources. Healthy corporations sponsor R&D in such institutions where it is required and relevant. I have no reports where AT product development managers have said, “Our full-time engineers are clueless, we need government to fund some random clusters of graduate students on a part-time basis to meet our needs.”
Fact: There is no published document identifying targeted areas within the AT field for technological innovation, either articulated by corporations or documented with clinical evidence. One might reasonably ask those calling for a focus on innovation, “Provide specific examples of product/service improvements requested by companies or demonstrated through functional outcomes data.
In summary, the concept of “technological innovation” simply has no standing within the existing NDIS framework. It happens that it is not the primary requirement for improving the quality of life for Persons with Disabilities. At least, not until consumers, clinicians and companies have sufficient experience with the existing platforms of AT to render informed opinions about future directions. At present, the call for ‘innovation’ is a sideshow guaranteed to distract the well meaning but uninvolved to look beyond the reality of existing and urgent requirements.
You had previously shared with me a pyramid depicting the progression of requirements for serving the needs of People with Disabilities. As one moves up the pyramid, there are fewer numbers of people but their AT needs are increasingly complex. We discussed adding the two other sides to the pyramid to reflect the corresponding factors. A second side of the pyramid could reflect the increasingly level of clinical expertise required to meet complex needs — and the role of continuing education, credentialing and consumer empowerment in ensuring the expertise is present and delivered. The third side would show the corresponding increase in cost of AT devices and services to thoroughly meet those complex needs, because without adequate reimbursement levels the AT companies cannot make sell and support the complex AT devices, nor can the AT clinicians cover the expenses associated with assessment, training and follow-along. Nowhere in that pyramid did I see a role for “technological innovation” because when a sustainable business case is present, the competitive forces of the free market ensure continuous innovation.
As I commented directly to the NDIA, I would purge any mention of “technological innovation” from the NDIS planning document. It is a Pandora’s box that if left open will shift available funds — at little cost to the decision-makers and at great benefit to the program implementers — from a clear and present focus on the mundane realities of supporting the AT device and service delivery system, to the politically and professionally sexy “future potential” of AT. As a result, PWD’s and clinicians will muddle along with a substantial portion of the funding is burned up by the well intentioned but largely clueless operating at the margins of the system. Believe me, I’m trying my best to bridge that same gap caused by U.S. legislation in the late 1980’s and early 1990’s, but with the bulk of the available resources under their control most government staff and academic faculty are driven by unrelated incentives.
This pattern has already occurred in the United States and in the European Union. Those who are indeed focused on delivering value will lack the time, attention and expertise to compete with those who set the rules of the competition. Even if invited to the table, industry will become disenfranchised and turn their attention to staying solvent. This leaves the resources to those who’s quality of life will be directly enhanced through the management of government sponsored programs, and the conduct of government sponsored “R&D”. If Consumers and Industry are not leading — and more importantly controlling — this system, they will soon be shaken loose and left in the dust by those who dwell within the system being created.
I am unable to provide specific guidance on your “technological innovation” model, because at a fundamental level it is irrelevant to the stated goals of the NDIS.
I wish you all every success in creating a system that is focused on delivering beneficial impacts on the quality of life for Persons with Disabilities. The rest of the world would greatly benefit from such an enlightened and selfless example.